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Fish Oil-Supplemented Parenteral Nutrition in Severe Acute Pancreatitis Patients and Effects on Immune Function and Infectious Risk: A Randomized Controlled Trial

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Abstract

The human leukocyte antigen (HLA)-DR expression on monocytes and plasma Interleukin (IL)-10 levels are key indicators of immune response during the acute phase of severe acute pancreatitis (SAP). We designed a pilot study to investigate whether ω−3 fatty acids (FAs) supplemented parenteral nutrition (PN) could improve immune response in SAP patients. Fifty-six SAP patients were enrolled (28 patients in each group) and received isocaloric and isonitrogenous parenteral nutrition, providing 1.0 g/kg/day standard soybean-oil based fat (ω−6 FAs group) or 0.8 g/kg/day soybean oil +0.2 g/kg/day ω−3 FAs based fat (ω−3 FAs group). IL-10, HLA-DR and the ratio of CD4+ to CD8+ were determined before PN treatment and on day 6 after starting PN. The infection and surgery rates were recorded until hospital discharge. A significant IL-10 increase was associated with the administration of ω−3 FAs (p = 0.04, vs ω−6 FAs group). Monocyte HLA-DR expression improved in both groups after 5 days of PN treatment. This increase was significantly higher in the ω−3 FAs group compared to ω−6 FAs (p = 0.01). There was no significant difference of CD4+/CD8+, infection and surgery rates between the two groups. In conclusion, ω−3 FAs supplemented PN can elevate the IL-10 level and HLA-DR expression in SAP patients. A larger trial is required to see whether ω−3 FAs supplemented PN treatment in SAP patients would result in better clinical outcomes than ω−6 FAs.

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Acknowledgement

This work was supported by National Natural Science Foundation of China (30500404). We thanked all the volunteers for participating.

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Correspondence to Jieshou Li.

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Wang, X., Li, W., Zhang, F. et al. Fish Oil-Supplemented Parenteral Nutrition in Severe Acute Pancreatitis Patients and Effects on Immune Function and Infectious Risk: A Randomized Controlled Trial. Inflammation 32, 304–309 (2009). https://doi.org/10.1007/s10753-009-9136-0

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