title: Oral administration of docosahexaenoic acid attenuates interleukin-1β response and clinical course of septic neonates.
abstract: OBJECTIVE
  To analyze cytokine responses and the clinical course of septic neonates orally supplemented with docosahexaenoic acid as well as to evaluate fatty acid incorporation into leukocytes.
  
  
  METHODS
  A quasiexperimental study was conducted in neonates who developed sepsis following a surgical procedure. Selected neonates were randomly assigned to receive 100 mg docosahexaenoic acid (G-DHA) daily or olive oil (G-OO) as placebo for 14 d throughout a sepsis episode. At selection (baseline), blood samples were obtained to determine interleukin-1 (IL-1)β, interleukin-6 (IL-6), and tumor necrosis factor-α as well as the leucocyte fatty acid profile. Measurements were repeated at 7 (D7) and 14 d (D14) of follow-up. Within- and between-group comparisons were conducted with parametric statistics after logarithmic transformation. Repeated measurement analyses with a general linear model procedure were used, adjusting according to human milk intake, use of anti-inflammatory drugs, and nutritional status.
  
  
  RESULTS
  Sixty-three neonates were included: 29 in G-DHA group and 34 in G-OO group. Although decreases of cytokines during hospitalization were similar in both groups, there was a greater decrease of IL-1β in the G-DHA group than in the G-OO group after adjusting by confounders (P = 0.028). Leukocyte docosahexaenoic acid increased from 4.96 ± 2.96 at baseline to 5.52 ± 3.05 and 5.92 ± 2.8 at D7 and D14, respectively, in the G-DHA group (P = 0.044). Illness severity was inversely associated with the proportion of docosahexaenoic acid in leukocytes throughout follow-up (P = 0.034).
  
  
  CONCLUSIONS
  Oral supplementation with docosahexaenoic acid to neonates attenuates IL-1β response and the clinical course of sepsis. This may be an additional strategy to further benefit ill neonates even if they are not candidates for parenteral nutrition.
authors.affiliation: Unit of Research in Medical Nutrition, Pediatric Hospital, Centro Médico Nacional Siglo XXI Mexican Institute of Social Security, Mexico City, Mexico. marsau2@prodigy.net.mx
authors.forename: Mardia
authors.initials: M
authors.lastname: López-Alarcón
authors.forename: Mariela
authors.initials: M
authors.lastname: Bernabe-García
authors.forename: Olivia
authors.initials: O
authors.lastname: del Valle
authors.forename: Gabriel
authors.initials: G
authors.lastname: González-Moreno
authors.forename: Azucena
authors.initials: A
authors.lastname: Martínez-Basilea
authors.forename: Raúl
authors.initials: R
authors.lastname: Villegas
mesh_terms: D000284:Administration, Oral; D016207:Cytokines / Q000097:blood; D004041:Dietary Fats / Q000008:administration & dosage; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D053583:Interleukin-1beta / Q000097:blood*; D007962:Leukocytes / Q000378:metabolism*; D000069463:Olive Oil; D010938:Plant Oils / Q000494:pharmacology; D011183:Postoperative Complications / Q000097:blood / Q000188:drug therapy*; D018805:Sepsis / Q000097:blood / Q000188:drug therapy*; D012720:Severity of Illness Index
chemical_list: D016207:Cytokines; D004041:Dietary Fats; D053583:Interleukin-1beta; D000069463:Olive Oil; D010938:Plant Oils; D004281:Docosahexaenoic Acids