Intravenous Fish Oil and Pediatric Intestinal Failure–Associated Liver Disease

Changes in Plasma Phytosterols, Cytokines, and Bile Acids and Erythrocyte Fatty Acids

Kara L. Calkins, Andrea De Barber, Robert D. Steiner, Martiniano J. Flores, Tristan R. Grogan, Susanne M. Henning, Laurie Reyen, Robert S. Venick

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Soybean oil (SO) emulsions are associated with intestinal failure–associated liver disease (IFALD); fish oil (FO) emulsions are used to treat IFALD. SO and FO differ with respect to their fatty acid and phytosterol content. In children with IFALD whose SO was replaced with FO, we aimed to (1) quantify changes in erythrocyte fatty acids and plasma phytosterols, cytokines, and bile acids and (2) correlate these changes with direct bilirubin (DB). Design: This study enrolled IFALD children who received 6 months of FO. Blood samples were collected prior to FO, and after 2 weeks and 3 and 6 months of FO. The primary outcome was 3-month vs baseline biomarker concentrations. Results: At study initiation, the median patient age was 3 months (interquartile range, 3–17 months), and mean ± standard deviation DB was 5.6 ± 0.7 mg/dL (n = 14). Cholestasis reversed in 79% of subjects. Eicosapentaenoic and docosahexaenoic acid was greater than baseline (P <.001, all time points). Linoleic and arachidonic acid and sitosterol and stigmasterol were less than baseline (P <.05, all time points). Three- and 6-month interleukin-8 (IL-8) and total and conjugated bile acids were less than baseline (P <.05). Baseline IL-8 was correlated with baseline DB (r = 0.71, P <.01). Early changes in stigmasterol and IL-8 were correlated with later DB changes (r = 0.68 and 0.75, P <.05). Conclusion: Specific fat emulsion components may play a role in IFALD. Stigmasterol and IL-8 may predict FO treatment response.

Original languageEnglish (US)
JournalJournal of Parenteral and Enteral Nutrition
DOIs
StateAccepted/In press - May 1 2017

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Phytosterols
Fish Oils
Bile Acids and Salts
Liver Diseases
Fatty Acids
Erythrocytes
Pediatrics
Cytokines
Stigmasterol
Interleukin-8
Bilirubin
Soybean Oil
Emulsions
Eicosapentaenoic Acid
Docosahexaenoic Acids
Cholestasis
Linoleic Acid
Arachidonic Acid
Biomarkers
Fats

Keywords

  • cytokines
  • fatty acids
  • life cycle
  • lipids
  • liver disease
  • nutrition
  • parenteral nutrition
  • pediatrics
  • short bowel syndrome

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Intravenous Fish Oil and Pediatric Intestinal Failure–Associated Liver Disease : Changes in Plasma Phytosterols, Cytokines, and Bile Acids and Erythrocyte Fatty Acids. / Calkins, Kara L.; De Barber, Andrea; Steiner, Robert D.; Flores, Martiniano J.; Grogan, Tristan R.; Henning, Susanne M.; Reyen, Laurie; Venick, Robert S.

In: Journal of Parenteral and Enteral Nutrition, 01.05.2017.

Research output: Contribution to journalArticle

Calkins, Kara L. ; De Barber, Andrea ; Steiner, Robert D. ; Flores, Martiniano J. ; Grogan, Tristan R. ; Henning, Susanne M. ; Reyen, Laurie ; Venick, Robert S. / Intravenous Fish Oil and Pediatric Intestinal Failure–Associated Liver Disease : Changes in Plasma Phytosterols, Cytokines, and Bile Acids and Erythrocyte Fatty Acids. In: Journal of Parenteral and Enteral Nutrition. 2017.
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abstract = "Background: Soybean oil (SO) emulsions are associated with intestinal failure–associated liver disease (IFALD); fish oil (FO) emulsions are used to treat IFALD. SO and FO differ with respect to their fatty acid and phytosterol content. In children with IFALD whose SO was replaced with FO, we aimed to (1) quantify changes in erythrocyte fatty acids and plasma phytosterols, cytokines, and bile acids and (2) correlate these changes with direct bilirubin (DB). Design: This study enrolled IFALD children who received 6 months of FO. Blood samples were collected prior to FO, and after 2 weeks and 3 and 6 months of FO. The primary outcome was 3-month vs baseline biomarker concentrations. Results: At study initiation, the median patient age was 3 months (interquartile range, 3–17 months), and mean ± standard deviation DB was 5.6 ± 0.7 mg/dL (n = 14). Cholestasis reversed in 79{\%} of subjects. Eicosapentaenoic and docosahexaenoic acid was greater than baseline (P <.001, all time points). Linoleic and arachidonic acid and sitosterol and stigmasterol were less than baseline (P <.05, all time points). Three- and 6-month interleukin-8 (IL-8) and total and conjugated bile acids were less than baseline (P <.05). Baseline IL-8 was correlated with baseline DB (r = 0.71, P <.01). Early changes in stigmasterol and IL-8 were correlated with later DB changes (r = 0.68 and 0.75, P <.05). Conclusion: Specific fat emulsion components may play a role in IFALD. Stigmasterol and IL-8 may predict FO treatment response.",
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author = "Calkins, {Kara L.} and {De Barber}, Andrea and Steiner, {Robert D.} and Flores, {Martiniano J.} and Grogan, {Tristan R.} and Henning, {Susanne M.} and Laurie Reyen and Venick, {Robert S.}",
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T1 - Intravenous Fish Oil and Pediatric Intestinal Failure–Associated Liver Disease

T2 - Changes in Plasma Phytosterols, Cytokines, and Bile Acids and Erythrocyte Fatty Acids

AU - Calkins, Kara L.

AU - De Barber, Andrea

AU - Steiner, Robert D.

AU - Flores, Martiniano J.

AU - Grogan, Tristan R.

AU - Henning, Susanne M.

AU - Reyen, Laurie

AU - Venick, Robert S.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background: Soybean oil (SO) emulsions are associated with intestinal failure–associated liver disease (IFALD); fish oil (FO) emulsions are used to treat IFALD. SO and FO differ with respect to their fatty acid and phytosterol content. In children with IFALD whose SO was replaced with FO, we aimed to (1) quantify changes in erythrocyte fatty acids and plasma phytosterols, cytokines, and bile acids and (2) correlate these changes with direct bilirubin (DB). Design: This study enrolled IFALD children who received 6 months of FO. Blood samples were collected prior to FO, and after 2 weeks and 3 and 6 months of FO. The primary outcome was 3-month vs baseline biomarker concentrations. Results: At study initiation, the median patient age was 3 months (interquartile range, 3–17 months), and mean ± standard deviation DB was 5.6 ± 0.7 mg/dL (n = 14). Cholestasis reversed in 79% of subjects. Eicosapentaenoic and docosahexaenoic acid was greater than baseline (P <.001, all time points). Linoleic and arachidonic acid and sitosterol and stigmasterol were less than baseline (P <.05, all time points). Three- and 6-month interleukin-8 (IL-8) and total and conjugated bile acids were less than baseline (P <.05). Baseline IL-8 was correlated with baseline DB (r = 0.71, P <.01). Early changes in stigmasterol and IL-8 were correlated with later DB changes (r = 0.68 and 0.75, P <.05). Conclusion: Specific fat emulsion components may play a role in IFALD. Stigmasterol and IL-8 may predict FO treatment response.

AB - Background: Soybean oil (SO) emulsions are associated with intestinal failure–associated liver disease (IFALD); fish oil (FO) emulsions are used to treat IFALD. SO and FO differ with respect to their fatty acid and phytosterol content. In children with IFALD whose SO was replaced with FO, we aimed to (1) quantify changes in erythrocyte fatty acids and plasma phytosterols, cytokines, and bile acids and (2) correlate these changes with direct bilirubin (DB). Design: This study enrolled IFALD children who received 6 months of FO. Blood samples were collected prior to FO, and after 2 weeks and 3 and 6 months of FO. The primary outcome was 3-month vs baseline biomarker concentrations. Results: At study initiation, the median patient age was 3 months (interquartile range, 3–17 months), and mean ± standard deviation DB was 5.6 ± 0.7 mg/dL (n = 14). Cholestasis reversed in 79% of subjects. Eicosapentaenoic and docosahexaenoic acid was greater than baseline (P <.001, all time points). Linoleic and arachidonic acid and sitosterol and stigmasterol were less than baseline (P <.05, all time points). Three- and 6-month interleukin-8 (IL-8) and total and conjugated bile acids were less than baseline (P <.05). Baseline IL-8 was correlated with baseline DB (r = 0.71, P <.01). Early changes in stigmasterol and IL-8 were correlated with later DB changes (r = 0.68 and 0.75, P <.05). Conclusion: Specific fat emulsion components may play a role in IFALD. Stigmasterol and IL-8 may predict FO treatment response.

KW - cytokines

KW - fatty acids

KW - life cycle

KW - lipids

KW - liver disease

KW - nutrition

KW - parenteral nutrition

KW - pediatrics

KW - short bowel syndrome

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