title: Parenteral fish oil as a pharmacological agent to modulate post-operative immune response: a randomized, double-blind, and controlled clinical trial in patients with gastrointestinal cancer.
abstract: BACKGROUND
  Fish oil-based lipid emulsions (FOLEs) have shown post-operative immunological and clinical benefits in parenteral nutrition.
  
  
  OBJECTIVE
  To assess post-operative immune response after short-term pre-operative parenteral infusion of isolated FOLE in gastrointestinal cancer patients.
  
  
  METHODS
  The patients (n = 63) received pre-operative peripheral infusion (0.2 g fat/kg body weight/d) of FOLE (Omegaven(®)) or control lipid emulsion (MCT/LCT; Lipovenos MCT(®)) for 3 days. Post-operative concentrations of inflammatory mediators, leukocyte functions, surface molecules, infections, and length of intensive care unit (ICU) and hospital stay were measured.
  
  
  RESULTS
  FOLE patients had a significant increase of IL-10 levels on day 3, decrease of IL-6 and IL-10 levels on day 6, lower decrease in leukocyte oxidative burst, maintenance of monocyte percentage expressing HLA-DR and CD32, and increase of CD32 neutrophil expression compared to MCT/LCT patients. No changes were observed in the frequency of post-operative infections or length of ICU and hospital stay.
  
  
  CONCLUSIONS
  Short-term pre-operative infusion of FO alone improves the post-operative immune response of gastrointestinal cancer patients without significantly changing post-operative infections or length of ICU and hospital stay. ID:NCT01218841.
authors: Department of Gastroenterology, Medical School, LIM 35, University of São Paulo, São Paulo, Brazil. torrinhas@uol.com.br
authors: Raquel Susana Matos
authors: RS
authors: de Miranda Torrinhas
authors: Raquel
authors: R
authors: Santana
authors: Thaís
authors: T
authors: Garcia
authors: Maria Fernanda
authors: MF
authors: Cury-Boaventura
authors: Maria Mirtes
authors: MM
authors: Sales
authors: Rui
authors: R
authors: Curi
authors: Dan Linetzky
authors: DL
authors: Waitzberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004311:Double-Blind Method; D004655:Emulsions / Q000737:chemistry; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000276:immunology* / Q000601:surgery; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D007362:Intensive Care Units; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007902:Length of Stay; D007962:Leukocytes / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects; D010288:Parenteral Nutrition; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D017452:Receptors, IgG / Q000378:metabolism; D016897:Respiratory Burst; D014280:Triglycerides / Q000032:analysis; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004655:Emulsions; D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D006684:HLA-DR Antigens; C508609:IL10 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D017452:Receptors, IgG; D014280:Triglycerides; C568345:fish oil triglycerides; D016753:Interleukin-10