Effect of ω-3 polyunsaturated fatty acid-supplemented parenteral nutrition on inflammatory and immune function in postoperative patients with gastrointestinal malignancy

Abstract

Background: There are no consensus regarding the efficacy of omega-3polyunsaturated fatty acids (PUFAs) on inflammatory and immune function in postoperative patients with gastrointestinal malignancy.Methods:The literatures published randomized control trials (RCT) were searched in PubMed, Embase, Scopus, Cochrane Library, CNKI, Weipu, and Wanfang Databases. The immune efficacy outcomes of ω-3 polyunsaturated fatty acid-supplemented parenteral nutrition in patients with gastrointestinal malignancy were compared.Results:Sixteen RCTs involving 1008 patients (506 in the omega-3 group, 502 in the control group) were enrolled into the analysis. The results of meta-analysis: the cell immunity: The proportions of CD3+, CD4+, CD4+/CD8+ in the omega-3 group were significantly higher than those in the control group (CD3+: WMD = 4.48; 95% CI, 3.34–5.62; P < .00001; I2 = 0%; CD4+: WMD = 5.55; 95% CI, 4.75–6.34; P < .00001; I2 = 0%; CD4+/CD8+: WMD = .28; 95% CI, 0.13–0.44; P = .0004; I2 = 81%). In the humoral immunity: The levels of IgA, IgM and IgG in the omega-3 group were significantly higher than those in the control group (IgA: WMD = 0.31; 95% CI, 0.25–0.37; P < .00001; I2 = 0%; IgM: WMD = 0.12; 95% CI, 0.06–1.81; P < .00001; I2 = 0%; IgG: WMD = 1.19; 95% CI, 0.80–1.58; P < .00001; I2 = 0%). The count of lymphocyte in the omega-3 group was significantly higher than that in the control group (WMD = 0.22; 95% CI, 0.12–0.33; P < .0001; I2 = 40%). In the postoperative inflammatory cytokine: The levels of interleukin-6, tumor necrosis factor (TNF)-α and C-reactive protein in the omega-3 group were significantly lower than those in the control group (IL-6: WMD = −3.09; 95% CI, −3.91 to 2.27; P < .00001; I2 = 45%; TNF-α: WMD = −1.65; 95% CI, −2.05 to 1.25; P < .00001; I2 = 28%; CRP: WMD = −4.28; 95% CI, −5.26 to 3.30; P < .00001; I2 = 37%). The rate of postoperative infective complications in the omega-3 group was significantly lower than that in the control group (OR = 0.36; 95% CI, 0.20–0.66; P = .0008; I2 = 0%).Conclusion:This meta-kanalysis confirmed that early intervention with Omega -3 fatty acid emulsion in gastrointestinal cancer can not only improve the postoperative indicators of immune function, reduce inflammatory reaction, and improve the postoperative curative effect but also improve the immune suppression induced by conventional PN or tumor. Therefore, postoperative patients with gastrointestinal cancer should add omega-3 unsaturated fatty acids in their PN formula. Further high-quality RCTs are needed to verify its efficacy.

The effects ofn-3 fatty acids from flaxseed oil on genetic and metabolic profiles in patients with gestational diabetes mellitus: a randomised, double-blind, placebo-controlled trial

“…However, flaxseed oil administration in sheep infected with F. hepatica did not affect production or gene expression of IL-4 and interferon-γ (14) . Similar to our findings, Zhao & Wang (34) found that n-3 fatty acids applied as a part of parenteral nutrition in postoperative patients with gastrointestinal malignancy decreased CRP and other inflammatory markers. An in vitro study demonstrated that peripheral blood lymphocytes of women with GDM when exposed to n-3 fatty acids caused elevated GSH and decreased MDA cell levels (35) .…”

Genetics of Omega-3 Long-Chain Polyunsaturated Fatty Acid Metabolism and Meat Eating Quality in Tattykeel Australian White Lambs

“…C18:1 as the most abundant MUFA in the adipose and muscle tissues of ruminants, and it is not easily susceptible to oxidation [29]. PUFA are further divided into four families: omega-3 (n-3), omega-6 (n-6), omega-7 (n-7) and omega-9 (n-9), based on the position of the initial double bond on the methyl terminal [30] or the location of the last double bond relative to the terminal methyl end of the molecule [31].…”

Effects of ω-3 polyunsaturated fatty acid-supplemented parenteral nutrition on postoperative complications for patients with Crohn’s disease: a cohort study

“…Zhang et al 30 found that ω-3 PUFA-supplemented PN could improve postoperative recovery, reduced postoperative complications, and shorten hospital stays after hepatectomy in patients with liver cirrhosis or liver cancer. A meta-analysis by Zhao et al 31 revealed that early application of ω-3 PUFAs in patients with gastrointestinal cancer could improve immunity, reduce the postoperative stress response, and attenuate metastasis or recurrence. However, other studies have shown that there is no signi cant correlation between ω-3 PUFAs and postoperative complications in colorectal or esophageal cancer patients 12,32−33 .…”