Immune Modulation by Parenteral Lipids
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Purpose
Immune modulating properties of parenteral lipid emulsions seem to contribute to the increased risk for infections which remains associated with the use of total parenteral nutrition. Emulsions based on soy bean oil (SO) are the oldest and still most widely used lipid source in TPN formulations but their high content of omega-6 polyunsaturated fatty acids (PUFAs) may be a drawback. Fish oil-based lipid emulsions (FO), rich in omega-3 PUFAs, has been approved for parenteral nutrition in many countries. Mainly retrospective studies on clinical outcomes in septic and postoperative patients have suggested clinical benefits with the inclusion of FO in parenteral nutrition regimens. The exact mechanisms behind the beneficial immunological effects of parenteral FO have, however, not yet been elucidated.
Objective:
To evaluate the effects of intravenous infusion of a FO-based lipid emulsion and a SO-based emulsion on immune function as evidenced by effects on peripheral blood leukocyte counts and functions and on the susceptibility to oxidative stress.
Study design:
Randomized placebo controlled cross-over pilot study with healthy volunteers.
| Condition | Intervention |
|---|---|
|
Infections Total Parenteral Nutrition |
Dietary Supplement: Parenteral lipid emulsion (Omegaven) Dietary Supplement: Parenteral lipid emulsion (Intralipid) Dietary Supplement: Parental lipid emulsion (Saline 0.9%) |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Immune Modulation by Omega-3 Versus Omega-6 Based Parenteral Lipids in Healthy Volunteers |
- leukocyte counts [ Time Frame: T=0, T=4 days, T=11 days ] [ Designated as safety issue: Yes ]
- leukocyte functions [ Time Frame: T=0, T=4 days and T=11 days ] [ Designated as safety issue: Yes ]
- (anti-)oxidant status [ Time Frame: T=0, T=4 days, T=11 days ] [ Designated as safety issue: Yes ]
- plasma and leukocyte cell membrane (phospho)lipid composition. [ Time Frame: T=0, t=4 and T=11 days ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 8 |
| Study Start Date: | August 2008 |
| Study Completion Date: | February 2010 |
| Primary Completion Date: | August 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
Omegaven 10%
|
Dietary Supplement: Parenteral lipid emulsion (Omegaven)
Omegaven 10%, 0.2g/kg/hr i.v.during 1 hour on 3 consecutive days
Other Name: Omegaven 10%, Fresenius Kabi, Bad Homburg Germany
|
|
Active Comparator: 2
Intralipid 10%
|
Dietary Supplement: Parenteral lipid emulsion (Intralipid)
Intralipid 10%, 0.2g/kg/hr i.v. during 1 hour on 3 consecutive days
Other Name: Intralipid 10%, Fresenius Kabi, Bad Homburg Germany
|
|
Placebo Comparator: 3
Placebo
|
Dietary Supplement: Parental lipid emulsion (Saline 0.9%)
Placebo (Saline 0.9%), same volume/hr as lipid emulsions
Other Name: lipid free control
|
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Adult (>18 yrs of age)
- Healthy
- Willingness to give written informed consent
Exclusion Criteria:
- Smoking > 5 cigarettes/day
- Diet with > 2 portions of fatty fish per day
- Use of oral fish oil or vitamin substrates
- History of metabolic disorder (especially diabetes or lipid disorders)
- History of allergic, inflammatory of immunological disease
- History of pulmonary, cardiovascular, renal or hematological disease
- Medication use
Contacts and Locations| Netherlands | |
| Radboud University Nijmegen Medical Centre | |
| Nijmegen, Gelderland, Netherlands, 6500 HB | |
| Study Director: | Geert JA Wanten, MD, MSc, PhD | Radboud University |
More Information
No publications provided
| Responsible Party: | M.W.J. Versleijen, MD, MSc and G.J.A. Wanten, MD, MSc, PhD, Radboud University Nijmegen Medical Centre |
| ClinicalTrials.gov Identifier: | NCT00734916 History of Changes |
| Other Study ID Numbers: | GW/MV/20307, CMO 2008/140 |
| Study First Received: | August 13, 2008 |
| Last Updated: | February 3, 2010 |
| Health Authority: | Netherlands: The Central Committee on Research Involving Human Subjects (CCMO) |
Keywords provided by Radboud University:
|
total parenteral nutrition infections Infectious complications related to parenteral nutrition |
ClinicalTrials.gov processed this record on May 16, 2013