n-3 versus n-6 polyunsaturated fatty acids in critical illness.
The effects of n-6 and n-3 polyunsaturated fatty acids (PUFA) on protein metabolism, cell-mediated immunity, and production of cytokines and prostanoids were studied in experimental animals and patients with esophageal cancer. In the experimental study using a rat burn model, n-6 PUFA increased serum interleukin-6 (IL-6) and tumor necrosis factor (TNF), alpha (P < 0.05), and decreased nitrogen balance (NB) (P < 0.05), when compared with a fat-free control. But addition of n-3 PUFA reduced TNF-alpha and IL-10 (P < 0.05) and improved NB (P < 0.05). Suppressed delayed type hypersensitivity (DTH) induced by burn injury, which was not influenced by n-6 PUFA, was significantly improved by the administration of n-3 PUFA. n-6 PUFA tended to increase, and n-3 PUFA significantly decreased the endotoxin translocation. DTH, granulocyte-macrophage colony-stimulating factor, and eicosapentaenoic acid (EPA) content increased proportionately with the intravenous dose of fish oil emulsion. The effects of n-6 and n-3 PUFA were studied in the patients who underwent surgery for esophageal cancer. In the group of patients fed by total parenteral nutrition with soybean oil emulsion, the serum IL-6 significantly increased at 2 and 6 h after operation (P < 0.05). Oral/enteral supplementation of EPA ethyl ester (1.8 g/d) significantly reduced the postoperative IL-6 production (P < 0.05 at 1, 2, and 6 h after operation), and improved cell-mediated immune function 3 wk after operation (P = 0.05). During the chemoradiation therapy, cell-mediated immune function was improved significantly in the patients fed enterally with EPA ethyl ester (n = 5), when compared with the patients without EPA (n = 14).
Tashiro
T
T
Department of Surgery, Chiba University School of Medicine, Japan.
Yamamori
H
H
Takagi
K
K
Hayashi
N
N
Furukawa
K
K
Nakajima
N
N
D000818:Animals; D002056:Burns / Q000628:therapy; D016638:Critical Illness / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000628:therapy; D016629:Esophagectomy / Q000009:adverse effects; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage*; D005395:Fish Oils / Q000008:administration & dosage; D005743:Gastrectomy / Q000009:adverse effects; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000097:blood; D006801:Humans; D006968:Hypersensitivity, Delayed; D007111:Immunity, Cellular; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D009584:Nitrogen / Q000378:metabolism; D010289:Parenteral Nutrition, Total; D051381:Rats; D017207:Rats, Sprague-Dawley; D013312:Stress, Physiological / Q000209:etiology / Q000628:therapy; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D015525:Fatty Acids, Omega-3; D005231:Fatty Acids, Unsaturated; D005395:Fish Oils; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D009584:Nitrogen