Journal of Intensive Care Medicine

Home | User not signed in

Official Journal of the ESICM and the ESPNIC

Log in | Register

Blunting the response to endotoxin in healthy subjects: effects of various doses of intravenous fish oil

Yann K. Pittet, Mette M. Berger, Thomas-Thi Pluess, Pierre Voirol, Jean-Pierre Revelly, Luc Tappy, René L. Chioléro
Original
Volume 36, Issue 2 / February , 2010

Pages 289 - 295

Abstract

Objective

To test the dose response effect of infused fish oil (FO) rich in n-3 PUFAs on the inflammatory response to endotoxin (LPS) and on membrane incorporation of fatty acids in healthy subjects.

Design

Prospective, sequential investigation comparing three different FO doses.

Subjects

Three groups of male subjects aged 26.8 ± 3.2 years (BMI 22.5 ± 2.1).

Intervention

One of three FO doses (Omegaven®10%) as a slow infusion before LPS: 0.5 g/kg 1 day before LPS, 0.2 g/kg 1 day before, or 0.2 g/kg 2 h before.

Measurements and results

Temperature, hemodynamic variables, indirect calorimetry and blood samples (TNF-α, stress hormones) were collected. After LPS temperature, ACTH and TNF-α concentrations increased in the three groups: the responses were significantly blunted (p < 0.0001) compared with the control group of the Pluess et al. trial. Cortisol was unchanged. Lowest plasma ACTH, TNF-α and temperature AUC values were observed after a single 0.2 g/kg dose of FO. EPA incorporation into platelet membranes was dose-dependent.

Conclusions

Having previously shown that the response to LPS was reproducible, this study shows that three FO doses blunted it to various degrees. The 0.2 g/kg perfusion immediately before LPS was the most efficient in blunting the responses, suggesting LPS capture in addition to the systemic and membrane effects.

Keywords

References

  1. Calder PC (2004) N-3 fatty acids, inflammation, and immunity–relevance to postsurgical and critically ill patients. Lipids 39:1147–1161
    • View reference on publisher's website
    • View reference on PubMed
  2. Calder PC (2008) The relationship between the fatty acid composition of immune cells and their function. Prostaglandins Leukot Essent Fatty Acids 79:101–108 Epub 2008 Oct 2023
    • View reference on publisher's website
    • View reference on PubMed
  3. Yaqoob P, Pala HS, Cortina-Borja M, Newsholme EA, Calder PC (2000) Encapsulated fish oil enriched in alpha-tocopherol alters plasma phospholipid and mononuclear cell fatty acid compositions but not mononuclear cell functions. Eur J Clin Invest 30:260–274
    • View reference on publisher's website
    • View reference on PubMed
  4. Pluess TT, Hayoz D, Berger MM, Tappy L, Revelly JP, Michaeli B, Carpentier YA, Chiolero RL (2007) Intravenous fish oil blunts the physiological response to endotoxin in healthy subjects. Intensive Care Med 33:789–797
  5. Simoens C, Richelle M, Rossle C, Derluyn M, Deckelbaum RJ, Carpentier YA (1995) Manipulation of tissue fatty acid profile by intravenous lipids in dogs. Clin Nutr 14:177–185
    • View reference on publisher's website
    • View reference on PubMed
  6. Livesey G, Elia M (1988) Estimation of energy expenditure, net carbohydrate utilization, and net fat oxidation and synthesis by indirect calorimetry: evaluation of errors with special reference to detailed composition of fuels. Am J Clin Nutr 47:608–628
    • View reference on PubMed
  7. Katan MB, Deslypere JP, van Birgelen AP, Penders M, Zegwaard M (1997) Kinetics of the incorporation of dietary fatty acids into serum cholesteryl esters, erythrocyte membranes, and adipose tissue: an 18-month controlled study. J Lipid Res 38:2012–2022
    • View reference on PubMed
  8. Calder PC, Bond JA, Harvey DJ, Gordon S, Newsholme EA (1990) Uptake and incorporation of saturated and unsaturated fatty acids into macrophage lipids and their effect upon macrophage adhesion and phagocytosis. Biochem J 269:807–814
    • View reference on PubMed
  9. Wanten GJ, Calder PC (2007) Immune modulation by parenteral lipid emulsions. Am J Clin Nutr 85:1171–1184
    • View reference on PubMed
  10. Finnegan YE, Minihane AM, Leigh-Firbank EC, Kew S, Meijer GW, Muggli R, Calder PC, Williams CM (2003) Plant- and marine-derived n-3 polyunsaturated fatty acids have differential effects on fasting and postprandial blood lipid concentrations and on the susceptibility of LDL to oxidative modification in moderately hyperlipidemic subjects. Am J Clin Nutr 77:783–795
    • View reference on PubMed
  11. Simoens CM, Deckelbaum RJ, Massaut JJ, Carpentier YA (2008) Inclusion of 10% fish oil in mixed medium-chain triacylglycerol-long-chain triacylglycerol emulsions increases plasma triacylglycerol clearance and induces rapid eicosapentaenoic acid (20:5n-3) incorporation into blood cell phospholipids. Am J Clin Nutr 88:282–288
    • View reference on PubMed
  12. Carpentier YA, Peltier S, Portois L, Sener A, Malaisse WJ (2008) Rapid lipid enrichment in omega3 fatty acids: plasma data. Int J Mol Med 21:355–365
    • View reference on PubMed
  13. Singer P, Shapiro H, Theilla M, Anbar R, Singer J, Cohen J (2008) Anti-inflammatory properties of omega-3 fatty acids in critical illness: novel mechanisms and an integrative perspective. Intensive Care Med 34:1580–1592
  14. Mascioli EA, Babayan VG, Bistrian BR, Blackburn GL (1988) Novel triglycerides for special medical purposes. J Parenter Enteral Nutr 12:127S–132S
    • View reference on publisher's website
  15. Pscheidl E, Schywalsky M, Tschaikowsky K, Böke-Pröls T (2000) Fish oil-supplemented parenteral diets normalize splanchnic blood flow and improve killing of translocated bacteria in a low-dose endotoxin rat model. Crit Care Med 28:1489–1496
    • View reference on publisher's website
    • View reference on PubMed
  16. Michaeli B, Berger MM, Revelly JP, Tappy L, Chioléro R (2007) Effects of fish oil on the neuro-endocrine responses to an endotoxin challenge in healthy volunteers. Clin Nutr 26:70–77
    • View reference on publisher's website
    • View reference on PubMed
  17. Feingold KR, Funk JL, Moser AH, Shigenaga JK, Rapp JH, Grunfeld C (1995) Role for circulating lipoproteins in protection from endotoxin toxicity. Infect Immun 63:2041–2046
    • View reference on PubMed

Sign In

Top 5 Articles Letters to the Editor

Reader Poll

Which articles do you prefer in Intensive Care Medicine ?

View previous poll results