Department of Surgery and the Vascular Biology Program, Children's Hospital Boston, Boston, MA 02115, USA.
Department of Surgery and the Vascular Biology Program, Children's Hospital Boston, Boston, MA 02115, USA.
J Pediatr Surg. 2011 Apr;46(4):666-673. doi: 10.1016/j.jpedsurg.2010.08.018.
Plant-based intravenous lipid emulsions have been shown to contribute to parenteral nutrition-associated liver disease (PNALD). There is mounting evidence that fish oil-based emulsions may prevent this liver injury. This study compares 5 emulsions with different fat compositions and their effect on hepatic steatosis, one of the first hits in PNALD.
C57BL/6J mice were placed on a fat-free diet and randomized into 5 equal groups. Each group received one of the commercially available intravenous lipid emulsions (Intralipid [Baxter/Fresenius Kabi, Deerfield, Ill], Liposyn II [Hospira Inc, Lake Forest, Ill], ClinOleic [Baxter/Clintec Parenteral SA, Cedex, France], SMOFlipid [Fresenius Kabi, Bad Homburg, Germany], or Omegaven [Fresenius Kabi Deutschland GmbH]) or normal saline. Liver enzymes, degree of steatosis, and fatty acid compositions were analyzed after 19 days.
Intralipid, Liposyn II, ClinOleic, and SMOFlipid groups all demonstrated moderate steatosis with hepatic fat contents of 17.4%, 21.9%, 22.5%, and 12.6%, respectively. Omegaven mice, however, had normal livers. Saline control mice developed biochemical evidence of essential fatty acid deficiency (EFAD). Lipid supplementation with Intralipid, Liposyn II, and Omegaven prevented the onset of biochemical EFAD, whereas administration of ClinOleic and SMOFlipid did not.
The fish oil-based lipid emulsion Omegaven prevented hepatic steatosis and EFAD in this murine model. ω-3 fatty acids may be efficacious in preventing PNALD and should be explored in the development of novel lipid emulsions.
植物性静脉内脂肪乳剂已被证明会导致肠外营养相关肝病（PNALD）。越来越多的证据表明，鱼油基乳剂可能预防这种肝损伤。本研究比较了 5 种不同脂肪成分的乳剂及其对肝脂肪变性的影响，肝脂肪变性是 PNALD 的最初表现之一。
C57BL/6J 小鼠接受无脂饮食并随机分为 5 组。每组接受一种市售静脉内脂肪乳剂（Intralipid [Baxter/Fresenius Kabi，Deerfield，Ill]、Liposyn II [Hospira Inc，Lake Forest，Ill]、ClinOleic [Baxter/Clintec Parenteral SA，Cedex，France]、SMOFlipid [Fresenius Kabi，Bad Homburg，Germany]或 Omegaven [Fresenius Kabi Deutschland GmbH]）或生理盐水。19 天后分析肝酶、脂肪变性程度和脂肪酸组成。
Intralipid、Liposyn II、ClinOleic 和 SMOFlipid 组的肝脏脂肪含量分别为 17.4%、21.9%、22.5%和 12.6%，均表现为中度脂肪变性。然而，Omegaven 组的小鼠肝脏正常。盐水对照组的小鼠出现必需脂肪酸缺乏症（EFAD）的生化证据。Intralipid、Liposyn II 和 Omegaven 的脂质补充预防了生化 EFAD 的发生，而 ClinOleic 和 SMOFlipid 的给药则没有。
本研究表明，在这种小鼠模型中，基于鱼油的脂肪乳剂 Omegaven 可预防肝脂肪变性和 EFAD。ω-3 脂肪酸可能对预防 PNALD 有效，应在新型脂肪乳剂的开发中进行探索。
