The mode of administration of total parenteral nutrition and nature of lipid content influence the generation of peroxides and aldehydes

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• 作者：Khalil Miloudi ; Bl ; ine Comte ; Th¨¦r¨¨se Rouleau ; Alain Montoudis ; Emile Levy ; Jean-Claude Lavoie
• 关键词：Hepatic oxidative stress ; Inflammation ; Lipid emulsion ; Premature newborn ; Total parenteral nutrition
• 刊名：Clinical Nutrition
• 出版年：2012
• 出版时间：August, 2012
• 年：2012
• 卷：31
• 期：4
• 页码：526-534
• 全文大小：686 K

文摘

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Summary

Background & aims

The absence of light protection of neonatal total parenteral nutrition (PN) contributes to the generation of 4-hydroxynonenal and peroxides. 4-Hydroxynonenal is suspected to be involved in PN-related liver complications. Aims: To find a practical modality to reduce 4-hydroxynonenal in PN and assess in?vivo the impact of PN containing low 4-hydroxynonenal concentration.

Methods

Six modalities of delivering PN were compared for the in?vitro generation of peroxides and 4-hydroxynonenal: 1) MV-AA?L: light-protected (-L) solution containing multivitamin (MV) mixed with amino acids?+?dextrose (AA); 2) MV-AA+L: MV-AA without photo-protection (+L); 3) MV-LIP+L: MV mixed with lipid emulsion (LIP). LIP was a) Intralipid20 % ^? or b) Omegaven^?. Hepatic markers of oxidative stress (glutathione, F_2¦Á-isoprostanes, GS-HNE) and inflammation (mRNA of TNF-¦Á and IL-1) were measured in newborn guinea pigs infused during 4-days with MV-AA+L compounded with Intralipid20 % ^? or Omegaven^?.

Results

Hydroperoxides and 4-hydroxynonenal were the lowest in MV-AA?L and the highest in MV-LIP+L. MV-AA+L with Omegaven^? was associated with the lowest levels of markers of oxidative stress and inflammation.

Conclusion

Compared to Intralipid20 % ^?, Omegaven^? reduces oxidative stress associated with PN and prevents liver inflammation. These findings offer an alternative strategy to light protection of PN, which in the clinical setting is a cumbersome modality.