The effect of lipid-based parenteral nutrition was assessed in eight patients with AIDS and weight loss of 10% or greater. All patients received home parenteral nutrition consisting of a lipid-based system with 50% of nonprotein calories given as fat. Measurements were made of body weight, serum albumin, and immune function as assessed by mitogen responses, P24 antigen levels and T-cell counts. Over a period of 2 months, weight gain and improved well-being were noted in all patients. An improved in vitro lymphocyte mitogenic response to phytohemagglutinin and to concanavalin A was also noted. No change in T-cell subsets was observed. Viral cultures and P24 serum levels also remained unchanged. Lipid-based parenteral nutrition is safe and probably efficacious in AIDS. (Journal of Parenteral and Enteral Nutrition 16:165-167, 1992)
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References
1.
Centers for Disease Control: Revision of the CDC surveillance case definition for AIDS. MMWR36:3S-48S, 1987
2.
Levy JA: Human immunodeficiency viruses and the pathogenesis of AIDS. JAMA261:2997-3006, 1989
3.
Garr MA, Boles JM, Youinou PY: Current concepts in immune derangement due to undernutrition. JPEN11:309-313, 1987
4.
Singer P., Rothkopf MM, Kvetan V., et al: Risks and benefits of home parenteral nutrition in AIDS. JPEN15:75-79. 1991
5.
Jarstrand C. , Berghem L., Lahnborg G.: Human granulocyte and reticuloendothelial system function during Intralipid infusion. JPEN2:663-670, 1978
6.
Mertin J., Hughes D.: Specific inhibitory action of polyunsaturated fatty acids on lymphocyte transformation induced by PHA and PPD. Arch Allergy Appl Immunol48:203-210, 1975
7.
Fisher GW, Hunter KW, Wilson SR, et al: Diminished bacterial defenses with Intralipid. Lancet2:819-820, 1980
8.
Ladish S., Poplack D., Hiliman B., et al: Inhibition of lymphocyte blastogenesis by Intralipid. Clin Res26:284A, 1978
9.
Ellaurie M., Calvelli T., Rubinstein A.: Immune complexes in pediatric human immunodeficiency virus infection . Am J Dis Child144:1207-1209, 1990
10.
Devash Y., Calvelli TA, Wood DG, et al: Vertical transmission of human immunodeficiency virus is correlated with the absence of high -affinity/avidity maternal antibodies to the gp120 principal neutralizing domain. Proc Natl Acad Sci USA87:3445-3449, 1990
11.
Spanier AH, Pietsch JB, Meakins JL, et al: The relationship between immune competence and nutrition. Surg Forum27:332-336, 1976
12.
Mullin HM, Kirkpatrick JR: Effect of nutritional support on immune competency in patients suffering from trauma, sepsis or malignant disease. Surgery90:610-613, 1981
13.
Spallholz JE : Selenium: What role in immunity and immune cytotoxicity. IN Selenium in Biology and Medicine, Spallholz JE, Martin JC, Ganter HE (eds). Avi Publishing Co , Westport, CT, 1981, pp 103-117
14.
Dworkin BM, Rosenthal WS, Wormser GP, et al: Selenium deficiency in the AIDS. JPEN10:405-407, 1986
15.
Fernandes G. , Nair M., Onoe K., et al: Impairment of cell-mediated immunity functions by dietary zinc deficiency in mice. Proc Natl Acad Sci USA76:457-461, 1979
16.
Chandra RK: Nutrition, immunity and infection: Present knowledge and future directions . Lancet1:688-691, 1983
17.
Droge W., Eck HP, Naher H., et al: Abnormal amino acid concentrations in the blood of patients with AIDS may contribute to the immunological defect. Biochem Biophys Acta Biol Chem369:142- 148, 1988
18.
Leung KH, Mihich E.: Prostaglandin modulation of development of cell-mediated immunity in culture . Nature288:597-600, 1980
19.
Darrow TL, Tomar RH: Prostaglandin-mediated regulation of the mixed lymphocyte culture and generation of cytotoxic cells. Cell Immunol56:172-183, 1980
20.
Brune K., Aehringhaus U., Peskar BA: Pharmacological control of leukotriene and prostaglandin production from mouse peritoneal macrophages. Agents Actions14:729-734, 1976
21.
Skeie B., Askanazi J., Rothkopf MM, et al: Intravenous fat emulsions and lung function: a review. Crit Care Med16:183-194, 1988
22.
Singer P., Venus B., Bursztein S., et al: Effects of infusing different rates of Intralipid to ventilated patients. Clin Nutr8:S116, 1989
23.
Newberne PM , Thurman GB: Lipids and the immune system. Cancer Res41:3803-3804, 1981
24.
Aloia RC, Jensen FC, Curtain CC, et al: Lipid composition and fluidity of the human immunodeficiency virus. Proc Natl Acad Sci USA85:900-904, 1988
25.
Schaffner CP , Plescia OJ, Pontani D., et al: Anti-viral activity of Amphotericin B methyl ester: Inhibition of HTLV-III replication in cell culture. Biochem Pharmacol35:4110-4113, 1986
26.
Aviram M., Williams KJ, McIntosh RA, et al: Intralipid infusion abolishes ability of human serum of cholesterol-load cultured macrophages. Atherosclerosis9:67-75, 1989
27.
Helms RA, Herrod HG, Burckart GJ, et al: E-rosette formation, total T-cells, and lymphocyte transformation in infants receiving intravenous safflower oil emulsion. JPEN7:541-545, 1983
28.
Ota DM, Jessup JM, Babcock GF, et al: Immune function during administration of a soybean oil emulsion . JPEN9:23-27, 1986
29.
Nordenstrom J., Jastrand C., Wirmik A.: Decreased chemotactic and random migration of leukocytes during Intralipid infusion. Am J Clin Nutr32:2416-2422, 1979
30.
Ring J., Seifert J., Mertin J., et al: Prolongation of skin allografts in rats by treatment with linoleic acid. Lancet2:1331, 1974
