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Influence of Adding Fish Oil to Parenteral Nutrition on Gut-Associated Lymphoid Tissue

Yoshinori Maeshima, MD^*, Kazuhiko Fukatsu, MD, PhD, Tomoyuki Moriya, MD, Fumie Ikezawa, MD, Chikara Ueno, MD^*, Daizoh Saitoh, MD, PhD and Hidetaka Mochizuki, MD, PhD^*

From the ^* Department of Surgery, National Defense Medical College, Saitama, Japan; Division of Basic Traumatology, National Defense Medical College Research Institute, Saitama, Japan; and the Department of Surgery, Chiba University, Chiba, Japan

Correspondence: Kazuhiko Fukatsu, MD, PhD, Division of Basic Traumatology, National Defense Medical College Research Institute, 3-2 Namiki, Tokorozawa, Saitama, Japan 359-8513. Electronic mail may be sent to fukatsu{at}ndmc.ac.jp.

Background: Lack of enteral nutrition reduces gut-associated lymphoid tissue (GALT) mass and function, a mechanism underlying the increased morbidity of infectious complications in severely injured or critically ill patients. Strategies to restore parenteral nutrition (PN)–induced changes of GALT mass and function have been pursued. However, the influences of adding fish oil to PN on gut immunity remain to be clarified. Methods: Male Institute of Cancer Research (ICR) mice (n = 50) were randomized to 4 groups: ad libitum chow (chow), fat free PN (fat (–)-PN), PN + fish oil (FO-PN), and PN + safflower oil (SO-PN). The PN groups were given isocaloric and isonitrogenous PN solutions. The FO- and SO-PN groups received 20% of total calories from fat emulsions. After 5 days of feeding, lymphocytes from Peyer's patches (PPs), the intraepithelial space (IE), and the lamina propria (LP) of the entire small intestine were isolated. GALT lymphocyte numbers and phenotypes (CD4+, CD8+, βTCR+, TCR+, B220+ cells) were determined. Immunoglobulin A (IgA) levels of small intestinal washings were also measured by enzyme-linked immunosorbent assay. Another set of mice (n = 24) was used to determine plasma fatty acid compositions after feeding. Results: Lymphocyte numbers from PPs and the LP and intestinal IgA levels were significantly lower in the PN groups than in the chow group, with no significant differences between any 2 PN groups. The FO- and SO-PN groups showed moderate recovery of IE cell numbers compared with the fat (–)-PN group. -3 and -6 fatty acid levels were increased with fish and safflower oil additions, respectively, compared with the fat (–)-PN group. Conclusions: Adding fish oil to PN does not exacerbate PN-induced GALT changes but rather partially reverses these changes, with increased plasma -3 fatty acid levels.

Journal of Parenteral and Enteral Nutrition, Vol. 31, No. 5, 416-422 (2007)
DOI: 10.1177/0148607107031005416


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