Impact of Clinical Use of Parenteral Lipid Emulsions on Bile Acid Metabolism and Composition in Neonatal Piglets

Lavallee, Celeste M.; Lim, David W.; Wizzard, Pamela; Mazurak, Vera C.; Mi, Si; Curtis, Jonathan M.; Willing, Benjamin P.; Yap, Jason; Wales, Paul W.; Turner, Justine

doi:10.1002/jpen.1437

Cited by 7 publications

(6 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Given this, the piglet has been a very useful model for studying neonatal PNAC development because of their large birth size and their metabolic needs are closer to that of humans. Piglets develop cholestasis from TPN within 2 weeks of SO-LE administration similar to human infants receiving TPN [ 51 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 ]. In piglets, this does not require the addition of any type of inflammatory insult, such as DSS.…”

Section: Lipid Emulsion Composition and Clinical Effectsmentioning

confidence: 99%

Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates

Guthrie

Burrin

2021

Nutrients

View full text Add to dashboard Cite

Total parenteral nutrition (TPN) is a life-saving intervention for infants that are unable to feed by mouth. Infants that remain on TPN for extended periods of time are at risk for the development of liver injury in the form of parenteral nutrition associated cholestasis (PNAC). Current research suggests the lipid component of TPN is a factor in the development of PNAC. Most notably, the fatty acid composition, vitamin E concentration, and presence of phytosterols are believed key mediators of lipid emulsion driven PNAC development. New emulsions comprised of fish oil and medium chain triglycerides show promise for reducing the incidence of PNAC in infants. In this review we will cover the current clinical studies on the benefit of fish oil and medium chain triglyceride containing lipid emulsions on the development of PNAC, the current constituents of lipid emulsions that may modulate the prevalence of PNAC, and potential new supplements to TPN to further reduce the incidence of PNAC.

show abstract

Section: Lipid Emulsion Composition and Clinical Effectsmentioning

confidence: 99%

Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates

Guthrie

Burrin

2021

Nutrients

View full text Add to dashboard Cite

show abstract

“…In contrast, fish oil containing lipid emulsions rich in EPA and DHA that derive antiinflammatory leukotriene B5, C5, D5, prostaglandin E3, prostagcyclin I3, and thromboxane A3, also mediated by the COX and 5-lipooxygenase pathways, might reduce inflammation reaction and improve liver function. Besides, PN containing fish oil increased gene expression of canalicular bile acid transporters, resulted in greater secretion of hydrophobic bile acids and increased bile flow in neonatal piglets [28,29] and rats [30]. These alterations may prevent cholestasis and explain the hepatoprotective effects of fish oil containing lipid emulsion.…”

Section: Discussionmentioning

confidence: 94%

Parenteral nutrition with fish oil-based lipid emulsion reduces the risk of cholestasis in preterm infants

WANG

Chen

Tsao

et al. 2019

Preprint

View full text Add to dashboard Cite

Background Preterm infants received long-term parenteral nutrition (PN) due to gastrointestinal immaturity. Mixed lipid emulsions composed of soybean oil, medium chain triglycerides (MCTs), olive oil, and fish oil, which have a relatively low ω-6: ω-3 ratio, may decrease the incidence of PN-associated cholestasis by reducing oxidative stress and providing an anti-inflammatory effect.Methods The retrospective cohort study enrolled a total 399 very low birth weight (VLBW) premature infants between January 2009 and November 2017 at a single neonatal intensive care unit. Preterm infants received total parenteral nutrition with either mixed lipid emulsion (SMOFlipid, n = 195) or soybean oil-based lipid emulsion (Lipovenoes, n = 204) for at least seven days. We compared the outcomes of PN-associated cholestasis, co-morbidities and mortality.Results The incidence of PN-associated cholestasis was significantly lower in the SMOFlipid group than the Lipovenoes group (10.3% vs 20.1%, P = 0.006). The related clinical laboratory findings, including levels of γ- GT (P = 0.019), triglyceride (P < 0.001), and cholesterol (P = 0.023), were significantly lower in the SMOFlipid group. The duration to full feeding days shortened in the SMOFlipid group compared with the Lipovenoes group (25 ± 10.33 vs 33 ± 16.22, P < 0.001). Relevant complications, such as severe retinopathy of prematurity (ROP, 3.6% vs 14.3%, P < 0.001) and bronchopulmonary dysplasia (BPD, 36.9% vs 46.7%, P = 0.046) were also reduced in the SMOFlipid group versus the Lipovenoes group, but there was no significant effect on severe intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), or mortality in both groups.Conclusions In very premature infants, PN with fish oil-based lipid emulsions is associated with a lower incidence of PN-associated cholestasis compared with soybean oil-based lipid emulsions.

show abstract

“… 36 In contrast, fish oil containing lipid emulsions that are rich in EPA and DHA might reduce an inflammatory reaction and improve liver function. Additionally, PN containing fish oil increases gene expression of canalicular bile acid transporters, resulting in greater secretion of hydrophobic bile acids and increased bile flow in neonatal piglets 37 , 38 and rats. 39 These alterations may prevent cholestasis and explain the hepatoprotective effects of fish oil containing lipid emulsion.…”

Section: Discussionmentioning

confidence: 99%

Parenteral nutrition with fish oil-based lipid emulsion reduces the risk of cholestasis in preterm infants

et al. 2021

View full text Add to dashboard Cite

Objective Preterm infants receive long-term parenteral nutrition (PN) for gastrointestinal immaturity. This study aimed to determine if mixed lipid emulsions containing fish oil decrease the incidence of PN-associated cholestasis by reducing oxidative stress and providing an anti-inflammatory effect. Methods This retrospective cohort study enrolled 399 very low birth weight premature infants (gestational age ≤32 weeks) between January 2009 and November 2017 at a single neonatal intensive care unit. Preterm infants received total PN with either mixed lipid emulsion including fish oil (SMOFlipid®, n = 195) or soybean oil-based lipid emulsion (Lipovenoes®, n = 204) for at least 7 days. We compared the outcomes of PN-associated cholestasis, comorbidities, and mortality between the groups. Results The incidence of PN-associated cholestasis was significantly lower in the SMOFlipid group than in the Lipovenoes group. The duration to full feeding days was significantly shorter in the SMOFlipid group compared with the Lipovenoes group. Relevant complications, such as severe retinopathy of prematurity and bronchopulmonary dysplasia, were also significantly reduced in the SMOFlipid group compared with the Lipovenoes group. Conclusion In premature infants, PN with fish oil-based lipid emulsions is associated with a lower incidence of PN-associated cholestasis compared with soybean oil-based lipid emulsions.

show abstract

Impact of Clinical Use of Parenteral Lipid Emulsions on Bile Acid Metabolism and Composition in Neonatal Piglets

Abstract: PN lipid modulation altered bile acid metabolism and composition. These alterations may explain the hepatoprotective effects of FO-containing PN lipids and support their use in the prevention and treatment of IFALD.

Cited by 7 publications

References 33 publications

Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates

Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates

Parenteral nutrition with fish oil-based lipid emulsion reduces the risk of cholestasis in preterm infants

Parenteral nutrition with fish oil-based lipid emulsion reduces the risk of cholestasis in preterm infants

Contact Info

Product

Resources

About