Omega-3 vs. omega-6 lipid emulsions exert differential influence on neutrophils in septic shock patients: impact on plasma fatty acids and lipid mediator generation.
Omega-3 vs. omega-6 lipid emulsions exert differential influence on neutrophils in septic shock patients: impact on plasma fatty acids and lipid mediator generation.
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DOI：
10.1007/s00134-003-1900-2
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发表时间：
2003-09
影响因子：
38.9
通讯作者：
Seeger W
中科院分区：
文献类型：
--
作者：
Mayer K;Fegbeutel C;Hattar K;Sibelius U;Krämer HJ;Heuer KU;Temmesfeld-Wollbrück B;Gokorsch S;Grimminger F;Seeger W
比较传统ω-6脂质输注和鱼油（ω-3）脂质输注用于肠外营养对中性粒细胞功能、脂质介质和血浆游离脂肪酸的影响。在大学医院重症监护室和实验室进行的开放标签、随机、初步研究。10名感染性休克患者和8名健康对照者。需要肠外营养的患者（每组5例）静脉注射ω-3或ω-6脂肪乳剂，持续10天。基线时，血浆游离脂肪酸水平升高数倍，包括高浓度的ω-6脂质前体花生四烯酸（AA）。从脓毒症患者中分离的中性粒细胞显示出对离体刺激的反应性显著降低，包括脂质介质生成[白三烯（LT），PAF]，呼吸爆发和磷酸肌醇水解信号传导。在ω-6脂质输注方案下，血浆游离脂肪酸异常和中性粒细胞功能受损持续存在或恶化。相比之下，ω-3脂质输注后，血浆游离脂肪酸组分迅速转变为ω-3酸二十碳五烯酸和二十二碳六烯酸相对于AA占优势。除LTB 4外，LTB 5也在这些患者的中性粒细胞刺激后出现，ω-3脂质组的中性粒细胞功能显著改善。ω-3与ω-6脂肪乳剂对血浆游离脂肪酸谱的影响不同，对中性粒细胞功能的影响也不同。因此，在脓毒症患者中以脂质为基础的肠外营养可能对后遗症以及免疫活性和炎症状态产生深远的影响。补充材料可在本文的在线版本http://dx.doi.org/10.1007/s00134-003-1900-2上获得。
To compare the effects of a conventional ω-6 lipid infusion and a fish oil based (ω-3) lipid infusion for parenteral nutrition on neutrophil function, lipid mediators, and plasma free fatty acids. Open-label, randomized, pilot study in a university hospital medical intensive care unit and experimental laboratory. Ten patients with septic shock and eight healthy controls. Patients (five per group) requiring parenteral nutrition received intravenously either a ω-3 or a ω-6 lipid emulsion for a 10-day period. At baseline levels of plasma free fatty acids were elevated several-fold, including high concentrations of the ω-6 lipid precursor arachidonic acid (AA). Neutrophils isolated from septic patients displayed markedly reduced responsiveness to ex vivo stimulation, including lipid mediator generation [leukotrienes (LT), PAF], respiratory burst, and phosphoinositide hydrolysis signaling. Under the ω-6 lipid infusion regimen abnormalities in plasma free fatty acids and impairment of neutrophil functions persisted or worsened. In contrast, a rapid switch in the plasma free fatty acid fraction to predominance of the ω-3 acids eicosapentaenoic acid and docosahexaenoic acid over AA occurred in response to ω-3 lipid infusion. LTB5, in addition to LTB4, appeared upon neutrophil stimulation originating from these patients, and neutrophil function was significantly improved in the ω-3 lipid group. ω-3 vs. ω-6 lipid emulsions differentially influence the plasma free fatty acid profile with impact on neutrophil functions. Lipid-based parenteral nutrition in septic patients may thus exert profound influence on sequelae and status of immunocompetence and inflammation. Supplementary material is available in the online version of this article at http://dx.doi.org/10.1007/s00134-003-1900-2.
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影响因子：
8.8
作者：
Bursten, SL;Federighi, DA;Repine, JE
通讯作者：
Repine, JE
DOI：
10.1097/00005373-199106000-00006
发表时间：
1991-06-01
影响因子：
--
作者：
BARTON, RG;WELLS, CL;CERRA, FB
通讯作者：
CERRA, FB
影响因子：
7.5
作者：
Guidet, B;Plot, O;Offenstadt, G
通讯作者：
Offenstadt, G
DOI：
10.1073/pnas.72.12.5130
发表时间：
1975-01-01
影响因子：
11.1
作者：
HAMMARSTROM, S;HAMBERG, M;VOORHEES, JJ
通讯作者：
VOORHEES, JJ
影响因子：
8.8
作者：
Bone, RC
通讯作者：
Bone, RC