Supplemental Parenteral Vitamin E Into Conventional Soybean Lipid Emulsion Does Not Prevent Parenteral Nutrition–Associated Liver Disease in Full‐Term Neonatal Piglets

Muto, Mitsuru; Lim, David W.; Soukvilay, Amanda; Field, Catherine J.; Wizzard, Pamela; Goruk, Susan; Ball, Ronald O.; Pencharz, Paul B.; Mi, Si; Curtis, Jonathan M.; Wales, Paul W.; Turner, Justine

doi:10.1177/0148607115612030

Cited by 19 publications

(18 citation statements)

References 36 publications

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“…In premature, neonatal piglets administered TPN containing SO-LE at 5 g/kg/d, α-tocopherol supplemented to concentrations present in FO-LE prevented an increase in direct bilirubin and bile acid concentrations, similar to the effect of FO-LE in the study [29]. In two term neonatal piglet TPN studies where SO-LE was given at a higher lipid load (10 g/kg/d), supplemental vitamin E, as α-tocopherol, failed to prevent PNAC based on serum conjugated bilirubin and serum bile acid levels [83,106]. An interesting observation made in both studies, was that the vitamin E supplemented groups showed no change in serum markers of oxidant stress relative to the standard SO-LE treatment groups.…”

Section: Vitamin Esupporting

confidence: 58%

“…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%

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

Guthrie

Burrin

2021

Nutrients

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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.

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Section: Vitamin Esupporting

confidence: 58%

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

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“…At the same lipid dose of 5 g/(kg·d), we recently showed prevention of cholestasis in preterm piglets by supplementing IL with vitamin E to a concentration equivalent to that present in OV (32). However, a recent publication in term piglets administered IL supplemented with vitamin E at 10 g/(kg·d) failed to show any effect on treatment (50). In this study, there were no changes in oxidative markers in piglets as well, even with an elevated serum vitamin E concentration in the supplemented compared with control group.…”

Section: Discussionmentioning

confidence: 94%

Multi-omic profiles of hepatic metabolism in TPN-fed preterm pigs administered new generation lipid emulsions

Guthrie

Kulkarni

Vlaardingerbroek

et al. 2016

Journal of Lipid Research

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“…This group did show that SO-mediated deficits in bile acid clearance were ameliorated by adding α-tocopherol to a commercial SO [21]. However, similar studies performed by Muto et al in a neonatal piglet model of IFALD showed no improvements in bile flow, serum bile acid concentration, or serum direct bilirubin levels with the addition of α-tocopherol to a commercially available SO emulsion [28].…”

Section: Discussionmentioning

confidence: 99%

Alpha-tocopherol in intravenous lipid emulsions imparts hepatic protection in a murine model of hepatosteatosis induced by the enteral administration of a parenteral nutrition solution

et al. 2019

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Intestinal failure-associated liver disease (IFALD) is a risk of parenteral nutrition (PN)-dependence. Intravenous soybean oil-based parenteral fat can exacerbate the risk of IFALD while intravenous fish oil can minimize its progression, yet the mechanisms by which soybean oil harms and fish oil protects the liver are uncertain. Properties that differentiate soybean and fish oils include α-tocopherol and phytosterol content. Soybean oil is rich in phytosterols and contains little α-tocopherol. Fish oil contains abundant α-tocopherol and little phytosterols. This study tested whether α-tocopherol confers hepatoprotective properties while phytosterols confer hepatotoxicity to intravenous fat emulsions. Utilizing emulsions formulated in the laboratory, a soybean oil emulsion (SO) failed to protect from hepatosteatosis in mice administered a PN solution enterally. An emulsion of soybean oil containing α-tocopherol (SO+AT) preserved normal hepatic architecture. A fish oil emulsion (FO) and an emulsion of fish oil containing phytosterols (FO+P) protected from steatosis in this model. Expression of hepatic acetyl CoA carboxylase (ACC) and peroxisome proliferator-activated receptor gamma (PPARγ), was increased in animals administered SO. ACC and PPARγ levels were comparable to chow-fed controls in animals receiving SO+AT, FO, and FO+P. This study suggests a hepatoprotective role for α-tocopherol in liver injury induced by the enteral administration of a parenteral nutrition solution. Phytosterols do not appear to compromise the hepatoprotective effects of fish oil.

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Supplemental Parenteral Vitamin E Into Conventional Soybean Lipid Emulsion Does Not Prevent Parenteral Nutrition–Associated Liver Disease in Full‐Term Neonatal Piglets

Cited by 19 publications

References 36 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

Multi-omic profiles of hepatic metabolism in TPN-fed preterm pigs administered new generation lipid emulsions

Alpha-tocopherol in intravenous lipid emulsions imparts hepatic protection in a murine model of hepatosteatosis induced by the enteral administration of a parenteral nutrition solution

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