n–3 PUFAs in cancer, surgery, and critical care: a systematic review on clinical effects, incorporation, and washout of oral or enteral compared with parenteral supplementation

Meij, Barbara S. van der; Schueren, Marian A.E. de van der; Langius, J.A.E.; Brouwer, Ingeborg A.; Leeuwen, Paul A. M. van

doi:10.3945/ajcn.110.007377

Cited by 59 publications

(30 citation statements)

References 69 publications

(257 reference statements)

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“…After Omegaven ® infusions, the concentrations of EPA in plasma and WBC increased, and the AA/EPA ratio in plasma and WBC phospholipids decreased. The increase of EPA in plasma PL in this patient (around 2%) was comparable with the increase resulting in immune-modulation in earlier studies [30], but was lower than the increase reached in other studies in cancer patients [20,31]. In patient 2, monocytes were isolated to explore the incorporation and washout of n-3 PUFA from these cells.…”

Section: Discussionsupporting

confidence: 77%

“…The incorporation in cancer patients after enteral supplementation was thought to be at least 3 to 4 weeks [19,32], but an increasing number of studies show the incorporation to occur within a day [30,33,34]. Depending on the frequency of blood sampling, incorporation within one or more days was also demonstrated after parenteral supplementation of n-3 PUFA in patients with sepsis and around surgery [31]. We took blood samples 2 days after the first infusion of Omegaven ® , and found incorporation of n-3 PUFA in WBC and plasma phospholipids.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility of Intermittent Fish Oil Infusions in Outpatients with Graft- Versus-Host Disease of the Digestive Tract

et al. 2013

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N-3 polyunsaturated fatty acids from fish oil may have immune-modulating effects in Graft-versus-Host Disease of the digestive tract (GVHD-DT). The objective of this pilot study was to investigate feasibility, safety and effects on fatty acid composition of plasma lipids and white blood cells (WBC), following intermittent fish oil infusion in outpatients with chronic GVHD-DT. Four outpatients received intermittent infusion of a 10% fish oil emulsion (Omegaven) during 4 hours, at day 1 (1.5 mL/kg), 3 (2.25 mL/kg) and 5, 8, 10 and 12 (3 mL/kg). At baseline and consecutive visits, fatty acid composition of plasma triglycerides (TG), plasma phospholipids (PL) and WBC, serum TG concentrations, routine laboratory tests, as well as adverse events were monitored. During the fish oil infusions, serum TG increased, but decreased 2 h after termination of infusion. In 3 patients, the dose of Omegaven ® needed to be reduced. EPA was incorporated into plasma PL, plasma TG and WBC as of 2 days after the first infusion; peak levels of EPA were reached at the final infusion, or 2 days after. In conclusion, intermittent fish oil infusions result in incorporation of EPA in plasma and WBC, but can be complicated by a reversible increase in serum triglycerides.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Feasibility of Intermittent Fish Oil Infusions in Outpatients with Graft- Versus-Host Disease of the Digestive Tract

et al. 2013

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“…Epidemiologic and experimental data have suggested that consumption of fish oil (FO) rich in u-3 polyunsaturated fatty acids (PUFAs) may play a role not only in cancer prevention but also in cancer therapy [1,2]. Although different mechanisms of action have been discussed in the literature [3], the anticancer properties of u-3 PUFAs have been primarily ascribed to their ability to downregulate proinflammatory eicosanoid synthesis from cyclooxygenase-2 (COX-2) [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Vitamin E content in fish oil emulsion does not prevent lipoperoxidative effects on human colorectal tumors

et al. 2013

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a b s t r a c tObjective: The anticancer action exerted by polyunsaturated fatty acid peroxidation may not be reproduced by commercially available lipid emulsions rich in vitamin E. Therefore, we evaluated the effects of fish oil (FO) emulsion containing a-tocopherol 0.19 g/L on human colorectal adenocarcinoma cells and tumors. Methods: HT-29 cell growth, survival, apoptosis, and lipid peroxidation were analyzed after a 24-h incubation with FO 18 to 80 mg/L. Soybean oil (SO) emulsion was used as an isocaloric and isolipidic control. In vivo, nude mice bearing HT-29 tumors were sacrificed 7 d after an 11-d treatment with intravenous injections of FO or SO 0.2 g • kg À1 • d À1 FO or SO to evaluate tumor growth, necrosis, and lipid peroxidation. Results: The FO inhibited cell viability and clonogenicity in a dose-dependent manner, whereas SO showed no significant effect compared with untreated controls. Lipid peroxidation and cell apoptosis after treatment with FO 45 mg/L were increased 2.0-fold (P < 0.01) and 1.6-fold (P ¼ 0.04), respectively. In vivo, FO treatment did not significantly affect tumor growth. However, immunohistochemical analyses of tumor tissue sections showed a decrease of 0.6-fold (P < 0.01) in the cell proliferation marker Ki-67 and an increase of 2.3-fold (P ¼ 0.03) in the necrotic area, whereas malondialdehyde and total peroxides were increased by 1.9-fold (P ¼ 0.09) and 7.0-fold (P < 0.01), respectively, in tumors of FO-treated compared with untreated mice. Conclusion: These results suggest that FO but not SO has an antitumor effect that can be correlated with lipid peroxidation, despite its vitamin E content.

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“…Three recent systematic reviews outlined the effects of the supplementation of n-3 PUFA and two of them focused on parenteral supplementation (87)(88)(89) .…”

Section: N-3 Pufamentioning

confidence: 99%

Novel nutritional substrates in surgery

et al. 2013

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Pharmaco-nutrients have beneficial effects on protective and immunological mechanisms in patients undergoing surgery, which are important for recovery after injury and in combating infectious agents. The aim of this review article was to outline the potential of the administration of nutritional substrates to surgical patients and the underlying mechanisms that make them particularly important in peri-operative care. Surgery causes a stress response, which has catabolic effects on the body's substrate stores. The amino acid glutamine is a stimulating agent for immune cells. It activates protective mechanisms through its role as a precursor for antioxidants and it improves the barrier function of the gut. Arginine also enhances the function of the immune system, since it is the substrate for T-lymphocytes. Furthermore, n-3 PUFA stabilise surgery-induced hyper-inflammation. Taurine is another substrate that may counteract the negative effects of surgical injury on acid–base balance and osmotic balance. These pharmaco-nutrients rapidly become deficient under the influence of surgical stress. Supplementation of these nutrients in surgical patients may restore their protective and immune-enhancing actions and improve clinical outcome. Moreover, pre-operative fasting is still common practice in the Western world, although fasting has a negative effect on the patient's condition and the recovery after surgery. This may be counteracted by a simple intervention such as administering a carbohydrate-rich supplement just before surgery. In conclusion, there are various nutritional substrates that may be of great value in improving the condition of the surgical patient, which may be beneficial for post-operative recovery.

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n–3 PUFAs in cancer, surgery, and critical care: a systematic review on clinical effects, incorporation, and washout of oral or enteral compared with parenteral supplementation

Abstract: This review shows the beneficial effects of n-3 FA supplementation in cancer, surgical oncology, and critical care patients. Supplementation in these specific patient populations could be considered with the route of administration taken into account.

Cited by 59 publications

References 69 publications

Feasibility of Intermittent Fish Oil Infusions in Outpatients with Graft- Versus-Host Disease of the Digestive Tract

Feasibility of Intermittent Fish Oil Infusions in Outpatients with Graft- Versus-Host Disease of the Digestive Tract

Vitamin E content in fish oil emulsion does not prevent lipoperoxidative effects on human colorectal tumors

Novel nutritional substrates in surgery

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