RESUMEN
The long-chain n-3 polyunsaturated fatty acids (LC-PUFAs) eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) in fish oil have immunomodulatory properties. B cells are a poorly studied target of EPA/DHA in humans. Therefore, in this pilot study, we tested how n-3 LC-PUFAs influence B-cell responses of obese humans. Obese men and women were assigned to consume four 1-g capsules per day of olive oil (OO, n=12), fish oil (FO, n=12) concentrate or high-DHA-FO concentrate (n=10) for 12 weeks in a parallel design. Relative to baseline, FO (n=9) lowered the percentage of circulating memory and plasma B cells, whereas the other supplements had no effect. There were no postintervention differences between the three supplements. Next, ex vivo B-cell cytokines were assayed after stimulation of Toll-like receptors (TLRs) and/or the B-cell receptor (BCR) to determine if the effects of n-3 LC-PUFAs were pathway-dependent. B-cell IL-10 and TNFα secretion was respectively increased with high DHA-FO (n=10), relative to baseline, with respective TLR9 and TLR9+BCR stimulation. OO (n=12) and FO (n=12) had no influence on B-cell cytokines compared to baseline, and there were no differences in postintervention cytokine levels between treatment groups. Finally, ex vivo antibody levels were assayed with FO (n=7) after TLR9+BCR stimulation. Compared to baseline, FO lowered IgM but not IgG levels accompanied by select modifications to the plasma lipidome. Altogether, the results suggest that n-3 LC-PUFAs could modulate B-cell activity in humans, which will require further testing in a larger cohort.
Asunto(s)
Linfocitos B/efectos de los fármacos , Aceites de Pescado/farmacología , Obesidad/dietoterapia , Adulto , Linfocitos B/inmunología , Índice de Masa Corporal , Células Cultivadas , Ácidos Docosahexaenoicos/sangre , Método Doble Ciego , Ingestión de Alimentos/efectos de los fármacos , Ácido Eicosapentaenoico/sangre , Ejercicio Físico , Femenino , Aceites de Pescado/inmunología , Humanos , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Obesidad/inmunología , Obesidad/metabolismo , Aceite de Oliva/farmacología , Proyectos Piloto , Receptores de Antígenos de Linfocitos B/metabolismo , Receptores Toll-Like/inmunología , Receptores Toll-Like/metabolismoRESUMEN
The aim of this study was to assess the effects of low levels of dietary fish meal (FM) and fish oil (FO) on disease resistance and gut associated lymphoid tissue (GALT) response after an experimental intestinal infection with V. anguillarum in European sea bass (Dicentrarchus labrax) For that purpose, sea bass juveniles were fed one of four diets containing combined levels of FO and FM as follows: 20%FM/6%FO, 20%FM/3%FO, 5%FM/6%FO and 5%FM/3%FO during 153 days. At the end of the feeding trial, fish were subjected to either an in vivo exposure to a sub-lethal dose of V. anguillarum via anal inoculation or to an ex vivo exposure to V. anguillarum. Additionally, inducible nitric oxide synthase (iNOS) and tumor necrosis factor α (TNFα) gut patterns of immunopositivity were studied. Growth performance was affected by dietary FM level, however ex vivo gut bacterial translocation rates and survival after the in vivo challenge test were affected by dietary FO level. After 5 months of feeding, low dietary FM levels led to a posterior gut up-regulation of interleukin-1ß (IL-1ß) and TNFα, major histocompatibility complex-II (MHCII) and cyclooxygenase-2 (COX2), which in turn reduced the gut associated lymphoid tissue (GALT) capacity of response after 24 h post infection and conditioned European sea bass capacity to recover gut homeostasis 7 days post infection. Immunoreactivity to anti-iNOS and anti-TNFα presented a gradient of increased immunopositivity towards the anus, regardless of the dietary FM/FO fed. Strong positive anti-TNFα isolated enterocytes were observed in the anterior gut in relation to low levels of dietary FM/FO. Submucosa and lamina propria immunoreactivity grade was related to the amount of leucocyte populations infiltrated and goblet cells presented immunopositivity to anti-iNOS but not to anti-TNFα. Thus, reducing FO content from 6% to a 3% by VO in European sea bass diets increases ex vivo and in vivo gut bacterial translocation rates, whereas reducing FM content from 20% down to 5% up-regulates the expression of several posterior gut inflammation-related genes conditioning fish growth and GALT capacity of response after bacterial infection.
Asunto(s)
Lubina/inmunología , Suplementos Dietéticos , Resistencia a la Enfermedad , Enfermedades de los Peces/inmunología , Aceites de Pescado/inmunología , Enfermedades Intestinales/veterinaria , Vibriosis/veterinaria , Alimentación Animal , Animales , Dieta/veterinaria , Enfermedades Intestinales/inmunología , Vibrio/fisiología , Vibriosis/inmunologíaRESUMEN
The review deals with a question what lipid emulsion should be administered to ICU patients according to recently published official parenteral and enteral nutrition guidelines. Classic lipid emulsions based on omega-6 fatty acids are immunosuppressive and should not be used with ICU patients. The olive/soy emulsion is immunoneutral and can be used for most patients. Many ICU patients are in an inflammatory state (e.g. sepsis, ARDS, pancreatitis). A common belief is that this "hyperinflammed patient population" would profit from an anti-inflammatory lipid component of their parenteral nutrition solution, such as fish oil. On the other hand, every anti-inflammatory therapy has the disadvantage of also being immunosuppressive. Inflammation is a necessary part of the host defense against infection and any correct anti-inflammatory medication presupposes the exact immunologic knowledge that there is too much inflammation for a given situation. This "too much" is certainly not fulfilled in every patient with sepsis, ARDS or pancreatitis. At the bedside it is nearly impossible to determine the degree of "hyper" inflammation. In reality, a number of these patients may be adequately inflamed or, in fact, even hypoinflammed. Specific emulsions which can be used in hyper- or hypoinflammation should be developed in the future. As long as these difficulties in the immunologic diagnosis prevail, the clinician might be best advised to use an immunoneutral lipid emulsion when choosing a lipid preparation for the ICU patients.
Asunto(s)
Cuidados Críticos/métodos , Emulsiones Grasas Intravenosas/química , Nutrición Parenteral/métodos , Emulsiones Grasas Intravenosas/administración & dosificación , Emulsiones Grasas Intravenosas/farmacología , Aceites de Pescado/administración & dosificación , Aceites de Pescado/inmunología , Aceites de Pescado/farmacología , Humanos , Tolerancia Inmunológica/efectos de los fármacos , Inflamación/inmunología , Inflamación/prevención & control , Aceite de Oliva , Aceites de Plantas/administración & dosificación , Aceites de Plantas/farmacología , Guías de Práctica Clínica como AsuntoRESUMEN
There may be a causal relationship between intake of n-6 polyunsaturated fatty acids (PUFAs) and childhood allergic diseases. This can be explained by plausible biological mechanisms involving eicosanoid mediators produced from the n-6 PUFA arachidonic acid. Long chain n-3 PUFAs are found in fish and fish oils. These fatty acids act to oppose the actions of n-6 PUFAs. Thus, it is considered that n-3 PUFAs will lower the risk of developing allergic diseases. In support of this, protective associations have been reported between maternal fish intake during pregnancy and allergic outcomes in infants and children from those pregnancies. However, studies of fish intake during infancy and childhood and allergic outcomes in those infants or children are inconsistent, although some reported a protective association. Supplementing pregnant women with fish oil can induce immunologic changes in cord blood. This supplementation has been reported in some studies to decrease sensitisation to common food allergens and to lower the prevalence and severity of atopic dermatitis in the first year of life. The protective effect of maternal n-3 PUFAs may last until adolescence of the offspring. Fish oil supplementation in infancy may decrease the risk of developing some manifestations of allergic disease, although this benefit may not persist. Whether fish oil is a useful therapy in children with asthma receiving standard therapy is not clear from studies performed to date and this requires further exploration.
Asunto(s)
Ácidos Grasos Omega-3/inmunología , Ácidos Grasos Omega-6/inmunología , Hipersensibilidad/inmunología , Adolescente , Adulto , Factores de Edad , Animales , Niño , Suplementos Dietéticos , Ácidos Grasos Omega-3/administración & dosificación , Ácidos Grasos Omega-6/administración & dosificación , Femenino , Aceites de Pescado/administración & dosificación , Aceites de Pescado/inmunología , Hipersensibilidad a los Alimentos/inmunología , Humanos , Lactante , EmbarazoRESUMEN
Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are bioactive n-3 long-chain polyunsaturated fatty acids (LCPUFAs) in fish oil that exert immunosuppressive effects. A significant amount of literature shows that n-3 LCPUFAs suppress dendritic cell (DC) function in vitro; however, few studies have determined if the effects are emulated at the animal level. In this study, we first focused on the functional consequences of 5% (weight/weight) fish oil on splenic CD11c(+) DCs. Administration of n-3 LCPUFAs, modelling human pharmacological intake (2% of total kcal from EPA,1·3% from DHA), to C57BL/6 mice for 3 weeks reduced DC surface expression of CD80 by 14% and tumour necrosis factor-α secretion by 29% upon lipopolysaccharide stimulation relative to a control diet. The n-3 LCPUFAs also significantly decreased CD11c(+) surface expression and phagocytosis by 12% compared with the control diet. Antigen presentation studies revealed a 22% decrease in CD69 surface expression on transgenic CD4(+) T lymphocytes activated by DCs from mice fed fish oil. We then determined if the functional changes were mechanistically associated with changes in lipid microdomain clustering or plasma membrane microviscosity with n-3 LCPUFAs, as reported for B and T lymphocytes. Fish oil administration to mice did not influence cholera-toxin induced lipid microdomain clustering or microviscosity, even though EPA and DHA levels were significantly elevated relative to the control diet. Overall, our data show that n-3 LCPUFAs exert immunosuppressive effects on DCs, validating in vitro studies. The results also show that DC microdomain clustering and microviscosity were not changed by the n-3 LCPUFA intervention used in this study.
Asunto(s)
Antígenos CD/metabolismo , Antígenos de Diferenciación de Linfocitos T/metabolismo , Células Dendríticas/inmunología , Grasas Insaturadas en la Dieta/farmacología , Ácidos Grasos Omega-3/farmacología , Lectinas Tipo C/metabolismo , Linfocitos T/inmunología , Animales , Presentación de Antígeno , Antígenos CD/genética , Antígenos de Diferenciación de Linfocitos T/genética , Células Dendríticas/efectos de los fármacos , Células Dendríticas/metabolismo , Grasas Insaturadas en la Dieta/administración & dosificación , Grasas Insaturadas en la Dieta/inmunología , Ácidos Docosahexaenoicos/administración & dosificación , Ácidos Docosahexaenoicos/inmunología , Ácidos Docosahexaenoicos/farmacología , Ácido Eicosapentaenoico/administración & dosificación , Ácido Eicosapentaenoico/inmunología , Ácido Eicosapentaenoico/farmacología , Ácidos Grasos Omega-3/administración & dosificación , Ácidos Grasos Omega-3/inmunología , Aceites de Pescado/administración & dosificación , Aceites de Pescado/inmunología , Aceites de Pescado/farmacología , Humanos , Lectinas Tipo C/genética , Masculino , Ratones , Ratones Endogámicos C57BL , FagocitosisRESUMEN
The aim of the present work was to determine if a plant protein-based diet containing vegetable oils (VO) as the major lipid source could alter the distribution of IgM immunoreactive cells (IRCs) and the IgM expression pattern in the intestine and haematopoietic tissues of gilthead sea bream (GSB) (Sparus aurata) challenged with the myxosporean Enteromyxum leei. In a first trial (T1), GSB fed for 9 months either a fish oil (FO) diet or a blend of VO at 66% of replacement (66VO diet) was challenged by exposure to parasite-contaminated water effluent. All fish were periodically and non-lethally sampled to know their infection status. After 102 days of exposure, samples of intestine and head kidney were obtained for IgM expression and immunohistochemical detection (IHC). Additional samples of spleen were taken for IHC. Fish were categorized as control (C, not exposed), and early (E), or late (L) infected. The 66VO diet had no effect on the number of IgM-IRCs in any of the tissues or on IgM expression in C fish, whereas the infection with E. leei had a strong effect on the intestine. A combined time-diet effect was also observed, since the highest expression and IRCs values were registered in the posterior intestine (Pi) of E-66VO fish. A positive correlation was found between IgM expression and the presence of IgM-IRCs in the Pi. The effect of the time of infection was studied more in detail in a second trial (T2) in which samples of Pi were taken at 0, 24, 51, 91 and 133 days after exposure to the parasite. A significant increase of the IgM expression was detected only in parasitized fish, and very late after exposure. These results show that the duration of the exposure to the parasite is the most determinant factor for the observed intestinal IgM increased phenotype which gets magnified by the feeding of a high VO-based diet.
Asunto(s)
Grasas de la Dieta/inmunología , Enfermedades de los Peces/inmunología , Regulación de la Expresión Génica , Inmunoglobulina M , Myxozoa/inmunología , Enfermedades Parasitarias en Animales/inmunología , Dorada/inmunología , Animales , Dieta/veterinaria , Aceites de Pescado/inmunología , Perfilación de la Expresión Génica , Inmunoglobulina M/genética , Inmunoglobulina M/inmunología , Intestinos/citología , Intestinos/inmunología , Riñón/citología , Riñón/inmunología , Aceites de Plantas , Dorada/genética , Dorada/parasitología , Bazo/citología , Bazo/inmunologíaRESUMEN
BACKGROUND: Parenteral nutrition (PN) is indispensable for meeting caloric and substrate needs of patients who cannot receive adequate amounts of enteral nutrition; however, PN impairs hepatic immunity. We examined the effects of ω-3 and -6 polyunsaturated fatty acids, added individually to fat-free PN, on hepatic immunity in a murine model. We focused on serum liver enzymes, cytokine production, histopathology, and the outcomes after intraportal bacterial challenge. METHODS: Male Institute of Cancer Research mice were randomized into 4 groups; ad libitum chow (CHOW), fat-free PN (FF-PN), PN + fish oil (FO-PN), or PN + safflower oil (SO-PN). After the mice had been fed for 5 days, hepatic mononuclear cells (MNCs) were isolated. The number of MNCs was counted and cytokine production (tumor necrosis factor [TNF]-α and interleukin [IL]-10) by hepatic MNCs in response to lipopolysaccharide (LPS) was measured. Blood samples were analyzed for hepatobiliary biochemical parameters. Moreover, 1.0 × 10(7) pseudomonas aeruginosa were delivered by intraportal injection. Survival and histology were examined. RESULTS: Hepatic MNC numbers were significantly less in the FO-PN and FF-PN than in the CHOW group, whereas the SO-PN group showed moderate recovery of hepatic MNC numbers. The CHOW, FO-PN, and SO-PN groups showed LPS dose-dependent increases in TNF-α levels. These increases were blunted in the FF-PN group. IL-10 levels were increased LPS dose-dependently in the CHOW and FO-PN groups, but no marked changes were observed with LPS stimulation in the SO-PN and FF-PN groups. Plasma levels of aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase were significantly greater in the FF-PN than in the FO- and SO-PN and CHOW groups. The FO-PN group showed significantly improved survival compared with the SO-PN and FF-PN groups, showing essentially no morphologic hepatic abnormalities. CONCLUSION: Addition of fish oil to PN was advantageous in terms of reversing PN-induced deterioration of hepatic immunity, as reflected by altered cytokine production. Fish oil administration was also useful for preventing PN-induced hepatobiliary dysfunction. These changes seem to result in better survival and to protect against severe tissue damage after intraportal bacterial challenge. This therapy may have the potential to ameliorate PN-induced impairment of host immunity and thereby decrease morbidity and mortality.
Asunto(s)
Ácidos Grasos Omega-3/inmunología , Ácidos Grasos Omega-6/inmunología , Aceites de Pescado/inmunología , Leucocitos Mononucleares/metabolismo , Hígado/inmunología , Nutrición Parenteral/métodos , Aceite de Cártamo/inmunología , Animales , Biomarcadores/metabolismo , Citocinas/metabolismo , Ácidos Grasos Omega-3/administración & dosificación , Ácidos Grasos Omega-6/administración & dosificación , Aceites de Pescado/administración & dosificación , Lipopolisacáridos/administración & dosificación , Lipopolisacáridos/inmunología , Hígado/citología , Hígado/microbiología , Hígado/patología , Masculino , Ratones , Ratones Endogámicos ICR , Nutrición Parenteral/efectos adversos , Infecciones por Pseudomonas/inmunología , Infecciones por Pseudomonas/prevención & control , Pseudomonas aeruginosa/inmunología , Distribución Aleatoria , Aceite de Cártamo/administración & dosificaciónRESUMEN
OBJECTIVE: The ω-3 polyunsaturated fatty acids can suppress immune system functions. This property may cause adverse effects by impairing host resistance to infection. The present study focused on estimating the impact of different dietary lipids on the immune system of mice after a secondary infection with Listeria monocytogenes. METHODS: BALB/c mice were divided into five dietary groups of olive oil, fish oil, sunflower oil, high-oleic sunflower oil, or low fat that was administered for 8 wk. The mice were immunized with 10(3) colony-forming units. Thirty-eight days later, each mouse was challenged with 10(4) colony-forming units. Mice survival and bacterial clearance from livers and spleens were determined. In addition, cytokine, chemokine, and adhesion molecule productions were quantified from the sera. RESULTS: Survival percentage in mice fed a fish oil diet was 100% and bacterial numbers from spleen were decreased at 72 h. Interleukin-12, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1 productions were decreased. Levels of tumor necrosis factor-α and interferon-γ were increased, whereas macrophage inflammatory protein-1α (MIP-1α) production was unaltered. CONCLUSION: Immune defense in mice fed a fish oil diet was improved after secondary exposure, acquiring an adequate resistance. This result could be attributable to an increase of a T-helper type 1 response.
Asunto(s)
Inmunidad Adaptativa/efectos de los fármacos , Citocinas/metabolismo , Grasas de la Dieta/inmunología , Ácidos Grasos Omega-3/inmunología , Aceites de Pescado/farmacología , Listeriosis/inmunología , Bazo/microbiología , Animales , Aceites de Pescado/inmunología , Inmunización , Molécula 1 de Adhesión Intercelular/metabolismo , Interferón gamma/metabolismo , Interleucina-12/metabolismo , Listeria monocytogenes , Listeriosis/metabolismo , Listeriosis/microbiología , Listeriosis/mortalidad , Ratones , Ratones Endogámicos BALB C , Ácido Oléico/inmunología , Ácido Oléico/farmacología , Aceite de Oliva , Aceites de Plantas/farmacología , Bazo/inmunología , Aceite de Girasol , Factor de Necrosis Tumoral alfa/metabolismo , Molécula 1 de Adhesión Celular Vascular/metabolismoRESUMEN
There are two main families of polyunsaturated fatty acids (PUFAs), the n-6 and the n-3 families. It has been suggested that there is a causal relationship between n-6 PUFA intake and allergic disease, and there are biologically plausible mechanisms, involving eicosanoid mediators of the n-6 PUFA arachidonic acid, that could explain this. Fish and fish oils are sources of long-chain n-3 PUFAs and these fatty acids act to oppose the actions of n-6 PUFAs. Thus, it is considered that n-3 PUFAs will protect against atopic sensitization and against the clinical manifestations of atopy. Evidence to examine this has been acquired from epidemiologic studies investigating associations between fish intake in pregnancy, lactation, infancy, and childhood, and atopic outcomes in infants and children and from intervention studies with fish oil supplements in pregnancy, lactation, infancy, and childhood, and atopic outcomes in infants and children. All five epidemiological studies investigating the effect of maternal fish intake during pregnancy on atopic or allergic outcomes in infants/children of those pregnancies concluded protective associations. One study investigating the effects of maternal fish intake during lactation did not observe any significant associations. The evidence from epidemiological studies investigating the effects of fish intake during infancy and childhood on atopic outcomes in those infants or children is inconsistent, although the majority of the studies (nine of 14) showed a protective effect of fish intake during infancy or childhood on atopic outcomes in those infants/children. Fish oil supplementation during pregnancy and lactation or during infancy or childhood results in a higher n-3 PUFA status in the infants or children. Fish oil provision to pregnant women is associated with immunologic changes in cord blood and such changes may persist. Studies performed to date indicate that provision of fish oil during pregnancy may reduce sensitization to common food allergens and reduce prevalence and severity of atopic dermatitis in the first year of life, with a possible persistence until adolescence with a reduction in eczema, hay fever, and asthma. Fish oil provision to infants or children may be associated with immunologic changes in the blood but it is not clear if these are of clinical significance and whether they persist. Fish oil supplementation in infancy may decrease the risk of developing some manifestations of allergic disease, but this benefit may not persist as other factors come into play. It is not clear whether fish oil can be used to treat children with asthma as the two studies conducted to date give divergent results. Further studies of increased long-chain n-3 PUFA provision in during pregnancy, lactation, and infancy are needed to more clearly identify the immunologic and clinical effects in infants and children and to identify protective and therapeutic effects and their persistence.
Asunto(s)
Aceites de Pescado/efectos adversos , Productos Pesqueros/efectos adversos , Hipersensibilidad Inmediata/epidemiología , Alérgenos/inmunología , Animales , Niño , Desensibilización Inmunológica , Suplementos Dietéticos , Exposición a Riesgos Ambientales/efectos adversos , Ácidos Grasos Omega-3/inmunología , Femenino , Aceites de Pescado/inmunología , Peces , Humanos , Hipersensibilidad Inmediata/inmunología , Hipersensibilidad Inmediata/prevención & control , Inmunidad Materno-Adquirida , Lactante , Lactancia , Embarazo , RiesgoRESUMEN
Scandinavian folk medicine used shark liver oil for the treatment of cancers and other ailments based on the rarity of tumors in sharks and their ability to resist infections. Shark liver oil is a source of alkylglycerols which have been studied as anti-cancer agents in several clinical trials. Moreover, alkylglycerols have been investigated for the treatment of radiation induced side effects and for their ability to boost the immune system. Several experimental studies have shown the ability of alkylglycerols to open the blood brain barrier to facilitate the access of therapeutic drugs to the central nervous system. This review covers the most important studies of alkylglycerols in both animals and humans.
Asunto(s)
Antineoplásicos/uso terapéutico , Aceites de Pescado/uso terapéutico , Glicerol/análogos & derivados , Glicerol/uso terapéutico , Éteres de Glicerilo/uso terapéutico , Sistema Inmunológico/efectos de los fármacos , Neoplasias/tratamiento farmacológico , Animales , Antineoplásicos/química , Antineoplásicos/inmunología , Barrera Hematoencefálica/efectos de los fármacos , Ensayos Clínicos como Asunto , Aceites de Pescado/química , Aceites de Pescado/inmunología , Glicerol/administración & dosificación , Glicerol/química , Éteres de Glicerilo/administración & dosificación , Éteres de Glicerilo/química , Humanos , Neoplasias/radioterapia , Traumatismos por Radiación/prevención & control , Tiburones , Escualeno/uso terapéuticoRESUMEN
Many chronic conditions involve excessive inflammation that is damaging to host tissues. Excessive or inappropriate inflammation and immunosuppression are components of the response to surgery, trauma, injury and infection in some individuals and these can lead, progressively, to sepsis and septic shock. Hyperinflammation is characterised by the production of inflammatory cytokines, eicosanoids and other inflammatory mediators, while the immunosuppression is characterised by impairment of antigen presentation and of certain T cell responses. N-6 fatty acids may contribute to the hyperinflamed and immunosuppressed states. N-3 fatty acids from fish oil decrease the production of inflammatory cytokines and eicosanoids. They act both directly (by replacing arachidonic acid as an eicosanoid precursor) and indirectly (by altering the expression of inflammatory genes through effects on transcription factor activation). Thus, these fatty acids are potentially useful anti-inflammatory agents and may be of benefit in patients with chronic inflammatory diseases or at risk of hyperinflammation and sepsis. An emerging application of n-3 fatty acids is in surgical or critically ill patients where they may be added to parenteral or enteral formulas. Studies to date are suggestive of clinical benefits from these approaches, although more robust data are needed especially in critically ill patients.
Asunto(s)
Ácidos Grasos/inmunología , Inflamación/inmunología , Fenómenos Fisiológicos de la Nutrición/inmunología , Animales , Antiinflamatorios/uso terapéutico , Núcleo Celular/inmunología , Enfermedad Crítica , Citocinas/inmunología , Eicosanoides/inmunología , Europa (Continente) , Ácidos Grasos/farmacología , Ácidos Grasos/uso terapéutico , Ácidos Grasos Omega-3/inmunología , Ácidos Grasos Omega-3/farmacología , Ácidos Grasos Omega-3/uso terapéutico , Ácidos Grasos Omega-6/inmunología , Aceites de Pescado/inmunología , Aceites de Pescado/farmacología , Aceites de Pescado/uso terapéutico , Humanos , Tolerancia Inmunológica/inmunología , Inflamación/prevención & control , Membranas/inmunología , Nutrición Parenteral/métodos , Complicaciones Posoperatorias/prevención & control , Sociedades MédicasRESUMEN
Current evidence indicates that omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid and docosahexaenoic acid found in fish oil, can prevent the development of inflammatory diseases by affecting different steps of the immune response. The capacity of omega-3 PUFAs to modulate synthesis of eicosanoids, activity of nuclear receptor and nuclear transcription factors, and production of resolvins may also mitigate inflammatory processes already present. Parenteral infusion of omega-3 PUFAs is advantageous, particularly in severely ill patients, because the fatty acids are rapidly incorporated by cells. In addition, when fatty acids are given parenterally, there are no losses from digestion and absorption as there are with enteral infusion. Recently, lipid emulsions enriched with omega-3 fish oil have been introduced as a component of parenteral nutrition. Currently, there is one lipid emulsion that contains only fish oil; it is infused together with conventionally used lipid emulsions. Other commercially available lipid emulsions contain fish oil in a fat mixture; one contains 10% fish oil and another 15% fish oil. Relevant experimental and clinical data from studies evaluating fish oil lipid emulsions are discussed in the present review. Administration of fish oil lipid emulsion, when compared with soybean oil lipid emulsion (rich in omega-6 PUFA), decreases the length of hospital and intensive care unit stay in surgical patients.
Asunto(s)
Antiinflamatorios/farmacología , Emulsiones Grasas Intravenosas/farmacología , Ácidos Grasos Omega-3/farmacología , Aceites de Pescado/farmacología , Factores Inmunológicos/farmacología , Inflamación/prevención & control , Nutrición Parenteral , Antiinflamatorios/uso terapéutico , Emulsiones Grasas Intravenosas/uso terapéutico , Ácidos Grasos Omega-3/inmunología , Ácidos Grasos Omega-3/uso terapéutico , Aceites de Pescado/inmunología , Aceites de Pescado/uso terapéutico , Humanos , Factores Inmunológicos/uso terapéutico , Nutrición Parenteral/métodos , Aceite de Soja/farmacología , Aceite de Soja/uso terapéuticoRESUMEN
Total parenteral nutrition is the final option for nutritional support of patients with severe intestinal failure. Lipid emulsions constitute the main source of fuel calories and fatty acids (FAs) in parenteral nutrition formulations. However, adverse effects on patient outcomes have been attributed to the use of lipids, mostly in relation to impaired immune defenses and altered inflammatory responses. Over the years, this issue has remained in the limelight, also because technical advances have provided no safeguard against the most daunting problems, ie, infectious complications. Nevertheless, numerous investigations have failed to produce a clear picture of the immunologic characteristics of the most commonly used soybean oil-derived lipid emulsions, although their high content of n-6 polyunsaturated FAs (PUFAs) has been considered a drawback because of their proinflammatory potential. This concern initiated the development of emulsions in which part of the n-6 FA component is replaced by less bioactive FAs, such as coconut oil (rich in medium-chain saturated FAs) or olive oil (rich in the n-9 monounsaturated FA oleic acid). Another approach has been to use fish oil (rich in n-3 PUFA), the FAs of which have biological activities different from those of n-6 PUFAs. Recent studies on the modulation of host defenses and inflammation by fish-oil emulsions have yielded consistent data, which indicate that these emulsions may provide a tool to beneficially alter the course of immune-mediated conditions. Although most of these lipids have not yet become available on the US market, this review synthesizes available information on immunologic characteristics of the different lipids that currently can be applied via parenteral nutrition support.
Asunto(s)
Grasas Insaturadas en la Dieta/inmunología , Emulsiones Grasas Intravenosas/efectos adversos , Sistema Inmunológico/efectos de los fármacos , Metabolismo de los Lípidos/efectos de los fármacos , Nutrición Parenteral Total/métodos , Aceite de Coco , Grasas Insaturadas en la Dieta/administración & dosificación , Emulsiones Grasas Intravenosas/química , Emulsiones Grasas Intravenosas/metabolismo , Ácidos Grasos Omega-3/administración & dosificación , Ácidos Grasos Omega-3/inmunología , Ácidos Grasos Omega-6/administración & dosificación , Ácidos Grasos Omega-6/inmunología , Aceites de Pescado/administración & dosificación , Aceites de Pescado/química , Aceites de Pescado/inmunología , Humanos , Metabolismo de los Lípidos/fisiología , Lípidos de la Membrana/metabolismo , Aceite de Oliva , Aceites de Plantas , Aceite de Soja/administración & dosificación , Aceite de Soja/química , Aceite de Soja/inmunologíaRESUMEN
CVD is associated with a cellular inflammatory/immune response. n-3 PUFA and moderate aerobic exercise independently alter cytokine production and leucocyte function. There is limited evidence for the combined effect of these treatments on immune function, particularly in patients with risk factors for CVD. We hypothesised that exercise would enhance the anti-inflammatory effects of n-3 PUFA. In a randomised, placebo-controlled study, fifty volunteers were allocated double-blind to consume either sunflower oil (6 g/d, placebo) or DHA-rich fish oil (6 g/d; about 2 g n-3 PUFA; 1.6 g DHA /d) for 12 weeks. Volunteers were further randomised to undertake regular exercise (walking 3 d/week for 45 min at 75 % of maximum heart rate) or maintain their usual physical activity for 12 weeks. Immune functions were assessed in blood taken initially and after 12 weeks. There was no effect on cytokine production by T cells and monocytes. Superoxide anion production from stimulated blood neutrophils was decreased by fish oil (19.5 (sem 8.5) %, P = 0.016) but not by exercise, and this change was negatively correlated with the incorporation of DHA into erythrocytes (r-0.385, P = 0.047). Participation in regular exercise maintained neutrophil bactericidal activity, which decreased in non-exercising subjects (2.9 (sem 0.7) %, P = 0.013). Neutrophil chemotaxis and adherence were not significantly affected by exercise, oil, or the combination of the two. Thus the combination of moderate exercise and fish-oil supplementation, which reduces cardiovascular risk, may also help to counteract inflammation.
Asunto(s)
Ejercicio Físico/fisiología , Ácidos Grasos Omega-3/administración & dosificación , Aceites de Pescado/administración & dosificación , Neutrófilos/inmunología , Actividad Bactericida de la Sangre/inmunología , Enfermedades Cardiovasculares/inmunología , Citocinas/inmunología , Suplementos Dietéticos , Ácidos Docosahexaenoicos/administración & dosificación , Ácidos Docosahexaenoicos/análisis , Ácidos Docosahexaenoicos/inmunología , Método Doble Ciego , Ácido Eicosapentaenoico/administración & dosificación , Ácido Eicosapentaenoico/análisis , Ácido Eicosapentaenoico/inmunología , Eritrocitos/química , Ácidos Grasos Omega-3/inmunología , Femenino , Aceites de Pescado/química , Aceites de Pescado/inmunología , Humanos , Masculino , Persona de Mediana Edad , Monocitos/inmunología , Aceites de Plantas/administración & dosificación , Factores de Riesgo , Aceite de Girasol , Superóxidos/inmunología , Linfocitos T/inmunologíaRESUMEN
Excessive or inappropriate inflammation and immunosuppression are components of the response to surgery, trauma, injury and infection in some individuals and can lead, progressively, to sepsis and septic shock. The hyperinflammation is characterised by the production of inflammatory cytokines, arachidonic acid-derived eicosanoids and other inflammatory mediators, while the immunosuppression is characterised by impairment of antigen presentation and of T-helper lymphocyte type-1 responses. Long-chain n-3 fatty acids from fish oil decrease the production of inflammatory cytokines and eicosanoids. They act both directly (by replacing arachidonic acid as an eicosanoid substrate and by inhibiting arachidonic acid metabolism) and indirectly (by altering the expression of inflammatory genes through effects on transcription factor activation). Thus, long-chain n-3 fatty acids are potentially useful anti-inflammatory agents and may be of benefit in patients at risk of hyperinflammation and sepsis. As a consequence, an emerging application for n-3 fatty acids, in which they may be added to parenteral (or enteral) formulas, is in surgical or critically-ill patients. Parenteral nutrition that includes n-3 fatty acids appears to preserve immune function better than standard formulas and appears to diminish the extent of the inflammatory response. Studies to date are suggestive of clinical benefits from these approaches, especially in patients post surgery, although evidence of clinical benefit in patients with sepsis is emerging.
Asunto(s)
Antiinflamatorios/uso terapéutico , Enfermedad Crítica/terapia , Ácidos Grasos Omega-3/uso terapéutico , Aceites de Pescado/uso terapéutico , Nutrición Parenteral/métodos , Antiinflamatorios/inmunología , Ácidos Grasos Omega-3/inmunología , Aceites de Pescado/inmunología , Humanos , Inflamación/prevención & control , Complicaciones Posoperatorias/prevención & controlRESUMEN
PURPOSE OF REVIEW: This paper synthesizes information from recent studies on the modulation of immune responses by lipid emulsions that are applied as part of parenteral nutrition. This issue is especially relevant in light of the high rate of infectious complications and disturbed inflammatory responses in patients receiving this form of nutritional support. RECENT FINDINGS: Studies reporting on novel emulsions based on olive and fish oils, structured lipids or mixed-type emulsions in which various lipid species replace conventional long-chain triglycerides indicate that these lipids are generally well tolerated. While long-chain triglycerides may promote inflammation due to conversion of n-6 polyunsaturated fatty acids into arachidonic acid-derived eicosanoids, structured lipids and olive oil emulsions appear more immune-neutral. Leukocyte-activating effects of medium-chain triglycerides in experimental studies await further characterization in vivo. A body of evidence shows that immune modulation by fish oil emulsions is essentially anti-inflammatory in nature. This is in line with the observation that n-3 polyunsaturated fatty acids in fish oil replace arachidonic acid in cell membranes as an eicosanoid substrate, resulting in a decreased production of pro-inflammatory mediators. Importantly, recent investigations indicate beneficial effects of parenteral fish oil on relevant clinical outcome measures. SUMMARY: The characteristics of, and mechanisms behind, the effects of various parenteral lipids on immune function are becoming increasingly well understood. The practical relevance of many of these findings is not immediately clear, however, and will have to be substantiated in adequately powered trials before we can translate these findings into a tailored approach for specific clinical situations.
Asunto(s)
Grasas Insaturadas en la Dieta/inmunología , Emulsiones Grasas Intravenosas/química , Sistema Inmunológico/efectos de los fármacos , Nutrición Parenteral Total/métodos , Triglicéridos/inmunología , Citocinas/biosíntesis , Grasas Insaturadas en la Dieta/administración & dosificación , Eicosanoides/metabolismo , Emulsiones Grasas Intravenosas/administración & dosificación , Aceites de Pescado/administración & dosificación , Aceites de Pescado/inmunología , Humanos , Sistema Inmunológico/citología , Aceite de Oliva , Aceites de Plantas/administración & dosificación , Triglicéridos/administración & dosificaciónRESUMEN
This study investigated the effect of n-3 fatty acid (FA)-containing parenteral nutrition on the circulatory lymphocyte subpopulation, intracellular cytokine and leukocyte adhesion molecule expression, and phagocytic activity in rats undergoing total gastrectomy. Normal rats with internal jugular catheters were assigned to normal control (NC) and two experimental groups and received total parenteral nutrition (TPN). At the same time, a total gastrectomy was performed in the experimental groups, whereas the NC group underwent a sham operation. The TPN solutions were isonitrogenous and identical in nutrient compositions except for differences in fat emulsion contents. The NC and one of the experimental groups received a soybean oil emulsion (SO), and the other experimental group received 50% soybean oil and 50% fish oil emulsion (FO). Half of the rats in each respective group were sacrificed 1 or 3 days after surgery or the sham operation to examine their immune response. The results showed that the FO group had a higher CD4 proportion and CD4/CD8 ratio than those of the SO and NC groups postoperatively. The phagocytic activity of peritoneal macrophages was higher in the FO group than in the NC group, but no difference was found between the SO and NC groups 3 days after surgery. The intracellular interferon (IFN)-gamma distribution in the FO group was higher than that of the SO group on postoperative days. Leukocyte adhesion molecule expressions and peritoneal monocyte chemotactic protein-1 levels were lower in the FO group than in the SO group on postoperative day 3. These results suggest that parenterally infused FO did not result in immunosuppression. In addition, FO administration promotes lymphocyte Th1 cytokine production, enhances peritoneal macrophage phagocytic activity, and reduces leukocyte adhesion molecule expression in rats with total gastrectomy.
Asunto(s)
Emulsiones Grasas Intravenosas/administración & dosificación , Ácidos Grasos Omega-3/administración & dosificación , Aceites de Pescado/administración & dosificación , Gastrectomía , Leucocitos Mononucleares/inmunología , Aceite de Soja/administración & dosificación , Animales , Relación CD4-CD8/métodos , Moléculas de Adhesión Celular/inmunología , Citocinas/sangre , Citocinas/inmunología , Ácidos Grasos Omega-3/inmunología , Aceites de Pescado/inmunología , Gastrectomía/efectos adversos , Inflamación/sangre , Inflamación/tratamiento farmacológico , Inflamación/inmunología , Infusiones Parenterales/métodos , Masculino , Fagocitosis/efectos de los fármacos , Fagocitosis/inmunología , Ratas , Ratas Wistar , Aceite de Soja/inmunologíaRESUMEN
PURPOSE OF REVIEW: Parallel increases in many inflammatory diseases over the last 40 years suggest that common environmental changes are promoting inflammatory immune responses and/or inhibiting the processes that normally keep these in check. One key change during this period has been declining intakes of anti-inflammatory dietary factors, including omega-3 polyunsaturated fatty acids (n-3 PUFA). As allergic diseases often first manifest in early infancy, prevention strategies need to be targeted early, even in utero. This review will examine recent evidence for the use of fish oil during this early period as a primary prevention strategy for allergic disease. RECENT FINDINGS: N-3 PUFA have well documented anti-inflammatory effects in vitro and have also been demonstrated to have health benefits in a range of chronic inflammatory diseases, including cardiovascular disease, rheumatoid arthritis and diabetes, supporting their role in modulating inflammation in vivo. Although the effects of fish oil supplementation in established allergic disease are less convincing, there is accumulating evidence that dietary n-3 PUFA may have greater effects before allergic responses are established. SUMMARY: Supplementation of the maternal diet in pregnancy with n-3 PUFA may provide a non-invasive intervention with significant potential to prevent the development of allergic and possibly other immune-mediated diseases.
Asunto(s)
Ácidos Grasos Omega-3/administración & dosificación , Desarrollo Fetal/efectos de los fármacos , Hipersensibilidad/prevención & control , Efectos Tardíos de la Exposición Prenatal , Suplementos Dietéticos , Ácidos Grasos Omega-3/inmunología , Femenino , Desarrollo Fetal/inmunología , Aceites de Pescado/inmunología , Humanos , Hipersensibilidad/inmunología , Lactante , EmbarazoRESUMEN
BACKGROUND: Supplementation of the diet with fish oil, which is rich in the long-chain n-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is reported to decrease several markers of immune function. However, whether EPA, DHA, or a combination of the 2 exerts these immunomodulatory effects is unclear. OBJECTIVE: The objective of the study was to determine the effects of supplementation with an EPA-rich or DHA-rich oil on a range of immune outcomes representing key functions of human neutrophils, monocytes, and lymphocytes in healthy humans. DESIGN: In a placebo-controlled, double-blind, parallel study, 42 healthy subjects were randomly allocated to receive supplementation with either placebo (olive oil), EPA (4.7 g/d), or DHA (4.9 g/d) for 4 wk. Blood samples were taken before and after supplementation. RESULTS: The fatty acid composition of plasma phospholipids and neutrophils was dramatically altered by supplementation with EPA or DHA, and the effects of EPA differed notably from those of DHA. DHA supplementation decreased T lymphocyte activation, as assessed by expression of CD69, whereas EPA supplementation had no significant effect. Neither the EPA-rich oil nor the DHA-rich oil had any significant effect on monocyte or neutrophil phagocytosis or on cytokine production or adhesion molecule expression by peripheral blood mononuclear cells. CONCLUSIONS: Supplementation with DHA, but not with EPA, suppresses T lymphocyte activation, as assessed by expression of CD69. EPA alone does not, therefore, influence CD69 expression. No other marker of immune function assessed in this study was significantly affected by either EPA or DHA.
Asunto(s)
Grasas de la Dieta/inmunología , Ácidos Docosahexaenoicos/inmunología , Ácidos Eicosanoicos/inmunología , Aceites de Pescado/inmunología , Activación de Linfocitos/efectos de los fármacos , Adulto , Anciano , Citocinas/biosíntesis , Ácidos Docosahexaenoicos/administración & dosificación , Método Doble Ciego , Ácidos Eicosanoicos/administración & dosificación , Aceites de Pescado/administración & dosificación , Humanos , Persona de Mediana Edad , Neutrófilos/efectos de los fármacos , Neutrófilos/inmunología , Fagocitosis/efectos de los fármacosRESUMEN
OBJECTIVE: Fish oil is a rich source of omega-3 fatty acids (FAs), especially eicosapentaenoic acid and docosahexaenoic acid. The existing data suggest that eicosapentaenoic acid and docosahexaenoic acid are the active agents in fish oil. A number of clinical trials have shown that dietary fish oil supplementation has antiatherogenic properties and immunomodulation effects. Fish oils are not used widely in parenteral nutrition because fish oil emulsions have not been commercially available until very recently. Studies concerning the use of fish oil in parenteral route are rare. METHODS: We reviewed the effect of parenteral fish oil infusion on lipid metabolism and immune response in normal and disease conditions. RESULTS: Studies showed that the main effects of parenteral infusion of fish oil are: 1) incorporation of omega-3 FAs into cellular membranes of many cell populations that consequently influence the disease process of some disease conditions, 2) an effect on eicosanoid metabolism leading to a decrease in platelet aggregation and thrombosis, 3) amelioration of the severity of diet-induced hepatic steatosis, 4) less accumulation of lipid peroxidation products in liver tissue, and 5) immunomodulation effects and therapeutic benefits in animal disease models or various disease conditions of humans. Most of these studies suggested that parenteral infusion of omega-3 FAs have clinical beneficial effects comparable to those of dietary administration. However, different effects of omega-3 and omega-6 FAs in some situations has been reported. For example, plasma triacylglycerol levels were not lowered after fish oil infusion in normal or diabetic rats when compared with those of safflower oil or soybean oil infusion. The reason for the difference remain unclear. CONCLUSION: The metabolic and immunologic effects of parenteral use of omega-3 FAs requires further evaluation, especially in some disease conditions.