HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Versleijen, M. W Articles by Wanten, G. J Search for Related Content PubMed PubMed Citation Articles by Versleijen, M. W Articles by Wanten, G. J Agricola Articles by Versleijen, M. W Articles by Wanten, G. J

Immune function and leukocyte sequestration under the influence of parenteral lipid emulsions in healthy humans: a placebo-controlled crossover study^1,2

¹ From the Departments of Gastroenterology and Hepatology (MWV, HMR, JBJ, and GJW), Nuclear Medicine (WJO), and Biochemistry (SEvE-dV and PHW), Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands

Background:It remains unclear whether immune modulation by lipids contributes to the high risk of infectious complications that is associated with the use of parenteral nutrition. Although mixed long- and medium-chain triacylglycerol (LCT-MCT)–containing emulsions, but not pure LCT emulsions, activate neutrophils and impair crucial leukocyte functions in vitro, in vivo studies have failed to corroborate these findings.

Objectives:The present investigation was conducted to evaluate the effects of LCT and LCT-MCT on immune function in healthy humans and to assess whether the lack of in vivo effects results from sampling errors due to extravascular sequestration of activated neutrophils.

Design:Saline, LCT-MCT, and LCT emulsions were administered intravenously for 4.5 h to 12 healthy volunteers in a randomized crossover design. Plasma triacylglycerol concentrations were clamped at a clinically relevant concentration of 3–5 mmol/L. Leukocyte population counts and neutrophil activation were assessed before and after infusion. Leukocyte sequestration was evaluated by monitoring the distribution of Technetium-99m–labeled autologous leukocytes during infusions.

Results:Whereas LCT exerted no greater effects than did saline, LCT-MCT significantly decreased lymphocyte counts. However, no evidence for neutrophil activation was found with either lipid. Moreover, the clearance of radiolabeled leukocytes from the liver, spleen, and lungs was not altered by any lipid, which suggested that lipid emulsions do not induce leukocyte sequestration.

Conclusions:Short-term infusion of LCT-MCT (but not LCT) to healthy humans modulates leukocyte population counts but, in clear contrast with the in vitro situation, does not induce neutrophil activation. These disparate findings cannot be explained by MCT-induced leukocyte sequestration.

Key Words: Total parenteral nutrition • lipid emulsion • immune modulation • neutrophil activation • leukocyte sequestration • healthy humans

This article has been cited by other articles:

				G. J. Wanten Letter to the Editor JPEN J Parenter Enteral Nutr, July 1, 2009; 33(4): 450 - 450. [Full Text] [PDF]