INFLUENCE OF A TOTAL PARENTERAL-NUTRITION ENRICHED WITH OMEGA-3-FATTY-ACIDS ON LEUKOTRIENE SYNTHESIS OF PERIPHERAL LEUKOCYTES AND SYSTEMIC CYTOKINE LEVELS IN PATIENTS WITH MAJOR SURGERY
P. Wachtler et al., INFLUENCE OF A TOTAL PARENTERAL-NUTRITION ENRICHED WITH OMEGA-3-FATTY-ACIDS ON LEUKOTRIENE SYNTHESIS OF PERIPHERAL LEUKOCYTES AND SYSTEMIC CYTOKINE LEVELS IN PATIENTS WITH MAJOR SURGERY, The journal of trauma, injury, infection, and critical care, 42(2), 1997, pp. 191-198
Objective: Nutritive immunomodulation of patients after major surgery.
Design: Prospective, randomized controlled double-blind study. Patien
ts: Forty patients undergoing major intestinal surgery, Patients were
divided into two groups: one received a total parenteral nutrition enr
iched with omega-3 fatty acids for 5 days postoperatively, the other a
n isocaloric, control nutrition. Material and Methods: We analyzed the
leukocyte ability to release leukotrienes from whole blood leukocytes
stimulated with the calcium ionophore A23187 (5 mu mol/L) by reverse
phase high-performance liquid chromatography and circulating cytokines
by enzyme-linked immunosorbent assay. Results: Leukocytes from patien
ts of the omega-3 fatty acids group generated significantly higher amo
unts of less biologically active leukotriene B-5 as compared to the co
ntrol group (p less than or equal to 0.001), This was accompanied by a
significant decrease in the generation of proinflammatory leukotriene
B-4 (p less than or equal to 0.006) in the study group. In contrast t
o interleukin-1 beta, interleukin-6, and interleukin-10 systemic level
s of tumor necrosis factor-alpha (p less than or equal to 0.05) were p
ostoperatively decreased in the study group. Conclusion: Our data prov
ide evidence that a total parenteral nutrition enriched with omega-3 f
atty acids modulates the lipid mediator pattern and systemic tumor nec
rosis factor-alpha levels.