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Impact of Clinical Use of Parenteral Lipid Emulsions on Bile Acid Metabolism and Composition in Neonatal Piglets
Author(s) -
Lavallee Celeste M.,
Lim David W.,
Wizzard Pamela R.,
Mazurak Vera C.,
Mi Si,
Curtis Jonathan M.,
Willing Benjamin P.,
Yap Jason Y.,
Wales Paul W.,
Turner Justine M.
Publication year - 2019
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.1437
Subject(s) - bile acid , medicine , farnesoid x receptor , parenteral nutrition , metabolism , liver disease , endocrinology , taurocholic acid , lipid metabolism , chenodeoxycholic acid , chemistry , biochemistry , biology , gene , nuclear receptor , transcription factor
Background Neonates with intestinal failure dependent on parenteral nutrition (PN) are at risk of intestinal failure–associated liver disease (IFALD). PN lipid composition relates to the risk of IFALD, but the mechanisms are poorly understood. We investigated the effects of soybean oil (SO), a mixed‐lipid (ML) emulsion containing fish oil (FO), and a pure FO. We hypothesized FO‐containing PN lipids would result in increased gene expression of canalicular bile acid transporters and a larger, more hydrophilic bile acid pool, predictive of increased bile flow. Methods Neonatal piglets were allocated to receive 1 of SO, ML, or FO throughout 14 days of PN feeding. Relative expression of genes involved in bile acid synthesis and transport were determined through quantitative polymerase chain reaction. Bile secreted from the liver was collected and measured. Bile acid composition was determined using tandem mass spectrometry. Regression analysis was used to determine predictors of bile flow. Results : PN reduced bile acid secretion ( P < .001). FO‐containing PN lipids were associated with greater expression of bile acid and organic solute transport genes ( P < .05) and greater secretion of hydrophobic bile acids ( P < .001). Farnesoid X receptor ( P = .01), bile salt export pump ( P < .01), multidrug resistant protein 2 ( P < .01), and unconjugated hyocholic acid ( P < .001) independently predicted bile flow. Conclusions : PN lipid modulation altered bile acid metabolism and composition. These alterations may explain the hepatoprotective effects of FO‐containing PN lipids and support their use in the prevention and treatment of IFALD.