Department of Anaesthesiology, Hannover Medical School, Germany.
Nutr Metab (Lond). 2008 Jul 14;5:19. doi: 10.1186/1743-7075-5-19.
It is increasingly recognized that infectious complications in patients treated with total parenteral nutrition (TPN) may be caused by altered immune responses. Neutrophils and monocytes are the first line of defence against bacterial and fungal infection through superoxide anion production during the respiratory burst. To characterize the impact of three different types of lipid solutions that are applied as part of TPN formulations, we investigated the unstimulated respiratory burst activation of neutrophils and monocytes in whole blood.
Whole blood samples were incubated with LCT (Intralipid(R)), LCT/MCT (Lipofundin(R)) and LCT-MUFA (ClinOleic(R)) in three concentrations (0.06, 0.3 and 0.6 mg ml-1) for time periods up to one hour. Hydrogen peroxide production during the respiratory burst of neutrophils and monocytes was measured by flow cytometry.
LCT and LCT-MUFA induced a hydrogen peroxide production in neutrophils and monocytes without presence of a physiological stimulus in contrast to LCT/MCT.
We concluded that parenteral nutrition containing unsaturated oleic (C18:1) and linoleic (C18:2) acid can induce respiratory burst of neutrophils and monocytes, resulting in an elevated risk of tissue damage by the uncontrolled production of reactive oxygen species. Contradictory observations reported in previous studies may in part be the result of different methods used to determine hydrogen peroxide production.
越来越多的人认识到,全肠外营养(TPN)治疗的患者的感染并发症可能是由于免疫反应改变引起的。中性粒细胞和单核细胞通过呼吸爆发期间超氧化物阴离子的产生,成为抵抗细菌和真菌感染的第一道防线。为了描述作为 TPN 配方一部分应用的三种不同类型的脂质溶液的影响,我们研究了全血中中性粒细胞和单核细胞的未刺激呼吸爆发激活。
将全血样本与 LCT(Intralipid(R))、LCT/MCT(Lipofundin(R))和 LCT-MUFA(ClinOleic(R))在三个浓度(0.06、0.3 和 0.6mg/ml)下孵育 1 小时,以研究中性粒细胞和单核细胞呼吸爆发期间的过氧化氢产生。通过流式细胞术测量中性粒细胞和单核细胞呼吸爆发期间的过氧化氢产生。
LCT 和 LCT-MUFA 在没有生理刺激的情况下诱导中性粒细胞和单核细胞产生过氧化氢,而 LCT/MCT 则没有。
我们得出结论,含有不饱和油酸(C18:1)和亚油酸(C18:2)的肠外营养可以诱导中性粒细胞和单核细胞的呼吸爆发,导致活性氧物质不受控制产生,从而增加组织损伤的风险。以前的研究报告的矛盾观察结果可能部分是由于用于确定过氧化氢产生的不同方法所致。