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Immunologic Properties Differ in Preterm Infants Fed Olive Oil vs Soy-Based Lipid Emulsions During Parenteral Nutrition
Agnieszka Gawecka, MD, PhD1,2,
Jacek Michalkiewicz, MD, PhD3,
Maria Katarzyna Kornacka, MD, PhD1,
Barbara Luckiewicz4 and
Iza Kubiszewska5
From the 1 Department of Neonatology, Medical
Academy, Warsaw, Poland; the 2 Pediatric Intensive Care
Unit, Medical Academy Children's Hospital, Warsaw, Poland; the3
Immunology and Microbiology Department, The
Children's Memorial Health Institute, Warsaw, Poland; the4
Hospital Pharmacy of Princess Anna Mazowiecka
Hospital, Warsaw, Poland; and the 5 Immunology
Department, Rydygiers's Medical Academy, Bydgoszcz, Poland.
Address correspondence to: Agnieszka Gawecka, Department of Neonatology,
Princess Anna Mazowiecka Hospital, ul. Karowa 2, Warsaw, Poland; e-mail:
maat{at}maat.pl.
Background: In the first period of life, premature infants need
parenteral nutrition. Lipid emulsions (LEs), which are a part of parenteral
nutrition, are known as potent immunological modulators and may therefore
influence the immune status of parenterally fed infants. The aim of the study
was to compare tumor necrosis factor (TNF)- , interleukin (IL)-6, and
IL-10 production in the peripheral blood mononuclear cells (PBMCs) of
premature infants parenterally fed with 2 LEs: olive oil (OO) and soybean oil
(SO). Methods: Premature infants born at <32 weeks' gestation and
with a birth weight <1500 g were randomized in a double-blind method within
the first 48 hours of life to receive 1 of 2 LEs: OO based or SO based. At
baseline and after 14 days, blood samples were collected, and PBMCs were
isolated and then cultured for 48 hours in medium only and in the presence of
anti-CD3 antibodies. Results: Of 44 recruited infants, 38 completed
the study, 18 in the OO group and 20 in the SO group. The cytokine synthesis
profile before the LE introduction was the same in both groups (nonstimulated
and anti-CD3-induced PBMC). In the succeeding 14 days of parenteral nutrition,
TNF- , IL-6, and IL-10 levels in nonstimulated PBMCs remained unchanged
in both groups. In contrast, IL-6 production was significantly higher in the
SO group. Conclusions: SO–based LE may promote an excess of
IL-6 production, especially in the T cell–dependent way of PBMC
activation (via anti-CD3). OO emulsion seems to be immunologically more
neutral than SO emulsion.
Key Words: LE parenteral nutrition premature infant cytokine
Journal of Parenteral and Enteral Nutrition, Vol. 32, No. 4,
448-453 (2008)
DOI: 10.1177/0148607108319802

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