Fish oil-enriched nutritional supplement attenuates progression of the acute-phase response in weight-losing patients with advanced pancreatic cancer

The presence of an acute-phase protein response (APPR) has been suggested t o shorten survival and contribute to weight loss in patients with pancreati c cancer. Fatty acids derived from fish oil have been shown to alter proinf lammatory cytokine production and acute-phase protein synthesis in vitro, T he present study was designed to determine the effects of a fish oil-enrich ed nutritional supplement on the concentrations of a range of individual ac ute-phase proteins (APP) in patients with advanced pancreatic cancer, In a sequential series, 18 patients with pancreatic cancer received the suppleme nt (providing 2 g eicosapentaenoic acid and 1 g docosahexaenoic acid/d) for 3 wk while another 18 received full supportive care alone. Six healthy sub jects sewed as additional controls. Acute-phase proteins were measured befo re and after the 3-wk intervention period in cancer patients. At baseline, albumin, transferrin and pre-albumin were significantly reduced and fibrino gen, haptoglobin, alpha-1-acid glycoprotein, alpha-1-antitrypsin, cerulopla smin and C-reactive protein (CRP) were significantly elevated in the cancer patients compared with healthy controls, reflecting their roles as negativ e and positive acute phase proteins, respectively. In the supplemented canc er group, the only significant change in APP concentrations over the 4-wk s tudy period was an increase in transferrin. In the control cancer group the re were further significant reductions in albumin, transferrin and pre-albu min, and a significant increase in CRP concentration, These results suggest that many positive and negative APP are altered in advanced pancreatic can cer. The APPR tends to progress in untreated patients but may be stabilized by the administration of a fish oil-enriched nutritional supplement. This may have implications for reducing wasting in such patients.