Parenteral fish oil as a pharmacological agent to modulate post-operative immune response: a randomized, double-blind, and controlled clinical trial in patients with gastrointestinal cancer

Clin Nutr. 2013 Aug;32(4):503-10. doi: 10.1016/j.clnu.2012.12.008. Epub 2012 Dec 22.

Abstract

Background: Fish oil-based lipid emulsions (FOLEs) have shown post-operative immunological and clinical benefits in parenteral nutrition.

Aim: To assess post-operative immune response after short-term pre-operative parenteral infusion of isolated FOLE in gastrointestinal cancer patients.

Methods: The patients (n = 63) received pre-operative peripheral infusion (0.2 g fat/kg body weight/d) of FOLE (Omegaven(®)) or control lipid emulsion (MCT/LCT; Lipovenos MCT(®)) for 3 days. Post-operative concentrations of inflammatory mediators, leukocyte functions, surface molecules, infections, and length of intensive care unit (ICU) and hospital stay were measured.

Results: FOLE patients had a significant increase of IL-10 levels on day 3, decrease of IL-6 and IL-10 levels on day 6, lower decrease in leukocyte oxidative burst, maintenance of monocyte percentage expressing HLA-DR and CD32, and increase of CD32 neutrophil expression compared to MCT/LCT patients. No changes were observed in the frequency of post-operative infections or length of ICU and hospital stay.

Conclusions: Short-term pre-operative infusion of FO alone improves the post-operative immune response of gastrointestinal cancer patients without significantly changing post-operative infections or length of ICU and hospital stay. ID:NCT01218841.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / blood
  • Double-Blind Method
  • Emulsions / chemistry
  • Fat Emulsions, Intravenous / administration & dosage
  • Female
  • Fish Oils / administration & dosage*
  • Gastrointestinal Neoplasms / drug therapy*
  • Gastrointestinal Neoplasms / immunology*
  • Gastrointestinal Neoplasms / surgery
  • HLA-DR Antigens / metabolism
  • Humans
  • Intensive Care Units
  • Interleukin-10 / blood
  • Interleukin-6 / blood
  • Length of Stay
  • Leukocytes / drug effects
  • Male
  • Middle Aged
  • Neutrophils / drug effects
  • Parenteral Nutrition*
  • Postoperative Care
  • Preoperative Care
  • Prospective Studies
  • Receptors, IgG / metabolism
  • Respiratory Burst
  • Triglycerides / analysis
  • Young Adult

Substances

  • Biomarkers
  • Emulsions
  • Fat Emulsions, Intravenous
  • Fish Oils
  • HLA-DR Antigens
  • IL10 protein, human
  • IL6 protein, human
  • Interleukin-6
  • Receptors, IgG
  • Triglycerides
  • fish oil triglycerides
  • Interleukin-10

Associated data

  • ClinicalTrials.gov/NCT01218841