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A Comparison of Fish Oil Sources for Parenteral Lipid Emulsions in a Murine Model
Author(s) -
Fell Gillian L.,
Cho Bennet S.,
Pan Amy,
Nose Vania,
AnezBustillos Lorenzo,
Dao Duy T.,
Baker Meredith A.,
Nandivada Prathima,
Gura Kathleen M.,
Puder Mark
Publication year - 2017
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 - 10.1177/0148607116640275
Subject(s) - fish oil , lethargy , docosahexaenoic acid , eicosapentaenoic acid , parenteral nutrition , medicine , polyunsaturated fatty acid , lipid emulsion , soybean oil , cholestasis , saline , chemistry , food science , fatty acid , biochemistry , biology , pathology , fish <actinopterygii> , fishery
Background: Fat emulsions are important components of parenteral nutrition (PN). Fish oil (FO) emulsions reverse cholestasis in PN‐associated liver disease. There are 2 FO monographs. One is “FO; rich in omega‐3 fatty acids” (NFO). The other, “omega‐3 acids,” (PFO), is enriched in omega‐3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The purpose of this study is to compare the effects of 20% NFO and PFO emulsions produced in the laboratory in a murine model. Methods: Emulsions were compounded containing different oils: soybean oil (SO), NFO, and two PFOs differing in percentage of fatty acids as triglycerides (PFO66 and PFO90). Chow‐fed mice received saline, one of the above emulsions, or a commercial FO (OM) intravenously (2.4 g/kg/day) for 19 days. On day 19, animals were euthanized. Livers, spleens, and lungs were procured for histologic analysis. Results: OM, SO, NFO, and PFO90 were well‐tolerated clinically. PFO66 resulted in tachypnea and lethargy for ~1 minute following injections. At euthanasia, PFO66 and PFO90 groups had organomegaly. Histologically, these groups had splenic and hepatic fat‐laden macrophages, and lungs had scattered fat deposits. Other groups had normal organs. Conclusions: PFO emulsions present an attractive possibility for improving inflammation in PN‐dependent patients by concentrating anti‐inflammatory EPA and DHA. However, 20% PFO emulsions were poorly tolerated and precipitated adverse end organ sequelae, suggesting that they may not be safe. Development of novel manufacturing methods may achieve safe 20% PFO parenteral emulsions, but by established formulation methods, these emulsions were clinically suboptimal despite meeting pharmacopeial standards.