Background
Parenteral nutrition (PN) is indispensable for meeting the caloric and substrate needs
of patients who cannot receive adequate amounts of enteral nutrition. However, PN
decreases hepatic mononuclear cell (MNC) numbers and impairs their functions. We examined
the effects of various ratios of ω-3 to ω-6 polyunsaturated fatty acids on hepatic
MNC number and function in a murine model. We focused on serum liver enzymes, lipid
metabolism, cytokine production, histopathology, and the outcomes of an intraportal
bacterial challenge.
Material and methods
In experiment 1, male Institute of Cancer Research mice were randomized to CHOW, 67%,
33%, 16%, 8%, 4%, and 0% fish oil (FO)-PN groups. After receiving their respective
diets for 5 days, 1.0 × 107 Pseudomonas aeruginosa were delivered by intraportal injection. Survival was observed
≤7 days after injection. Liver histologies after intraportal bacterial challenge were
examined in the CHOW, 33%, 8%, and 0% FO-PN groups. In experiment 2, the mice were
divided into 4 groups: CHOW, 33%, 8%, and 0% FO-PN. After the mice had been fed for
5 days, MNC were isolated. Hepatic MNC were counted and cytokine productions (tumor
necrosis factor [TNF]-α and interleukin [IL]-10) by MNC in response to lipopolysaccharide
(LPS) were measured. Blood samples were analyzed for lipid metabolism and hepatobiliary
biochemical parameters. Liver histologies were also examined.
Results
In experiment 1, survival times were significantly shorter in the 4% and 0% FO-PN
groups than in the CHOW group. Survival rates at 168 hours were 100%, 64%, 86%, 73%,
67%, 11%, and 13% in the CHOW, 67%, 33%, 16%, 8%, 4%, and 0% FO-PN groups, respectively.
At 72 hours after intraportal bacterial challenge, the 0% FO-PN group showed severe
tissue damage, whereas such damage was reduced in the 8% and 33% FO-PN groups. In
experiment 2, the CHOW, 33%, 8%, and 0% FO-PN groups showed LPS dose-dependent increases
in TNF-α levels. IL-10 levels were also LPS dose-dependently increased in the CHOW
and 33% FO-PN groups. However, no marked changes were observed in response to LPS
stimulation in either the 8% or the 0% FO-PN group. There were no differences in serum
levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase,
or total bilirubin among these 4 groups. In the 0% FO-PN group, serum total cholesterol
levels were greater than those in the 8% and 33% FO-PN groups. Without bacterial challenge,
livers from the 0% FO-PN group showed steatosis, but these changes were attenuated
in the 8% and 33% FO-PN groups.
Conclusion
The 30–40% ratio of FO to soybean oil with 20% of total calories supplied by lipid
seems to be the best PN for preservation of hepatic MNC number and function.
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Article info
Publication history
Published online: November 25, 2013
Accepted:
November 15,
2013
Identification
Copyright
© 2014 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
