Blunting the response to endotoxin in healthy subjects: effects of various doses of intravenous fish oil

Intensive Care Med. 2010 Feb;36(2):289-95. doi: 10.1007/s00134-009-1689-8. Epub 2009 Oct 21.

Abstract

Objective: To test the dose response effect of infused fish oil (FO) rich in n-3 PUFAs on the inflammatory response to endotoxin (LPS) and on membrane incorporation of fatty acids in healthy subjects.

Design: Prospective, sequential investigation comparing three different FO doses.

Subjects: Three groups of male subjects aged 26.8 +/- 3.2 years (BMI 22.5 +/- 2.1).

Intervention: One of three FO doses (Omegaven10%) as a slow infusion before LPS: 0.5 g/kg 1 day before LPS, 0.2 g/kg 1 day before, or 0.2 g/kg 2 h before.

Measurements and results: Temperature, hemodynamic variables, indirect calorimetry and blood samples (TNF-alpha, stress hormones) were collected. After LPS temperature, ACTH and TNF-alpha concentrations increased in the three groups: the responses were significantly blunted (p < 0.0001) compared with the control group of the Pluess et al. trial. Cortisol was unchanged. Lowest plasma ACTH, TNF-alpha and temperature AUC values were observed after a single 0.2 g/kg dose of FO. EPA incorporation into platelet membranes was dose-dependent.

Conclusions: Having previously shown that the response to LPS was reproducible, this study shows that three FO doses blunted it to various degrees. The 0.2 g/kg perfusion immediately before LPS was the most efficient in blunting the responses, suggesting LPS capture in addition to the systemic and membrane effects.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenocorticotropic Hormone / blood
  • Adrenocorticotropic Hormone / drug effects
  • Adult
  • Calorimetry, Indirect
  • Endotoxins / antagonists & inhibitors*
  • Endotoxins / metabolism*
  • Fish Oils / administration & dosage
  • Fish Oils / pharmacology*
  • Fish Oils / therapeutic use
  • Humans
  • Infusions, Intravenous
  • Male
  • Prospective Studies
  • Sepsis / metabolism*
  • Sepsis / therapy*
  • Time Factors
  • Tumor Necrosis Factor-alpha / metabolism
  • Young Adult

Substances

  • Endotoxins
  • Fish Oils
  • Tumor Necrosis Factor-alpha
  • Adrenocorticotropic Hormone