title: Vitamin E in New-Generation Lipid Emulsions Protects Against Parenteral Nutrition-Associated Liver Disease in Parenteral Nutrition-Fed Preterm Pigs.
abstract: Parenteral nutrition (PN) in preterm infants leads to PN-associated liver disease (PNALD). PNALD has been linked to serum accumulation of phytosterols that are abundant in plant oil but absent in fish oil emulsions.
  
  
  
  Whether modifying the phytosterol and vitamin E composition of soy and fish oil lipid emulsions affects development of PNALD in preterm pigs.
  
  
  
  We measured markers of PNALD in preterm pigs that received 14 days of PN that included 1 of the following: (1) Intralipid (IL, 100% soybean oil), (2) Intralipid + vitamin E (ILE, d-α-tocopherol), (3) Omegaven (OV, 100% fish oil), or (4) Omegaven + phytosterols (PS, β-sitosterol, campesterol, and stigmasterol).
  
  
  
  Serum levels of direct bilirubin, gamma glutamyl transferase, serum triglyceride, low-density lipoprotein, and hepatic triglyceride content were significantly lower (P < .05) in the ILE, OV, and PS compared to IL. Hepatic cholesterol 7-hydroxylase and organic solute transporter-α expression was lower (P < .05) and portal plasma FGF19 higher in the ILE, OV, and PS vs IL. Hepatic expression of mitochondrial carnitine palmitoyltransferase 1A and microsomal cytochrome P450 2E1 fatty acid oxidation genes was higher in ILE, OV, and PS vs IL. In vivo (13)C-CDCA clearance and expression of pregnane X receptor target genes, cytochrome P450 3A29 and multidrug resistance-associated protein 2, were higher in ILE, OV, and PS vs IL.
  
  
  
  α-tocopherol in Omegaven and added to Intralipid prevented serum and liver increases in biliary and lipidemic markers of PNALD in preterm piglets. The addition of phytosterols to Omegaven did not produce evidence of PNALD.
authors.affiliation: Section of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ng
authors.affiliation: USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Stoll
authors.affiliation: USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA.
authors.forename: Shaji
authors.initials: S
authors.lastname: Chacko
authors.affiliation: Department of Neonatology, La Paz University Hospital, Madrid, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Saenz de Pipaon
authors.affiliation: Department of Animal Science, Aarhus University, Tjele, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Lauridsen
authors.affiliation: Department of Animal and Poultry Science, University of Guelph, Guelph, Ontario, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: Gray
authors.affiliation: Department of Animal and Poultry Science, University of Guelph, Guelph, Ontario, Canada.
authors.forename: E James
authors.initials: EJ
authors.lastname: Squires
authors.affiliation: USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Marini
authors.affiliation: Texas Children's Hospital, Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Irving J
authors.initials: IJ
authors.lastname: Zamora
authors.affiliation: Texas Children's Hospital, Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Oluyinka O
authors.initials: OO
authors.lastname: Olutoye
authors.affiliation: Section of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA USDA/ARS Children's Nutrition Research Center, Houston, Texas, USA Doug.Burrin@ars.usda.gov.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Burrin
mesh_terms: D000818:Animals; D000831:Animals, Newborn / Q000254:growth & development*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D005217:Fat Emulsions, Intravenous; D005395:Fish Oils / Q000737:chemistry; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008107:Liver Diseases / Q000209:etiology / Q000517:prevention & control*; D010288:Parenteral Nutrition / Q000009:adverse effects*; D010840:Phytosterols / Q000097:blood; D013024:Soybean Oil / Q000737:chemistry; D034421:Sus scrofa; D014810:Vitamin E / Q000008:administration & dosage*
chemical_list: D015415:Biomarkers; D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D010840:Phytosterols; D014810:Vitamin E; D013024:Soybean Oil
keywords: cholestasis; life cycle; liver disease; neonates; nuclear receptors; phytosterols; research and diseases