title: Human leukocyte death after a preoperative infusion of medium/long-chain triglyceride and fish oil parenteral emulsions: a randomized study in gastrointestinal cancer patients.
abstract: BACKGROUND
  Parenteral lipid emulsions (LEs) can influence leukocyte functions. The authors investigated the effect of 2 LEs on leukocyte death in surgical patients with gastrointestinal cancer.
  
  
  METHODS
  Twenty-five patients from a randomized, double-blind clinical trial (ID: NCT01218841) were randomly included to evaluate leukocyte death after 3 days of preoperative infusion (0.2 g fat/kg/d) of an LE composed equally of medium/long-chain triglycerides and soybean oil (MCTs/LCTs) or pure fish oil (FO). Blood samples were collected before (t0) and after LE infusion (t1) and on the third postoperative day (t2).
  
  
  RESULTS
  After LE infusion (t1 vs t0), MCTs/LCTs did not influence cell death; FO slightly increased the proportion of necrotic lymphocytes (5%). At the postoperative period (t2 vs t0), MCTs/LCTs tripled the proportion of apoptotic lymphocytes; FO maintained the slightly increased proportion of necrotic lymphocytes (7%) and reduced the percentage of apoptotic lymphocytes by 74%. In the postoperative period, MCT/LCT emulsion increased the proportion of apoptotic neutrophils, and FO emulsion did not change any parameter of apoptosis in the neutrophil population. There were no differences in lymphocyte or neutrophil death when MCT/LCT and FO treatments were compared during either preoperative or postoperative periods. MCT/LCTs altered the expression of 12 of 108 genes related to cell death, with both pro- and antiapoptotic effects; FO modulated the expression of 7 genes, demonstrating an antiapoptotic effect.
  
  
  CONCLUSIONS
  In patients with gastrointestinal cancer, preoperative MCT/LCT infusion was associated with postoperative lymphocyte and neutrophil apoptosis. FO has a protective effect on postoperative lymphocyte apoptosis.
authors.affiliation: Institute of Physical Activity and Sports Science, Cruzeiro do Sul University, São Paulo, Brazil.
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Cury-Boaventura
authors.forename: Raquel Susana Matos de Miranda
authors.initials: RS
authors.lastname: Torrinhas
authors.forename: André Borella Pereira
authors.initials: AB
authors.lastname: de Godoy
authors.forename: Rui
authors.initials: R
authors.lastname: Curi
authors.forename: Dan Linetzky
authors.initials: DL
authors.lastname: Waitzberg
mesh_terms: D017209:Apoptosis / Q000187:drug effects* / Q000235:genetics; D005217:Fat Emulsions, Intravenous / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005395:Fish Oils / Q000494:pharmacology / Q000627:therapeutic use*; D005770:Gastrointestinal Neoplasms / Q000276:immunology / Q000601:surgery; D015870:Gene Expression / Q000187:drug effects; D006801:Humans; D007263:Infusions, Parenteral; D007962:Leukocytes / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects; D011183:Postoperative Complications / Q000276:immunology / Q000517:prevention & control*; D011300:Preoperative Care; D014280:Triglycerides / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D014280:Triglycerides