The Role of Phytosterols in the Pathogenesis of Liver Complications of Pediatric Parenteral Nutrition

Omega-3 Fatty Acid Supplementation Prevents Hepatic Steatosis in a Murine Model of Nonalcoholic Fatty Liver Disease

“…In 1982, Allardyce (52) described a cohort of 35 patients who received total parenteral nutrition with conventional lipid emulsions for Ͼ3 wk and concluded that the symptoms of cholestasis in these patients recovered when the lipid supplementation was reduced. These data were corroborated by other clinical observations (44,(53)(54)(55) and in animal models (56). A study by Zaman et al (57) demonstrated that isolated perfusion of rat livers with total parenteral nutrition that was supplemented with Intralipid led to more steatosis and poorer liver function than livers that were perfused with parenteral nutrition only.…”

Intravenous fish oil lipid emulsion promotes a shift toward anti-inflammatory proresolving lipid mediators

“…SOLE are also rich in phytosterols, compounds that are similar to cholesterol and are found in plants. Phytosterols are toxic to the liver; in neonatal piglets, intravenous phytosterols induce cholestasis (8). Furthermore, the provision of predominantly -3 or -6 lipids alters the composition of the cell membrane, which then alters the downstream production of LMs.…”

Fish Oil–Based Lipid Emulsions in the Treatment of Parenteral Nutrition-Associated Liver Disease: An Ongoing Positive Experience

“…However, evidence accumulated over the past few decades strongly suggests the lipid component of TPN as the most probable cause of PNALD. Both animal and human research during the past decade has implicated phytosterols and v-6 (n-6) fatty acids as the most likely components in the current lipid formulations as primary reasons for PNALD (8)(9)(10)(11)(12). In contrast, fish oil-based lipid emulsions (FOLEs) have been shown to be associated with full resolution of PNALD (13)(14)(15)(16)(17)(18).…”