Human Leukocyte Death After a Preoperative Infusion of Medium/Long-Chain Triglyceride and Fish Oil Parenteral Emulsions: A Randomized Study in Gastrointestinal Cancer Patients

Author(s)

Cury-Boaventura, Maria Fernanda ^[1] ; Matos de Miranda Torrinhas, Raquel Susana ^[2] ; Pereira de Godoy, Andre Borella ^[3] ; Curi, Rui ^[3] ; Waitzberg, Dan Linetzky

Affiliation

^[1] Univ Cruzeiro Sul, Inst Phys Act & Sports Sci, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med, Lab Nutr & Cirurgia Metab Aparelho Digest, Dept Gastroenterol, LIM 35, BR-01246903 Sao Paulo - Brazil

^[3] Univ Sao Paulo, Dept Physiol & Biophys, Inst Biomed Sci, BR-01246903 Sao Paulo - Brazil

• Document type: Journal article
• Source: Journal of Parenteral and Enteral Nutrition; v. 36, n. 6, p. 677-684, NOV 2012.
• Web of Science Citations: 3

Abstract

Background: Parenteral lipid emulsions (LEs) can influence leukocyte functions. The authors investigated the effect of 2 LEs on leukocyte death in surgical patients with gastrointestinal cancer. Material and Methods: Twenty-five patients from a randomized, double-blind clinical trial (ID: NCT01218841) were randomly included to evaluate leukocyte death after 3 days of preoperative infusion (0.2 g fat/kg/d) of an LE composed equally of medium/long-chain triglycerides and soybean oil (MCTs/LCTs) or pure fish oil (FO). Blood samples were collected before (t0) and after LE infusion (t1) and on the third postoperative day (t2). Results: After LE infusion (t1 vs t0), MCTs/LCTs did not influence cell death; FO slightly increased the proportion of necrotic lymphocytes (5%). At the postoperative period (t2 vs t0), MCTs/LCTs tripled the proportion of apoptotic lymphocytes; FO maintained the slightly increased proportion of necrotic lymphocytes (7%) and reduced the percentage of apoptotic lymphocytes by 74%. In the postoperative period, MCT/LCT emulsion increased the proportion of apoptotic neutrophils, and FO emulsion did not change any parameter of apoptosis in the neutrophil population. There were no differences in lymphocyte or neutrophil death when MCT/LCT and FO treatments were compared during either preoperative or postoperative periods. MCT/LCTs altered the expression of 12 of 108 genes related to cell death, with both pro- and antiapoptotic effects; FO modulated the expression of 7 genes, demonstrating an antiapoptotic effect. Conclusion: In patients with gastrointestinal cancer, preoperative MCT/LCT infusion was associated with postoperative lymphocyte and neutrophil apoptosis. FO has a protective effect on postoperative lymphocyte apoptosis. (JPEN J Parenter Enteral Nutr. 2012; 36: 677-684) (AU)

• FAPESP's process: 08/00163-9 - Toxicity of different lipid emulsions on lymphocytes and neutrophils of patients with gastric or colon cancer
• Grantee: Maria Fernanda Cury Boaventura
• Support Opportunities: Regular Research Grants