Influence of intravenous n‐3 lipid supplementation on fatty acid profiles and lipid mediator generation in a patient with severe ulcerative colitis

Abstract

N-3 fatty acids were supplied to a 36-year-old female patient suffering from ulcerative colitis and severe steroid side-effects, in a sequence of parenteral and enteral administration. During a moderately active period of disease, 200 ml d-1 fish oil-derived lipid emulsion (eicosapentaenoic acid [EPA], 4.2 g; docosahexaenoic acid [DHA], 4.2 g) was infused for 9 days, in parallel with rapid tapering of the steroid dose. Disease activity declined rapidly, and the patient was subsequently provided with 16 fish oil capsules per day (EPA, 2.9 g; DHA, 1.9 g) for 2 months. At the end of this period of therapy, severe colitis recurred with intestinal and extraintestinal manifestations. The n-3 lipid emulsion was then used for intravenous alimentation (29 days, maximum dose 300 ml per day); during this time, marked improvement of the inflammatory bowel disease was noted. During both periods of parenteral n-3 lipid administration, total plasma EPA and DHA contents increased several-fold, surpassing that of arachidonic acid; this plasma n-3 fatty acid enrichment was only maintained to a minor extent during the intermediate period of dietary fish oil supplementation. The intravenously administered EPA-containing triglycerides were rapidly hydrolyzed, as evidenced by the appearance of substantial quantities of EPA in the plasma free fatty acid fraction. Platelet and neutrophil total membrane content of EPA and DHA as well as n-3 fatty acid/AA membrane ratios similarly increased during the periods of intravenous n-3 lipid administration and declined during oral fish oil uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

ω-3 Fatty acids suppress monocyte adhesion to human endothelial cells: role of endothelial PAF generation

“…This effect of the -3 fatty acids oc-curred independent of the endothelial expression of the adhesion molecules ICAM-1, VCAM-1, E-selectin, and P-selectin but is probably related to the suppression of endothelial PAF synthesis by EPA and DHA. The applied concentrations of -3 fatty acids (10 mol/l) are in the range of free plasmatic EPA/DHA levels appearing under long-term oral supplementation with fish oil (4) and under short-term infusion of fish oil-based -3-based lipid emulsions; the latter approach even provoked plasmatic-free EPA/DHA concentrations of Ͼ100 mol/l in septic patients (11,25). The impressive effect of -3 fatty acids on monocyte-endothelium interaction may be of interest for dampening inflammatory processes in acute and chronic diseases, in which activation and transmigration of mononuclear cells largely contribute to the pathogenic sequels.…”

Short-Time Infusion of Fish Oil-Based Lipid Emulsions, Approved for Parenteral Nutrition, Reduces Monocyte Proinflammatory Cytokine Generation and Adhesive Interaction with Endothelium in Humans

“…In contrast, when administering a fish oil-based lipid emulsion via i.v. in patients with inflammatory bowel and skin disease, we recently demonstrated rapid changes in cell membrane fatty acid composition and lipid mediator generation (13,14).…”

Pharmaconutrition with Omega-3 Fatty Acids: Status Quo and Further Perspectives

“…In the last decade first studies describing beneficial effects of fish oil on the regulation of the cellular immune response were performed in chronic inflammatory diseases or autoimmune processes, such as ulcerative colitis [30], atopic dermatitis, or rheumatoid arthritis. Interestingly enough, these work focused on diseases in which the dysbalance of pro-and anti-inflammatory features is integral part of the respective pathomechanisms [31].…”