Immune function and leukocyte sequestration under the influence of parenteral lipid emulsions in healthy humans: a placebo-controlled crossover study.
BACKGROUND: It remains unclear whether immune modulation by lipids contributes to the high risk of infectious complications that is associated with the use of parenteral nutrition. Although mixed long- and medium-chain triacylglycerol (LCT-MCT)-containing emulsions, but not pure LCT emulsions, activ...
| Publicado en: | American Journal of Clinical Nutrition Vol. 87; no. 3; pp. 539 - 548 |
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| Autores principales: | , , , , , , |
| Formato: | clinical trial research Journal Article |
| Publicado: |
Elsevier B.V.
Mar2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105901815&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105901815 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00029165 AJC jtl: American Journal of Clinical Nutrition issn: 00029165 maglogo: N pubinfo: dt: Mar2008 vid: 87 iid: 3 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 105901815 2009876394 10.1093/ajcn/87.3.539 NLM18326590 105901815 ppf: 539 ppct: 9 formats: tig: atl: Immune function and leukocyte sequestration under the influence of parenteral lipid emulsions in healthy humans: a placebo-controlled crossover study. aug: au: Versleijen MW Oyen WJ Roelofs HM van Emst-de Vries SE Willems PH Jansen JB Wanten GJ affil: Departments of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands. sug: subj: Fat Emulsions, Intravenous Pharmacodynamics Immunity Drug Effects Leukocytes Drug Effects Total Parenteral Nutrition Methods Triglycerides Blood Triglycerides Immunology Triglycerides Pharmacodynamics Triglycerides Adult Clinical Trials Crossover Design Fat Emulsions, Intravenous Adverse Effects Female Immunity Physiology Leukocyte Count Leukocytes Immunology Leukocytes Physiology Male Middle Age Radiopharmaceuticals Metabolism Reactive Oxygen Species Metabolism Time Factors Human Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: BACKGROUND: It remains unclear whether immune modulation by lipids contributes to the high risk of infectious complications that is associated with the use of parenteral nutrition. Although mixed long- and medium-chain triacylglycerol (LCT-MCT)-containing emulsions, but not pure LCT emulsions, activate neutrophils and impair crucial leukocyte functions in vitro, in vivo studies have failed to corroborate these findings. OBJECTIVES: The present investigation was conducted to evaluate the effects of LCT and LCT-MCT on immune function in healthy humans and to assess whether the lack of in vivo effects results from sampling errors due to extravascular sequestration of activated neutrophils. DESIGN: Saline, LCT-MCT, and LCT emulsions were administered intravenously for 4.5 h to 12 healthy volunteers in a randomized crossover design. Plasma triacylglycerol concentrations were clamped at a clinically relevant concentration of 3-5 mmol/L. Leukocyte population counts and neutrophil activation were assessed before and after infusion. Leukocyte sequestration was evaluated by monitoring the distribution of Technetium-99m-labeled autologous leukocytes during infusions. RESULTS: Whereas LCT exerted no greater effects than did saline, LCT-MCT significantly decreased lymphocyte counts. However, no evidence for neutrophil activation was found with either lipid. Moreover, the clearance of radiolabeled leukocytes from the liver, spleen, and lungs was not altered by any lipid, which suggested that lipid emulsions do not induce leukocyte sequestration. CONCLUSIONS: Short-term infusion of LCT-MCT (but not LCT) to healthy humans modulates leukocyte population counts but, in clear contrast with the in vitro situation, does not induce neutrophil activation. These disparate findings cannot be explained by MCT-induced leukocyte sequestration. Copyright © 2008 American Society for Nutrition pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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