Current status of lipid emulsions in the prevention of intestinal failure-associated liver disease

Lim, Joel D.; Oschman, Alexandra; Curiel, Kayla

doi:10.1097/mot.0000000000000620

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…Since IFALD can become a life-threatening complication, there is ongoing discussion about the type of ILE that is most beneficial in patients dependent on PN [ 26 , 27 , 28 , 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

High Dose Intravenous Fish Oil Reduces Inflammation—A Retrospective Tale from Two Centers

Kłęk¹,

Mańkowska-Wierzbicka

Ścisło

et al. 2020

Nutrients

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Aim: Patients on parenteral nutrition (PN) are prone to inflammation. This may aggravate an existing proinflammatory state and become a critical factor in the development of liver dysfunction (LD). Intravenous fish oil may attenuate this inflammatory state, but data on its use in adults are scarce. The aim of this study was to investigate the effects of adding a pure fish oil intravenous lipid emulsion (ILE) into short- and long-term PN in patients either at risk of, or with existing, inflammation. Methods: A retrospective analysis of 61 patients (32 female, 29 male, mean age 51.5 ± 12.6 years) who received all-in-one PN, including amino acids, glucose, and lipids supplemented with pure fish oil ILE, was performed. Pure fish oil ILE (Omegaven®, Fresenius Kabi, Bad Homburg, Germany) was used along with the standard ILE to reach a fish oil dose of 0.4–0.5 g fish oil/kg/d. Diagnoses were chronic intestinal failure (CIF, n = 20), Crohn’s disease (CD, n = 22), and ulcerative colitis (UC, n = 19). The observation period was 12 months for CIF and 21 days for UC and CD. Results: A reduction in inflammation was noticeable in all patients and became statistically significant in CD (hsCRP p < 0.0001, ESR p = 0.0034, procalcitonin p = 0.0014, Il-6 p = 0.001) and UC groups (hsCRP and ESR p < 0.0001, Il-6 p = 0.0001, TNF-α p = 0.0113). In the CIF group, the total bilirubin concentration (p = 0.2157) and aspartate transaminase SGOT (p = 0.1785) did not vary over time. Conclusions: PN with pure fish oil ILE reduces some inflammatory parameters in IBD and maintains liver function parameters in CIF patients. Fish oil might become a valuable ingredient in both short- and long-term PN in patients at risk of liver dysfunction.

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“…Since IFALD can become a life-threatening complication, there is ongoing discussion about the type of ILE that is most beneficial in patients dependent on PN [ 26 , 27 , 28 , 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

High Dose Intravenous Fish Oil Reduces Inflammation—A Retrospective Tale from Two Centers

Kłęk¹,

Mańkowska-Wierzbicka

Ścisło

et al. 2020

Nutrients

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“…Soybean oil–based lipid emulsions should be prescribed as <1 g/kg/day 5 as infusion rates greater than this prevent adequate clearance of phospholipids and fatty acids in the liver, which can lead to increased deposition 33 . Soy‐based lipid emulsions are predominantly ω‐6 fatty acids with high amounts of phytosterols and have been long associated with cholestasis, 34 whereas mixed oil lipid emulsions have recently emerged for use in the US and have been shown to be safe and well‐tolerated and improve cholestasis in studies 35 . With the use of mixed lipid emulsions, lipid provision can be increased up to 2.5 g/kg/day, allowing for reduced dextrose provision 36 .…”

Section: Pretransplant Nutrition Supportmentioning

confidence: 99%

Nutrition care for the adult post–intestinal transplant patient

Dowhan,

Moccia,

Fujiki

2023

Nut in Clin Prac

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Intestinal transplantation has emerged as an accepted treatment choice for individuals experiencing irreversible intestinal failure. This treatment is particularly relevant for those who are not candidates or have poor response to autologous gut reconstruction or trophic hormone therapy, and who can no longer be sustained on parenteral nutrition. One of the main goals of transplant is to eliminate the need for parenteral support and its associated complications, while safely restoring complete nutrition autonomy. An intestinal transplant is a complex process that goes beyond merely replacing the intestines to provide nourishment and ceasing parenteral support. It requires an integrated management approach in the pretransplant and posttransplant setting, and high‐quality nutrition treatment is one of the cornerstones leading to favorable outcomes and long‐term management. Since the outset of intestinal transplant in the early 2000s, there is observed improvement of achieving nutrition autonomy sooner in the initial posttransplant phase; however, the development of nutrition complications in the chronic posttransplant period remains a long‐term risk. This review delineates the decision‐making process and clinical protocols used to nutritionally manage and monitor pre– and post–intestine transplant patients.

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“…Chronic reduction in the soybean oil-based lipid emulsion administration seems to outweigh the benefits. Soybean oil-based lipid emulsions contain an essential fatty acid which deficiency is particularly undesirable in the preterm infant due to possible impairment in brain growth and development [ 8 ]. Therefore, the second approach involving searching for active compounds that may reduce the problem of IFALD, including cholestasis and hepatic steatosis in PN-depended patients, attracts more and more attention.…”

Section: Introductionmentioning

confidence: 99%

The Development of Magnolol-Loaded Intravenous Emulsion with Low Hepatotoxic Potential

Gostyńska,

Czerniel,

Kuźmińska

et al. 2023

Pharmaceuticals

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Intestinal failure-associated liver disease (IFALD) is a severe liver injury occurring due to factors related to intestinal failure and parenteral nutrition administration. Different approaches are studied to reduce the risk or ameliorate the course of IFALD, including providing omega-3 fatty acids instead of soybean oil-based lipid emulsion or administering active compounds that exert a hepatoprotective effect. This study aimed to develop, optimize, and characterize magnolol-loaded intravenous lipid emulsion for parenteral nutrition. The preformulation studies allowed for chosen oils mixture of the highest capacity of magnolol solubilization. Then, magnolol-loaded SMOFlipid was developed using the passive incorporation method. The Box–Behnken design and response surface methodology were used to optimize the entrapment efficiency. The optimal formulation was subjected to short-term stress tests, and its effect on normal human liver cells and erythrocytes was determined using the MTT and hemolysis tests, respectively. The optimized magnolol-loaded SMOFlipid was characterized by the mean droplet diameter of 327.6 ± 2.9 nm with a polydispersity index of 0.12 ± 0.02 and zeta potential of −32.8 ± 1.2 mV. The entrapment efficiency of magnolol was above 98%, and pH and osmolality were sufficient for intravenous administration. The magnolol-loaded SMOFlipid samples showed a significantly lower toxic effect than bare SMOFlipid in the same concentration on THLE-2 cells, and revealed an acceptable hemolytic effect of 8.3%. The developed formulation was characterized by satisfactory stability. The in vitro studies showed the reduced cytotoxic effect of MAG-SMOF applied in high concentrations compared to bare SMOFlipid and the non-hemolytic effect on human blood cells. The magnolol-loaded SMOFlipid is promising for further development of hepatoprotective lipid emulsion for parenteral nutrition.

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Current status of lipid emulsions in the prevention of intestinal failure-associated liver disease

Cited by 6 publications

References 25 publications

High Dose Intravenous Fish Oil Reduces Inflammation—A Retrospective Tale from Two Centers

High Dose Intravenous Fish Oil Reduces Inflammation—A Retrospective Tale from Two Centers

Nutrition care for the adult post–intestinal transplant patient

The Development of Magnolol-Loaded Intravenous Emulsion with Low Hepatotoxic Potential

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