Long-term efficacy and safety of a new olive oil-based intravenous fat emulsion in pediatric patients: a double-blind randomized study.

BACKGROUND: A new intravenous lipid emulsion (ILE) prepared from a mixture of soybean and olive oils contains only long-chain triacylglycerols, with a low proportion (20%) of polyunsaturated fatty acids and 60% monounsaturated fatty acids. OBJECTIVE: The goal of this randomized, double-blind clinical trial was to assess in children the efficacy and safety of this new ILE compared with a control group receiving a soybean-oil emulsion. DESIGN: Eighteen children received for 2 mo 24% of nonprotein energy (1.80 g kg (-)(1) d(-)(1)) either as the new ILE or a soybean oil-based emulsion. Assessments were performed on days -30, 0, 30, and 60 and the changes (day 60 - day 0) assessed by analysis of variance. RESULTS: There were no significant differences in triacylglycerol, apolipoproteins A-I and B, or HDL cholesterol between the 2 groups, whereas total and LDL cholesterol were higher in the soybean oil group on day 60. The pattern of 20:4n-6 in erythrocyte membranes did not change significantly, nor did the ratio of 20:3n-9 to 20:4n-6. On day 60, 18:1n-9 was significantly higher in the olive oil group, the ratio of Sigma(n)-6 > C(18) + 18:3n-6 to 18:2n-6 was 2.20 +/- 0.09 in the olive oil group and 1.33 +/- 0.16 in the soybean-oil group, and Sigma(n)-3 > C(18) was 3.83 +/- 0.30 in the olive oil group and 4. 03 +/- 0.33 in the soybean-oil group. The peroxidation index was lower after the olive oil treatment. CONCLUSIONS: The olive oil-based emulsion was well tolerated, maintained a normal EFA status, and may be more suitable for prevention of lipid peroxidation than the soybean-oil-based emulsion.

In vivo effects of olive oil-based lipid emulsion on lymphocyte activation in rats.

Numerous studies suggest that immune function may be compromised by lipid emulsions rich in polyunsaturated fatty acids, especially linoleic acid. In our study, we compared the effect of a new olive oil-based lipid emulsion (ClinOleic(R)) containing 18% linoleic acid, and an emulsion based on soybean oil (Ivelip(R); 52% linoleic acid) on lymphocyte functions. Weaning Wistar rats (n= 24) were fed for 4 weeks on an oral diet that contained 12% of total energy as lipids from soybean oil. Then they received, during 6 days, a total parenteral nutrition (260 kcal/kg/d) in which 12% of total energy was brought by one of the two lipid emulsions. The fatty acid profile of spleen lymphocyte phospholipids reflected lipid intakes, with a higher content of oleic acid in ClinOleic(R) group and linoleic acid in Ivelip(R) group. A greater proportion of cells expressed the interleukin-2 receptor a-chain (CD25) after administration of ClinOleic(R) when compared to Ivelip(R) (55.43 +/- 3.47 vs 45.48 +/- 3.26%, P<< 0.05). Moreover, the CD25 expression was positively correlated with oleic acid content of spleen lymphocyte phospholipids (r= 0.500, P<< 0.018). These results show that ClinOleic(R) is able to induce, in vivo, a greater proportion of cells expressing CD25, and suggest that oleic acid could have a role in the observed effects.

Effects of parenteral lipid emulsions with different fatty acid composition on immune cell functions in vitro.

BACKGROUND: Numerous studies suggest that immune function may be compromised by lipid emulsions rich in polyunsaturated fatty acids (PUFAs). In our study, we compared the effect of a new olive oil-based lipid emulsion (ClinOleic) containing a moderate level of PUFAs, with emulsions based on soybean oil (Intralipid or Ivelip), on immune functions of human cell in vitro. METHODS: Peripheral white blood cells were collected from healthy volunteers. Lymphocyte proliferation was evaluated by [3H]-thymidine incorporation after stimulation with either phytohemagglutinin (PHA) or antibodies against T-cell specific antigens. Lymphocytes subsets and T-cell activation markers (CD25 and HLA-DR) were measured by flow cytometry. The release of cytokines (interleukin [IL]-2, IL-1beta, and tumor necrosis factor-alpha [TNF-alpha]) was measured by enzyme-linked immunosorbent assay (ELISA), after lymphocytes or monocytes/macrophages stimulation with PHA or lipopolysaccharide (LPS). RESULTS: A significant dose-dependent inhibition of thymidine incorporation was observed with Intralipid and Ivelip (incorporation down to 39.9% of control, p < .001) whereas ClinOleic showed no inhibitory effect. Activation antigen expression on both CD4+ and CD8+ T-cells tended to decrease with Intralipid (CD25: -53.4% on CD4+ and -57.4% on CD8+; HLA-DR: -61.5% on CD4+ and -58.5% on CD8+) but not with ClinOleic (from -2.9% for CD25 on CD4+ to 16.7% for HLA-DR on CD4+). Intralipid decreased significantly IL-2 production (-39.0%, p < .05) whereas ClinOleic had little effect (-13.0%, NS). Intralipid and ClinOleic tended to inhibit to a similar extent the release of pro-inflammatory cytokines (TNF-alpha: -21.5% and -34.8%, IL-1beta: -45.1% and -40.3%; respectively). CONCLUSIONS: Our results suggest that an olive oil-based lipid emulsion could modulate immune response selectively, maintaining protective immunity and reducing inflammatory response. Olive oil may offer an immunologically neutral alternative to soybean oil for use in parenteral lipid emulsions.

Digestion and absorption of tube-feeding emulsions with different droplet sizes and compositions in the rat.

Assimilation of lipid nutrients depends on the efficiency of emulsified fat hydrolysis by digestive lipases. As shown in vitro, the activity of preduodenal and pancreatic lipases is governed by the physicochemical properties of emulsions. Thus the aim of this study was to evaluate in the rat how emulsions are digested and assimilated depending on their droplet size or solute composition. Fasted rats were intragastrically tube fed emulsions with different median droplet sizes (0.6 microns, fine; 22 microns, coarse) or solute composition (0.8 microns, complex fine) containing 14C-triolein and 3H-cholesterol. Two and 5 hours after feeding, fat-droplet size was measured in gastric and duodenal contents, and lipids were radioactively quantified in different compartments. In the stomach, the droplet size of the fine emulsions significantly increased to values (13 microns to 24 microns) comparable with those of the coarse emulsion (35 microns to 36 microns). In the duodenum, the droplet sizes of the three emulsions were in the range of 14 microns to 33 microns. After 2 hours, gastric triglyceride hydrolysis was significantly higher with the fine than with the coarse emulsion and was lower with the complex fine emulsion. Gastric emptying of fat was significantly different, with the following decreasing order: coarse, fine, and complex fine emulsion. In the small intestine, the fine and coarse emulsions were processed comparably, whereas the assimilation of the fine complex emulsion was significantly delayed. Calculations indicate that ingested fatty acids were distributed in the peripheral tissues at different rates with the same decreasing order. The fate of a lipophilic nutrient, cholesterol, was also markedly altered by the type of emulsion. These data support the concept that tube-fed emulsions with different droplet sizes and solute composition are digested differently and thus are metabolized differently.

A reliable and quick radial thin layer chromatographic method for the diagnosis of mono- and disaccharide disorders.

The authors propose a radial thin layer chromatographic method for the separation of mono- and disaccharides, which shows better resolution, and is more sensitive (0.25 microgram for glucose) and less time-consuming (20 min) than the linear technique. Moreover, the procedures used for the detection of sugars and their dansyl-derivatives (staining with naphthoresorcinol and fluorescence of the dansyl-hydrazones) make the identification more specific and reliable. This simple method is quite suitable for the analysis of biological samples (urine, faeces) and the diagnosis of metabolic disorders in children.