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Open AccessArticle

Immunomodulation by an Omega-6 Fatty Acid Reduced Mixed Lipid Emulsion in Murine Acute Respiratory Distress Syndrome

1
University of Giessen and Marburg Lung Center (UGMLC), University Hospital of Giessen, Justus-Liebig-University of Giessen, 35392 Giessen, Germany
2
Department of General and Thoracic Surgery, University Hospital of Giessen, Justus-Liebig-University of Giessen, 35392 Giessen, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2048; https://doi.org/10.3390/jcm9072048
Received: 21 May 2020 / Revised: 21 June 2020 / Accepted: 24 June 2020 / Published: 29 June 2020
(This article belongs to the Special Issue Sepsis: Current Clinical Practices and New Perspectives)
Background: Acute respiratory distress syndrome (ARDS) is associated with both high morbidity and mortality in intensive care units worldwide. Patients with ARDS often require parenteral nutrition with lipid emulsions as essential components. In the present study, we assessed the immunomodulatory and apoptotic effects of a modern, n-6-reduced lipid emulsion mixture in murine ARDS. Methods: Mice received an infusion of either normal saline solution, pure long-chain triglyceride (LCT) emulsion, or SMOF (soybean oil, medium-chain triglycerides, olive oil, and fish oil) before a lipopolysaccharide (LPS) challenge. Mice were sacrificed at different time points (0, 24, or 72 h) after ARDS induction, and an analysis of inflammatory cytokines, protein concentrations, and the cellular composition of the alveolar and interstitial compartments was performed with special focus on alveolar apoptosis and necrosis. Results: Mice infused with SMOF showed decreased leukocyte invasion, protein leakage, myeloperoxidase activity, and cytokine production in alveolar spaces after LPS challenge compared to animals that received LCT. There were fewer cells in the lung interstitium of the SMOF group compared to the LCT group. Both lipid emulsions exerted pro-apoptotic and pro-necrotic properties on alveolar immune cells, with significantly increased necrosis in mice infused with LCT compared to SMOF. Conclusion: SMOF has both anti-inflammatory and pro-resolving influences in murine ARDS. Partial replacement of n-6 fatty acids with n-3/n-9 fatty acids may therefore benefit critically ill patients at risk for ARDS who require parenteral nutrition. View Full-Text
Keywords: olive oil; acute respiratory distress syndrome; lipid emulsion; inflammation; fish olive oil; acute respiratory distress syndrome; lipid emulsion; inflammation; fish
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Hecker, M.; Rose, M.; Hecker, A.; Dietrich, H.; Schaefer, M.B.; Sommer, N.; Seeger, W.; Mayer, K. Immunomodulation by an Omega-6 Fatty Acid Reduced Mixed Lipid Emulsion in Murine Acute Respiratory Distress Syndrome. J. Clin. Med. 2020, 9, 2048.

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