Fish oil lipid emulsions and immune response: what clinicians need to know.
Current evidence indicates that omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid and docosahexaenoic acid found in fish oil, can prevent the development of inflammatory diseases by affecting different steps of the immune response. The capacity of omega-3 PUFAs to modulate synthesis of eicosanoids, activity of nuclear receptor and nuclear transcription factors, and production of resolvins may also mitigate inflammatory processes already present. Parenteral infusion of omega-3 PUFAs is advantageous, particularly in severely ill patients, because the fatty acids are rapidly incorporated by cells. In addition, when fatty acids are given parenterally, there are no losses from digestion and absorption as there are with enteral infusion. Recently, lipid emulsions enriched with omega-3 fish oil have been introduced as a component of parenteral nutrition. Currently, there is one lipid emulsion that contains only fish oil; it is infused together with conventionally used lipid emulsions. Other commercially available lipid emulsions contain fish oil in a fat mixture; one contains 10% fish oil and another 15% fish oil. Relevant experimental and clinical data from studies evaluating fish oil lipid emulsions are discussed in the present review. Administration of fish oil lipid emulsion, when compared with soybean oil lipid emulsion (rich in omega-6 PUFA), decreases the length of hospital and intensive care unit stay in surgical patients.
Waitzberg
Dan Linetzky
DL
Laboratory of Nutrition and Metabolic Surgery of the Digestive System, Gastroenterology Department, University of São Paulo Medical School, Brazil. metanutri@terra.com.br
Torrinhas
Raquel Susana
RS
D000893:Anti-Inflammatory Agents / Q000494:pharmacology* / Q000627:therapeutic use; D005217:Fat Emulsions, Intravenous / Q000494:pharmacology* / Q000627:therapeutic use; D015525:Fatty Acids, Omega-3 / Q000276:immunology / Q000494:pharmacology* / Q000627:therapeutic use; D005395:Fish Oils / Q000276:immunology / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000494:pharmacology* / Q000627:therapeutic use; D007249:Inflammation / Q000517:prevention & control*; D010288:Parenteral Nutrition / Q000379:methods; D013024:Soybean Oil / Q000494:pharmacology / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D005217:Fat Emulsions, Intravenous; D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D007155:Immunologic Factors; D013024:Soybean Oil