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Effect of a Fish Oil Structured Lipid‐Based Diet on Prostaglandin Release From Mononuclear Cells in Cancer Patients After Surgery
Author(s) -
Swails Wendy S.,
Kenler Andrew S.,
Driscoll David F.,
Demichele Stephen J.,
Babineau Timothy J.,
Utsunamiya Tohru,
Chavali Sambasiva,
Forse R. Armour,
Bistrian Bruce R.
Publication year - 1997
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 - 10.1177/0148607197021005266
Subject(s) - medicine , fish oil , peripheral blood mononuclear cell , gastroenterology , eicosanoid , prostaglandin , triglyceride , prostaglandin e , urinalysis , endocrinology , immunology , biology , cholesterol , arachidonic acid , urinary system , biochemistry , in vitro , fishery , fish <actinopterygii> , enzyme
Background: The authors compared the effect on eicosanoid production (prostaglandin E 2 [PGE 2 ], 6‐keto PGF 1α , and thromboxane B 2 ) from peripheral blood mononuclear cells (PBMC) of feeding an enteral diet containing a fish oil/mediumchain triglyceride structured lipid (FOSL‐HN) vs an isonitrogenous, isocaloric formula (O‐HN) in patients undergoing major abdominal surgery for upper gastrointestinal malignancies. A previous study, which used the same formulas and experimental design, suggested improved renal and liver function as well as a reduced number of gastrointestinal and infectious complications with the use of fish oil structured lipids. This study sought to investigate the potential mechanism for these effects by assessing eicosanoid production from PBMC with the two diets. Methods: This prospective, blinded, randomized trial was conducted in 20 patients who were jejunally fed either FOSL‐HN or O‐HN for 7 days. Serum chemistries, hematology, urinalysis, gastrointestinal complications, liver and renal function, and eicosanoid production from isolated PBMC, either unstimulated or stimulated with endotoxin, were measured at endotoxin baseline and on day 7. Comparisons were made in 10 and 8 evaluable patients based a priori on the ability to reach a tube feeding rate of >40 mL/h. Results: Patients receiving FOSL‐HN experienced no untoward side effects compared with patients given O‐HN and demonstrated the same general trend toward improved hepatic, renal and immune function found in the previous study. There was a significant reduction in PGE 2 (p <.03) and 6‐keto PGF 1α (p <.01) production from PBMC with endotoxin stimulation in patients receiving FOSL‐HN. Conclusions: The results of early enteral feeding with FOSL‐HN after surgery in this follow‐up study provide further support to claims of safety, tolerance, and improved physiologic function. There was an associated reduction in eicosanoid production from PBMCs, which is presumed to be the principal mechanism for these effects. (journal of Parenteral and Enteral Nutrition 21:266–274, 1997)