Influence of a total parenteral nutrition enriched with omega-3 fatty acids on leukotriene synthesis of peripheral leukocytes and systemic cytokine levels in patients with major surgery.
OBJECTIVE
Nutritive immunomodulation of patients after major surgery.


METHODS
Prospective, randomized controlled double-blind study.


METHODS
Forty patients undergoing major intestinal surgery. Patients were divided into two groups: one received a total parenteral nutrition enriched with omega-3 fatty acids for 5 days postoperatively, the other an isocaloric, control nutrition.


METHODS
We analyzed the leukocyte ability to release leukotrienes from whole blood leukocytes stimulated with the calcium ionophore A23187 (5 micromol/L) by reverse phase high-performance liquid chromatography and circulating cytokines by enzyme-linked immunosorbent assay.


RESULTS
Leukocytes from patients of the omega-3 fatty acids group generated significantly higher amounts of less biologically active leukotriene B5 as compared to the control group (p < or = 0.001). This was accompanied by a significant decrease in the generation of proinflammatory leukotriene B4 (p < or = 0.006) in the study group. In contrast to interleukin-1beta, interleukin-6, and interleukin-10 systemic levels of tumor necrosis factor-alpha (p < or = 0.05) were postoperatively decreased in the study group.


CONCLUSIONS
Our data provide evidence that a total parenteral nutrition enriched with omega-3 fatty acids modulates the lipid mediator pattern and systemic tumor necrosis factor-alpha levels.
Wachtler
P
P
Department of Microbiology and Immunology, Ruhr-University Bochum, Germany.
König
W
W
Senkal
M
M
Kemen
M
M
Köller
M
M
D000328:Adult; D000368:Aged; D000001:Calcimycin; D002851:Chromatography, High Pressure Liquid; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007378:Interleukins / Q000097:blood*; D007414:Intestinal Neoplasms / Q000601:surgery; D007476:Ionophores; D007902:Length of Stay; D007962:Leukocytes / Q000378:metabolism*; D015289:Leukotrienes / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications; D011446:Prospective Studies; D013514:Surgical Procedures, Operative
D015525:Fatty Acids, Omega-3; D007378:Interleukins; D007476:Ionophores; D015289:Leukotrienes; D000001:Calcimycin