A short-term long-chain triglycerides infusion has no influence on immune function of adult patients undergoing gastrointestinal surgery.

BACKGROUND Parenteral nutrition (PN) support containing long-chain triglycerides (LCT) plays a critical supportive role in surgical patients' management. This study aims to investigate the effects of intravenous (IV) LCT emulsion on human immune function in adult patients receiving a gastrointestinal surgical procedure. METHODS Sixty adult patients were randomly assigned either to the LCT treatment group (n = 32) or to the control group (n = 28). After an abdominal operation, the subjects received PN treatment with or without LCT for 5 days. Neutrophil, peripheral blood mononuclear cell (PBMC), lymphocyte and CD4/CD8, serum immunoglobulin A (IgA), IgG, IgM, complement C3 and C4, interleukin (IL)-2, IL-4, IL-10, IL-12, tumor necrosis factor (TNF)-alpha, and interferon (IFN)-gamma were measured and statistically analyzed. RESULTS The LCT and control groups did not differ significantly at entry in terms of general features. Except for a significant increase of neutrophil number at 24 hours after the surgery in both groups (p < .01), all parameters representing the patients' immune function had no significant difference between the LCT and the control groups with respect to neutrophil and PBMC count, lymphocyte, CD4/CD8, serum IgA, IgG, IgM, complement C3, C4, IL-2, IL-4, IL-10, IL-12, TNF-alpha, and IFN-gamma (p > .05, respectively) 24 hours before the operation, and 24 hours and 120 hours after the operation. CONCLUSIONS The regimens of LCT administration may have diverse effects on human immune function in different patient populations. However, LCT emulsion at an appropriate dose and infusion speed does not alter human immune function of adult patients undergoing moderate gastrointestinal surgery.

[1]  R. Curi,et al.  Toxicity of a soybean oil emulsion on human lymphocytes and neutrophils. , 2006, JPEN. Journal of parenteral and enteral nutrition.

[2]  Leah Gramlich,et al.  Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. , 2003, JPEN. Journal of parenteral and enteral nutrition.

[3]  A. Andoh,et al.  A comparison of the effects of medium- and long-chain triglycerides on neutrophil stimulation in experimental ileitis , 2003, Journal of Gastroenterology.

[4]  J. Garnacho-Montero,et al.  Effects of three intravenous lipid emulsions on the survival and mononuclear phagocyte function of septic rats. , 2002, Nutrition.

[5]  J. Kotzerke,et al.  Hepatic reticuloendothelial function during parenteral nutrition including an MCT/LCT or LCT emulsion after liver transplantation – a double‐blind study , 2002 .

[6]  M. Kuo,et al.  Effects of medium-chain triglyceride in parenteral nutrition on rats undergoing gastrectomy. , 2002, Clinical nutrition.

[7]  R. Meier,et al.  Parenteral lipid emulsions and phagocytic systems , 2002, British Journal of Nutrition.

[8]  L. Jacobs,et al.  Parenteral Administration of Medium- but Not Long-Chain Lipid Emulsions May Increase the Risk for Infections by Candida albicans , 2001, Infection and Immunity.

[9]  J. Curfs,et al.  With medium-chain triglycerides, higher and faster oxygen radical production by stimulated polymorphonuclear leukocytes occurs. , 2000, JPEN. Journal of parenteral and enteral nutrition.

[10]  M. Gleeson,et al.  THE MEASUREMENT OF IgA AND IgG TRANSGLUTAMINASE ANTIBODIES IN CELIAC DISEASE: A COMPARISON WITH CURRENT DIAGNOSTIC METHODS , 2000, Pathology.

[11]  T. Gooley,et al.  Intravenous lipid dose and incidence of bacteremia and fungemia in patients undergoing bone marrow transplantation. , 1998, The American journal of clinical nutrition.

[12]  C. Pichard,et al.  Effect of parenteral medium- and long-chain triglycerides on lymphocytes subpopulations and functions in patients with acquired immunodeficiency syndrome: a prospective study. , 1998, JPEN. Journal of parenteral and enteral nutrition.

[13]  J. Siepler,et al.  A prospective, randomized trial of intravenous fat emulsion administration in trauma victims requiring total parenteral nutrition. , 1997, The Journal of trauma.

[14]  M. Salgado,et al.  Effect of total parenteral nutrition with different lipid emulsions of human monocyte and neutrophil functions. , 1997, Nutrition.

[15]  M. Salgado,et al.  Influence of medium-chain triglyceride-based lipid emulsion on rat polymorphonuclear cell functions. , 1996, Nutrition.

[16]  J. Balibrea,et al.  NO2/NO3 and cytokine plasma profiles under different postoperative parenteral nutrition regimens. , 1996, Nutrition.

[17]  A. Buchman,et al.  Intestinal immune function is unaffected by parenteral nutrition in man. , 1995, Journal of the American College of Nutrition.

[18]  J. Nordenström,et al.  Metabolic effects of infusion of a structured-triglyceride emulsion in healthy subjects. , 1995, Nutrition.

[19]  C. Gogos,et al.  Medium- and long-chain triglycerides have different effects on the synthesis of tumor necrosis factor by human mononuclear cells in patients under total parenteral nutrition. , 1994, Journal of the American College of Nutrition.

[20]  G. Blackburn,et al.  Parenteral infusion of long- and medium-chain triglycerides and reticuloendothelial system function in man. , 1990, JPEN. Journal of parenteral and enteral nutrition.

[21]  R. Platt,et al.  Association of intravenous lipid emulsion and coagulase-negative staphylococcal bacteremia in neonatal intensive care units. , 1990 .

[22]  C. Gogos,et al.  Effect of different types of total parenteral nutrition on T-lymphocyte subpopulations and NK cells. , 1990, The American journal of clinical nutrition.

[23]  P. Guillou,et al.  Pharmacological concentrations of lipid emulsions inhibit interleukin-2-dependent lymphocyte responses in vitro. , 1990, JPEN. Journal of parenteral and enteral nutrition.

[24]  O. Goulet,et al.  Lipid tolerance in children receiving long-term parenteral nutrition: a biochemical and immunologic study. , 1988, The Journal of pediatrics.

[25]  R. Strunk,et al.  Normal macrophage function in infants receiving Intralipid by low-dose intermittent administration. , 1985, The Journal of pediatrics.

[26]  J. Neoptolemos,et al.  The effects of intralipid and heparin on human monocyte and lymphocyte function. , 1984, JPEN. Journal of parenteral and enteral nutrition.

[27]  Pickering Lk,et al.  Mechanisms of intralipid effect on polymorphonuclear leukocytes. , 1983 .

[28]  I. Julander,et al.  The effect of intralipid on mononuclear and polymorphonuclear phagocytes. , 1983, The American journal of clinical nutrition.

[29]  M. McCarthy,et al.  Essential fatty acid deficiency in critically III surgical patients , 1981 .

[30]  J. Nordenström,et al.  Decreased chemotactic and random migration of leukocytes during Intralipid infusion. , 1979, The American journal of clinical nutrition.