Some new insights in intestinal failure-associated liver disease.
OBJECTIVE
To point new insights in the cholestasis that is a complication of both intestinal failure and parenteral nutrition. View on liver disease has recently evolved with the onset of fish oil-based intravenous lipid emulsions (ILE).


RESULTS
Focused on the role of ILE in causing liver disease. Reversal of cholestasis was recently achieved in infants with short bowel syndrome, by replacing the 'reference' soybean oil-based ILE by fish oil-based ILE.


CONCLUSIONS
It is likely that this reversal involves several factors such as the change in n-6: n-3 ratio, the reduction in phytosterol load, the increased provision of alpha-tocopherol as antioxidant agent. Alternative issue might be based on the use of a new generation of ILE aiming to provide n-3 and to reduce n-6 fatty acids load while enhancing alpha-tocopherol intake. New data are based on the use of an ILE containing a balanced proportion of four types of oil as a physical mixture of 30% soybean oil, 30% medium-chain triglycerides, 25% olive oil and 15% fish oil with amounts of alpha-tocopherol calculated according to the number of double bonds. This new emulsion was reported to be beneficial in reversing or preventing liver disease.
Goulet
Olivier
O
Department of Pediatric Gastroenterology, Hepatology and Nutrition, Intestinal Failure Rehabilitation Center, Hospital Necker-Enfants Malades, University of Paris-Descartes, 75743 Paris Cedex 15, Paris, France. olivier.goulet@nck.aphp.fr
Joly
Francisca
F
Corriol
Odile
O
Colomb-Jung
Virginie
V
D002779:Cholestasis / Q000209:etiology / Q000628:therapy*; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects / Q000627:therapeutic use*; D005395:Fish Oils / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000150:complications / Q000628:therapy*; D008107:Liver Diseases / Q000209:etiology / Q000517:prevention & control*; D016031:Liver Transplantation; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D012307:Risk Factors; D012778:Short Bowel Syndrome / Q000150:complications / Q000628:therapy*; D013024:Soybean Oil / Q000009:adverse effects / Q000627:therapeutic use*
D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D013024:Soybean Oil