Influences of soybean oil emulsion on stress response and cell-mediated immune function in moderately or severely stressed patients.
OBJECTIVE
We previously reported that omega-6 fat emulsion increases cytokine production in burned rats. Effects of soybean oil emulsion on surgical stress responses and lymphocyte function according to the surgical severity have not been studied in detail. We investigated the effects of soybean oil emulsion, which contains 50% omega-6 fatty acid, on postoperative stress responses and cell-mediated immune function according to the severity of surgical stress.


METHODS
Eight patients who underwent gastric or colorectal surgery and nine who underwent esophagectomy were fed fat-free total parenteral nutrition. Ten patients who underwent gastric or colorectal surgery and seven who underwent esophagectomy were fed total parenteral nutrition with soybean oil emulsion. Total parenteral nutrition provided 1.5 g of protein and 40 kcal per kilogram every day from 7 d before surgery to postoperative day 14. Soybean oil emulsion (Intralipid) accounted for 20% of the total calories. Serum interleukin-6, C-reactive protein, glucagon, and concanavalin A- or phytohemagglutinin-stimulated lymphocyte proliferation were determined.


RESULTS
In the group of moderately stressed patients, soybean oil emulsion did not amplify the measured levels. In the group of severely stressed patients, soybean oil emulsion amplified the level of serum interleukin-6 and decreased concanavalin A- or phytohemagglutinin-stimulated lymphocyte proliferation.


CONCLUSIONS
Soybean oil emulsion amplifies the stress responses and possibly suppresses cell-mediated immune function induced by surgical stress in severely stressed patients, but not in moderately stressed patients.
Furukawa
Katsunori
K
First Department of Surgery, Chiba University School of Medicine, Japan. k-furukawa@umin.ac.jp
Yamamori
Hideo
H
Takagi
Kazuya
K
Hayashi
Naganori
N
Suzuki
Ryoji
R
Nakajima
Nobuyuki
N
Tashiro
Tsuguhiko
T
D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D003208:Concanavalin A; D004655:Emulsions; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects*; D015850:Interleukin-6 / Q000097:blood; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000379:methods; D010835:Phytohemagglutinins; D011184:Postoperative Period; D012720:Severity of Illness Index; D013024:Soybean Oil / Q000008:administration & dosage / Q000494:pharmacology*; D013312:Stress, Physiological / Q000209:etiology / Q000276:immunology* / Q000628:therapy; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
D004655:Emulsions; D005217:Fat Emulsions, Intravenous; D015850:Interleukin-6; D010835:Phytohemagglutinins; D003208:Concanavalin A; D013024:Soybean Oil; D002097:C-Reactive Protein