The rationale for the use of parenteral omega-3 lipids in children with short bowel syndrome and liver disease.
Parenteral nutrition associated liver disease (PNALD) is the major source of morbidity and mortality in children with short bowel syndrome (SBS). There is emerging evidence that omega-6 fatty acids (omega6FA) within the parenteral solution play a major role in PNALD and their effects may be reversed or ameliorated by substitution with omega-3 fatty acids (omega3FA). This paper reviews the mechanisms whereby omega3FAs may influence PNALD by improving bile flow, inhibiting steatosis, and having immunomodulatory effects. The early clinical experience with omega3FAs in SBS and PNALD is briefly reviewed and the implications of such, and future directions are considered.
Diamond
Ivan R
IR
Group for Improvement of Intestinal Function and Treatment (GIFT), The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada, M5G 1X8.
Sterescu
Anca
A
Pencharz
Paul B
PB
Wales
Paul W
PW
D002648:Child; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D006801:Humans; D008107:Liver Diseases / Q000209:etiology / Q000628:therapy*; D010288:Parenteral Nutrition / Q000379:methods*; D012778:Short Bowel Syndrome / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome
D015525:Fatty Acids, Omega-3