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Abstract

Background: Lack of enteral nutrition reduces gut-associated lymphoid tissue (GALT) mass and function, a mechanism underlying the increased morbidity of infectious complications in severely injured or critically ill patients. Strategies to restore parenteral nutrition (PN)–induced changes of GALT mass and function have been pursued. However, the influences of adding fish oil to PN on gut immunity remain to be clarified. Methods: Male Institute of Cancer Research (ICR) mice (n = 50) were randomized to 4 groups: ad libitum chow (chow), fat free PN (fat (–)-PN), PN + fish oil (FO-PN), and PN + safflower oil (SO-PN). The PN groups were given isocaloric and isonitrogenous PN solutions. The FO- and SO-PN groups received 20% of total calories from fat emulsions. After 5 days of feeding, lymphocytes from Peyer's patches (PPs), the intraepithelial space (IE), and the lamina propria (LP) of the entire small intestine were isolated. GALT lymphocyte numbers and phenotypes (CD4+, CD8+, αβTCR+,γδ TCR+, B220+ cells) were determined. Immunoglobulin A (IgA) levels of small intestinal washings were also measured by enzyme-linked immunosorbent assay. Another set of mice (n = 24) was used to determine plasma fatty acid compositions after feeding. Results: Lymphocyte numbers from PPs and the LP and intestinal IgA levels were significantly lower in the PN groups than in the chow group, with no significant differences between any 2 PN groups. The FO- and SO-PN groups showed moderate recovery of IE cell numbers compared with the fat (–)-PN group. Ω-3 and ω-6 fatty acid levels were increased with fish and safflower oil additions, respectively, compared with the fat (–)-PN group. Conclusions: Adding fish oil to PN does not exacerbate PN-induced GALT changes but rather partially reverses these changes, with increased plasma ω-3 fatty acid levels.

We studied the influence of fish oil, added to parenteral nutrition (PN), on gut-associated lymphoid tissue (GALT) mass and function. Fish oil did not exacerbate PN-induced GALT atrophy but rather partially reversed such changes.

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References

Moore FA. Effects of immune-enhancing diets on infectious morbidity and multiple organ failure. JPEN J Parenter Enteral Nutr. 2001 ;25(2 suppl):S36– S42.

Senkal M, Haaker R, Linseisen J, Wolfram G, Homann HH, Stehle P. Preoperative oral supplementation with long-chain omega-3 fatty acids beneficially alters phospholipid fatty acid patterns in liver, gut mucosa, and tumor tissue. JPEN J Parenter Enteral Nutr. 2005 ;29:236– 240.

Bastian L, Weimann A. Immunonutrition in patients after multiple trauma. Br J Nutr. 2002 ;87(suppl 1):S133– S134.

Heyland DK, Novak F, Drover JW, Jain M, Su X, Suchner U. Should immunonutrition become routine in critically ill patients? A systematic review of the evidence. JAMA. 2001 ;286:944– 953.

Consensus recommendations from the US Summit on Immune-Enhancing Enteral Therapy. JPEN J Parenter Enteral Nutr. 2001 ;25(2 suppl):S61– S63.

Furst P, Kuhn KS. Fish oil emulsions: what benefits can they bring?Clin Nutr. 2000;19:7– 14.

James MJ, Gibson RA, Cleland LG. Dietary polyunsaturated fatty acids and inflammatory mediator production. Am J Clin Nutr. 2000 ;71(1 suppl):343S– 348S.

Heller AR, Rossler S, Litz RJ, et al. Omega-3 fatty acids improve the diagnosis-related clinical outcome. Crit Care Med. 2006 ;34:972– 979.

Roulet M, Frascarolo P, Pilet M, Chapuis G. Effects of intravenously infused fish oil on platelet fatty acid phospholipid composition and on platelet function in postoperative trauma. JPEN J Parenter Enteral Nutr. 1997;21:296– 301.

10.

Yao GX, Xue XB, Jiang ZM, Yang NF, Wilmore DW. Effects of perioperative parenteral glutamine-dipeptide supplementation on plasma endotoxin level, plasma endotoxin inactivation capacity and clinical outcome.Clin Nutr. 2005;24:510– 515.

11.

Hulsewe KW, van Acker BA, Hameeteman W, et al. Does glutamine-enriched parenteral nutrition really affect intestinal morphology and gut permeability? Clin Nutr. 2004 ;23:1217– 1225.

12.

Wu XT, Li JS, Zhao XF, et al. Effects of n-3 fatty acid, fructose-1,6-diphosphate and glutamine on mucosal cell proliferation and apoptosis of small bowel graft after transplantation in rats. World J Gastroenterol. 2003;9:1323– 1326.

13.

Avula CP, Zaman AK, Lawrence R, Fernandes G. Induction of apoptosis and apoptotic mediators in Balb/C splenic lymphocytes by dietary n-3 and n-6 fatty acids. Lipids. 1999 ;34:921– 927.

14.

Purasiri P, McKechnie A, Heys SD, Eremin O. Modulation in vitro of human natural cytotoxicity, lymphocyte proliferative response to mitogens and cytokine production by essential fatty acids.Immunology. 1997;92:166– 172.

15.

Endres S, Meydani SN, Ghorbani R, Schindler R, Dinarello CA. Dietary supplementation with n-3 fatty acids suppresses interleukin-2 production and mononuclear cell proliferation. J Leukoc Biol. 1993 ;54:599– 603.

16.

Latham P, Lund EK, Brown JC, Johnson IT. Effects of cellular redox balance on induction of apoptosis by eicosapentaenoic acid in HT29 colorectal adenocarcinoma cells and rat colon in vivo. Gut. 2001 ;49:97– 105.

17.

Sitren HS, Heller PA, Bailey LB, Cerda JJ. Total parenteral nutrition in the mouse: development of a technique. JPEN J Parenter Enteral Nutr. 1983;7:582– 586.

18.

Mahaffey SM, Copeland EM III, Talbert JL, Baumgartner TG, Sitren HS. Further studies of a technique for total parenteral nutrition in the mouse. Nutr Res. 1985;5:1121– 1130.

19.

Li J, Kudsk KA, Gocinski B, Dent D, Glezer J, Langkamp-Henken B. Effects of parenteral and enteral nutrition on gut-associated lymphoid tissue.J Trauma. 1995;39:44– 51; discussion 51–52.

20.

Folch J, Lees M, Sloane Stanley GH. A simple method for the isolation and purification of total lipids from animal tissues. J Biol Chem. 1957;226:497– 509.

21.

Metcalfe LD, Schmitz AA, Pelka JR. Rapid preparation of fatty acid esters from lipids for gas chromatographic analysis. Anal Chem. 1966 ;38:514– 515.

22.

Bannon CD, Craske JD, Hai NT, Harper NL, O'Rourke KL. Analysis of fatty acid methyl esters with high accuracy and reliability, II: methylation of fats and oils with boron trifluoride-methanol. J Chromatogr A. 1982;247:63– 69.

23.

Kudsk KA, Li J, Renegar KB. Loss of upper respiratory tract immunity with parenteral feeding. Ann Surg. 1996 ;223:629– 635.

24.

Johnson CD, Kudsk KA. Nutrition and intestinal mucosal immunity.Clin Nutr. 1999;18:337– 344.

25.

Salmi M, Jalkanen S. Lymphocyte homing to the gut: attraction, adhesion, and commitment. Immunol Rev. 2005 ;206:100– 113.

26.

King BK, Kudsk KA, Li J, Wu Y, Renegar KB. Route and type of nutrition influence mucosal immunity to bacterial pneumonia. Ann Surg. 1999;229:272– 278.

27.

Johnson CD, Kudsk KA, Fukatsu K, Renegar KB, Zarzaur BL. Route of nutrition influences generation of antibody-forming cells and initial defense to an active viral infection in the upper respiratory tract. Ann Surg. 2003;237:565– 573.

28.

Alverdy JA, Aoys E, Weiss-Carrington P, Burke DA. The effect of glutamine-enriched TPN on gut immune cellularity. J Surg Res. 1992 ;52:34– 38.

29.

Wildhaber BE, Yang H, Teitelbaum DH. Total parenteral nutrition-induced apoptosis in mouse intestinal epithelium: modulation by keratinocyte growth factor. J Surg Res. 2003 ;112:144– 151.

30.

Okamoto K, Fukatsu K, Ueno C, et al. T lymphocyte numbers in human gut associated lymphoid tissue are reduced without enteral nutrition.JPEN J Parenter Enteral Nutr. 2005 ;29:56– 58.

31.

Wu Y, Kudsk KA, DeWitt RC, Tolley EA, Li J. Route and type of nutrition influence IgA-mediating intestinal cytokines. Ann Surg. 1999;229:662– 667.

32.

Dunstan JA, Roper J, Mitoulas L, Hartmann PE, Simmer K, Prescott SL. The effect of supplementation with fish oil during pregnancy on breast milk immunoglobulin A, soluble CD14, cytokine levels and fatty acid composition. Clin Exp Allergy. 2004 ;34:1237– 1242.

33.

Costabile M, Hii CS, Robinson BS, et al. A novel long chain polyunsaturated fatty acid, beta-Oxa 21:3n-3, inhibits T lymphocyte proliferation, cytokine production, delayed-type hypersensitivity, and carrageenan-induced paw reaction and selectively targets intracellular signals. J Immunol. 2001 ;167:3980– 3987.

34.

Kudsk KA. Current aspects of mucosal immunology and its influence by nutrition. Am J Surg. 2002 ;183:390– 398.

Influence of Adding Fish Oil to Parenteral Nutrition on Gut-Associated Lymphoid Tissue

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