Unsaturated long-chain fatty acids induce the respiratory burst of human neutrophils and monocytes in whole blood

Abstract Background It is increasingly recognized that infectious complications in patients treated with total parenteral nutrition (TPN) may be caused by altered immune responses. Neutrophils and monocytes are the first line of defence against bacterial and fungal infection through superoxide anion production during the respiratory burst. To characterize the impact of three different types of lipid solutions that are applied as part of TPN formulations, we investigated the unstimulated respiratory burst activation of neutrophils and monocytes in whole blood. Methods Whole blood samples were incubated with LCT (Intralipid®), LCT/MCT (Lipofundin®) and LCT-MUFA (ClinOleic®) in three concentrations (0.06, 0.3 and 0.6 mg ml-1) for time periods up to one hour. Hydrogen peroxide production during the respiratory burst of neutrophils and monocytes was measured by flow cytometry. Results LCT and LCT-MUFA induced a hydrogen peroxide production in neutrophils and monocytes without presence of a physiological stimulus in contrast to LCT/MCT. Conclusion We concluded that parenteral nutrition containing unsaturated oleic (C18:1) and linoleic (C18:2) acid can induce respiratory burst of neutrophils and monocytes, resulting in an elevated risk of tissue damage by the uncontrolled production of reactive oxygen species. Contradictory observations reported in previous studies may in part be the result of different methods used to determine hydrogen peroxide production.</p

Hydroxyethyl starch 130/0.42/6:1 for perioperative plasma volume replacement in 1130 children: results of an European prospective multicenter observational postauthorization safety study (PASS)

Introduction: Third-generation hydroxyethyl starch (HES) is now approved also for the use in children, but safety studies including large numbers of pediatric patients are still missing. Therefore, we performed an European multicentric prospective observational postauthorization safety study (PASS) to evaluate the use of HES 130/0.42/6:1 in normal saline (ns-HES) or a balanced electrolyte solution (bal-HES) in children undergoing surgery. Methods: Children aged up to 12 years with ASA risk scores of I-III receiving nsHES (Venofundin 6%; Braun) or bal-HES (Tetraspan 6%; Braun) were followed perioperatively. Demographic data, surgical procedures performed, anesthesia, hemodynamic and laboratory data, adverse events (AE), and adverse drug reactions (ADR) were documented using a standardized case report form. Results: Of 1130 children studied at 11 European pediatric centers from 2006 to 2009 (ns-HES, 629 children; bal-HES, 475 children; mean age, 3.6 +/- 3.8 [ range, day of birth-12 years]; and body weight, 15.4 +/- 13 [0.9-90 kg]), 1104 were included for analysis. The mean infused HES volume was 10.6 +/- 5.8 (0.83-50) ml.kg(-1). In the 399 (36.1%) cases with blood gas analysis before and after HES infusion, hemoglobin and strong ion difference decreased significantly in both groups, whereas bicarbonate and base excess (BE before infusion: ns-HES) 1.8 +/- 3.1, bal-HES) 1.2 +/- 3.3 mM; after infusion: ns-HES) 2.5 +/- 2.8; bal-HES) 1.1 +/- 3.2 mM, P <0.05) decreased only with ns-HES but remained stable with bal-HES. Chloride concentrations increased in both groups and were significantly higher with ns-HES (Cl before infusion: ns-HES 105.5 +/- 3.6, bal-HES 104.9 +/- 2.9 mM; Cl after infusion: ns-HES 107.6 +/- 3.4, bal-HES 106.3 +/- 2.9 mM, P <0.05). For the AE/ADR rates, dose-response but no age relationships could be demonstrated. No serious and no severe ADR directly related to HES (i. e. anaphylactoid reaction, clotting disorders, renal failure) were observed. Conclusion: Moderate doses of HES 130/0.42/6: 1 for perioperative plasma volume replacement seem to be safe even in neonates and small infants. The probability of serious ADR is lower than 0.3%. Changes in acid-base balance may be decreased when HES is used in an acetate-containing balanced electrolyte solution instead of normal saline. Caution should be exercised in patients with renal function disturbances and those with an increased bleeding ris

Unsaturated long-chain fatty acids induce the respiratory burst of human neutrophils and monocytes in whole blood-0

Atelets and bacteria. (B) Neutrophils and monocytes were identified by setting a polygonal gate in a forward scatter/sideward scatter dot plot. The negative control sample (C) was used to define a marker for rhodamine 123 (FL 1) where less than 5% of the cells would be positive. The percentage of neutrophils having produced hydrogen peroxide following lipid incubation was determined by counting the number of rhodamine positive cells above this marker position and by dividing it by the whole number of events observed (D).<p><b>Copyright information:</b></p><p>Taken from "Unsaturated long-chain fatty acids induce the respiratory burst of human neutrophils and monocytes in whole blood"</p><p>http://www.nutritionandmetabolism.com/content/5/1/19</p><p>Nutrition & Metabolism 2008;5():19-19.</p><p>Published online 14 Jul 2008</p><p>PMCID:PMC2483276.</p><p></p

Unsaturated long-chain fatty acids induce the respiratory burst of human neutrophils and monocytes in whole blood-1

Atelets and bacteria. (B) Neutrophils and monocytes were identified by setting a polygonal gate in a forward scatter/sideward scatter dot plot. The negative control sample (C) was used to define a marker for rhodamine 123 (FL 1) where less than 5% of the cells would be positive. The percentage of neutrophils having produced hydrogen peroxide following lipid incubation was determined by counting the number of rhodamine positive cells above this marker position and by dividing it by the whole number of events observed (D).<p><b>Copyright information:</b></p><p>Taken from "Unsaturated long-chain fatty acids induce the respiratory burst of human neutrophils and monocytes in whole blood"</p><p>http://www.nutritionandmetabolism.com/content/5/1/19</p><p>Nutrition & Metabolism 2008;5():19-19.</p><p>Published online 14 Jul 2008</p><p>PMCID:PMC2483276.</p><p></p