Constant infusion rates of lipid emulsions to stabilize plasma triglyceride concentrations: Medium-chain triglyceride/long-chain triglyceride emulsions (MCT/LCT) versus LCT

Iriyama, Keiji; Miki, Chikao; Inoue, Takahito; Kawarabayashi, Nobuaki; Urata, Hisashi; Shigemori, Chika

doi:10.1007/s005950050123

Cited by 9 publications

(8 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This observation was made at a 'clinically physiological' triglyceride concentration of 1 mmol L -1 , i.e. well within the ranges (up to 10 mmol L -1 ) reported with the infusion of parenteral lipid emulsions in clinical practice [15,16]. Furthermore, as for PUFA, the effects at this concentration seem dependent on the carbon-chain length of the involved fatty acids.…”

Section: Discussionsupporting

confidence: 81%

Saturated triglycerides and fatty acids activate neutrophils depending on carbon chain‐length

Wanten¹,

Janssen²,

Naber³

2002

Eur J Clin Investigation

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 81%

Saturated triglycerides and fatty acids activate neutrophils depending on carbon chain‐length

Wanten¹,

Janssen²,

Naber³

2002

Eur J Clin Investigation

View full text Add to dashboard Cite

show abstract

“…33 The initial supply of LE should be slow (Х0.05 g of lipid/kg of body weight/h) during the first 30 minutes, and then the infusion speed is increased gradually until about 0.1 g lipid/kg body weight/h. 34 In pediatric patients, LE infusions should begin at 0.5-1 g/kg per day and advance progressively at a rate of 0.5 g/kg per day to a maximum of 3 g/kg per day, except in the premature or septic infants, when LE infusion rates should be reduced. 35 Excess LE administration should be avoided because it can lead to respiratory distress, coagulopathies, abnormal liver functions test, impaired reticuloendothelial system function, immunosuppression (result of fat overload), hypercholesterolemia (due to liposome excess), and hypertriglyceridemia.…”

Section: Le In Clinical Practicementioning

confidence: 99%

New Parenteral Lipid Emulsions for Clinical Use

Waitzberg

Torrinhas

Jacintho

2006

J Parenter Enteral Nutr

199

193

View full text Add to dashboard Cite

Routine use of parenteral lipid emulsions (LE) in clinical practice began in 1961, with the development of soybean oil (SO) - based LE. Although clinically safe, experimental reports indicated that SO-based LE could exert a negative influence on immunological functions. Those findings were related to its absolute and relative excess of omega-6 polyunsaturated fatty acids (PUFA) and the low amount of omega-3 PUFA and also to its high PUFA content with an increased peroxidation risk. This motivated the development of new LE basically designed along the reduction of omega-6 PUFA and the omega-3 PUFA addition in order to obtain balanced levels of the omega-6/omega-3 ratio. The new LE for clinical use (available in Europe and South America) are differentiated by their content in polyunsaturated (omega-6 and omega-3), monounsaturated, and saturated fatty acids (FA), as well as FA source of their origin, including soy, coconut, olive, and fish oil. This article presents the new LE nutrition and energy functions but also its biochemical, metabolic, and immunomodulating aspects, according to their FA content. LE at 20% when infused from 1.0 to 2.0 g/kg body weight/day rates, either alone or in association with amino acids and glucose, are safe and well tolerated in routine clinical practice. LE combining SO with medium-chain triglycerides and/or olive oil have less omega-6 PUFA and are better metabolized, with less inflammatory and immunosuppressive effects than in relation to pure SO-based LE. The omega-3 PUFA used alone or as component of a new and complex LE (soy, MCT, olive and fish oil) has demonstrated anti-inflammatory and immunomodulatory effects.

show abstract

“…In order to stabilize plasma triglyceride concentrations at a clinically relevant concentration of 3 to 5 mmol/liter, emulsions (overall, ca. 220 ml) were infused according to a triglyceride-clamp schedule (16,17). For emulsion characteristics, see Table 1.…”

mentioning

confidence: 99%

Parenteral Administration of Medium- but Not Long-Chain Lipid Emulsions May Increase the Risk for Infections byCandida albicans

Wanten¹,

Netea²,

Naber³

et al. 2002

Infect Immun

View full text Add to dashboard Cite

Intravenous administration to volunteers of an emulsion of medium-chain lipids, but not of an emulsion of pure long-chain lipids or a placebo, increased the growth of Candida albicans in serum and modulated Candida-induced cytokine production by mononuclear cells in a way suggesting that medium-chain, but not long-chain, triglycerides increase the risk for infections by Candida.The provision of total parenteral nutrition (TPN) is an indispensable strategy to improve the nutritional status of critically ill patients. However, altered immune responses by the TPN lipid component may contribute to the increased rate of infectious complications for these patients (43). It remains unclear whether structurally different lipid emulsions containing either pure long-chain triglycerides (LCT) or mixed longand medium-chain triglycerides (LCT-MCT) exert distinct immune-modulating effects (1, 3, 4, 7, 8, 10, 12-15, 18, 25, 27, 28, 32, 33, 35-37, 40, 42, 43, 44). Recently, we found that LCT-MCT, unlike LCT, increase in vitro oxygen radical production and adhesion of neutrophils but decrease cellular motility and killing of Candida albicans (20,(45)(46)(47)(48). This observation is important because clinical studies indicate that 5% of all patients receiving TPN develop candidemia, with significant mortality and morbidity (38).In the present study, we exposed LCT and LCT-MCT to the metabolisms and immune systems of healthy volunteers. We investigated the effects of lipids on two pathogenetic aspects of Candida infections: yeast growth and the balance of proinflammatory (gamma interferon [␥-IFN], tumor necrosis factor alpha [TNF-␣], interleukin-1␤ , and IL-6) and anti-inflammatory (IL-10) cytokines (2,19,29,30,34,41).Emulsions containing LCT, LCT-MCT, or saline were administered during 4 h to eight volunteers in a study with a crossover design and a 1-week washout period. Blood samples were taken before and after 4 h of lipid or placebo administration and analyzed as described below. In order to stabilize plasma triglyceride concentrations at a clinically relevant concentration of 3 to 5 mmol/liter, emulsions (overall, ca. 220 ml) were infused according to a triglyceride-clamp schedule (16,17). For emulsion characteristics, see Table 1.Leukocytes were isolated from 20 ml of blood anticoagulated with lithium-heparin (6,21,45). Peripheral blood mononuclear cells (PBMC) were removed and suspended in medium (RPMI 1640 DM; Flow Laboratories, Irvine, United Kingdom). Heat-killed C. albicans (strain UC820; final concentration, 10 7 CFU/ml) was used for ex vivo PBMC stimulation in the cytokine assays. After PBMC isolation, cell numbers were adjusted (5 ϫ 10 6 /ml) and cell suspension samples were incubated with Candida (24 h, 37°C). After incubation, the supernatants were frozen (Ϫ20°C) until assayed. IL-1␤ and TNF-␣ (both in nanograms per milliliter) in supernatants were measured by radioimmunoassays as described previously (23). Detection limits of the assay were 20 pg/ml for TNF-␣ and 40 pg/ml for IL-1␤. Interassay variation was les...

show abstract

Constant infusion rates of lipid emulsions to stabilize plasma triglyceride concentrations: Medium-chain triglyceride/long-chain triglyceride emulsions (MCT/LCT) versus LCT

Cited by 9 publications

References 12 publications

Saturated triglycerides and fatty acids activate neutrophils depending on carbon chain‐length

Saturated triglycerides and fatty acids activate neutrophils depending on carbon chain‐length

New Parenteral Lipid Emulsions for Clinical Use

Parenteral Administration of Medium- but Not Long-Chain Lipid Emulsions May Increase the Risk for Infections byCandida albicans

Contact Info

Product

Resources

About