This Article Full Text Full Text (PDF) All Versions of this Article: 0148607109332773v1 33/5/541    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by de Meijer, V. E. Articles by Puder, M. PubMed PubMed Citation Articles by de Meijer, V. E. Articles by Puder, M. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Dietary Fats Liver Diseases Social Bookmarking                         What's this?

Fish Oil–Based Lipid Emulsions Prevent and Reverse Parenteral Nutrition–Associated Liver Disease: The Boston Experience

From the ¹ Department of Surgery and the Vascular Biology Program and the ² Department of Pharmacy, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts.

Address correspondence to: Mark Puder, MD, PhD, 300 Longwood Avenue, Fegan 3, Boston, MA 02115; e-mail: mark.puder{at}childrens.harvard.edu.

Parenteral nutrition–associated liver disease (PNALD) is the most prevalent and most severe complication of long-term parenteral nutrition. Its underlying pathophysiology, however, largely remains to be elucidated. The currently approved parenteral lipid emulsions in the United States contain safflower or soybean oils, both rich in -6 polyunsaturated fatty acids (PUFAs). Mounting evidence indicates that the -6 PUFAs originating from plant oils in these lipid emulsions may play a role in the onset of liver injury. Fish oil–based lipid emulsions, in contrast, are primarily composed of -3 PUFAs, thus providing a promising alternative. The authors review the literature on the role of lipid emulsions in the onset of PNALD and discuss prevention and treatment strategies using a fish oil–based lipid emulsion. They conclude that a fish oil–based emulsion is hepatoprotective in a murine model of PNALD, and it appears to be safe and efficacious for the treatment of this type of liver disease in children. A prospective randomized trial that is currently under way at the authors' institution will objectively determine the place of fish oil monotherapy in the prevention of PNALD.

Key Words: fish oil • parenteral nutrition • parenteral formulas/compounding • liver disease • lipids • fatty acids

This version was published on September 1, 2009

Journal of Parenteral and Enteral Nutrition, Vol. 33, No. 5, 541-547 (2009)
DOI: 10.1177/0148607109332773


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?