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Influence of a Total Parenteral Nutrition Enriched with omega-3 Fatty Acids on Leukotriene Synthesis of Peripheral Leukocytes and Systemic Cytokine Levels in Patients with Major Surgery

Wachtler, P.; Konig, W. MD; Senkal, M. MD; Kemen, M. MD; Koller, M. PhD

The Journal of Trauma: Injury, Infection, and Critical Care: February 1997 - Volume 42 - Issue 2 - p 191-198

Objective  Nutritive immunomodulation of patients after major surgery.

Design  Prospective, randomized controlled double-blind study.

Patients  Forty patients undergoing major intestinal surgery. Patients were divided into two groups: one received a total parenteral nutrition enriched with omega-3 fatty acids for 5 days postoperatively, the other an isocaloric, control nutrition.

Material and Methods  We analyzed the leukocyte ability to release leukotrienes from whole blood leukocytes stimulated with the calcium ionophore A23187 (5 micromol/L) by reverse phase high-performance liquid chromatography and circulating cytokines by enzyme-linked immunosorbent assay.

Results  Leukocytes from patients of the omega-3 fatty acids group generated significantly higher amounts of less biologically active leukotriene B5 as compared to the control group (p < or = to 0.001). This was accompanied by a significant decrease in the generation of proinflammatory leukotriene B4 (p < or = to 0.006) in the study group. In contrast to interleukin-1beta, interleukin-6, and interleukin-10 systemic levels of tumor necrosis factor-alpha (p < or = to 0.05) were postoperatively decreased in the study group.

Conclusion  Our data provide evidence that a total parenteral nutrition enriched with omega-3 fatty acids modulates the lipid mediator pattern and systemic tumor necrosis factor-alpha levels.

From the Department of Microbiology and Immunology, Department of Host Defense Mechanisms(P.W., W.K.), and the Department of Surgery, St. Josef-Hospital (M.S., M.K., M.K.) Ruhr-University Bochum, Bochum, Germany.

This study was supported by Fraunhofer-Gesellschaft, Munich, Germany, and by Deutsche Forschungsgemeinschaft (Ko 1302/2-1).

The results of this paper have been partly presented in abstract form at the ESPEN-Meeting, Rome, Italy, 1995.

Address for reprints: Dr. Manfred Koller, Department of Microbiology and Immunology, Department of Host Defense Mechanisms, Ruhr-University Bochum, Universitatsstr. 150, 44780 Bochum, Germany.

© Williams & Wilkins 1997. All Rights Reserved.