Effects of perioperative supplementation with omega-3 fatty acids on leukotriene B₄ and leukotriene B₅ production by stimulated neutrophils in patients with colorectal cancer: a randomized, placebo-controlled intervention trial.

Lone Sorensen,Søren Lundbye-Christensen,Ole Thorlacius-Ussing,Henrik Rasmussen,Karen Lindorff-Larsen,Erik Schmidt,Philip Calder

doi:10.3390/nu6104043

Abstract

Omega-3 fatty acids (n-3 FA) may have beneficial clinical and immune-modulating effects in surgical patients. In a randomized, double-blind, prospective, placebo-controlled trial, 148 patients referred for elective colorectal cancer surgery received an n-3 FA-enriched oral nutritional supplement (ONS) providing 2.0 g of eicosapentaenoic acid (EPA) and 1.0 g of docosahexaenoic acid (DHA) per day or a standard ONS for seven days before surgery. On the day of operation, there was a significant increase in the production of leukotriene B5 (LTB5) (p < 0.01) and 5-hydroxyeicosapentaenoic acid (5-HEPE) (p < 0.01), a significant decrease in the production of leukotriene B4 (LTB4) (p < 0.01) and a trend for a decrease in the production of 5-hydroxyeicosatetraenoic acid (5-HETE) (p < 0.1) from stimulated neutrophils in the active group compared with controls. There was no association between LTB4 values and postoperative complications. In conclusion, oral n-3 FA exerts anti-inflammatory effects in surgical patients, without reducing the risk of postoperative complications.

Highlights

IntroductionPatients undergoing surgery are at risk of developing complications in the postoperative period [1,2,3]
Patients undergoing surgery are at risk of developing complications in the postoperative period [1,2,3].This is believed to be partly caused by changes in the immune response following surgery [4]
All eligible participants (n = 610) were asked to participate, but 230 participants were not included. This was due to a change in clinical practice during the study, such that many patients were offered surgery within a five-day period, which did not allow for participants to complete the seven-day intervention

Summary

Introduction

Patients undergoing surgery are at risk of developing complications in the postoperative period [1,2,3]. This is believed to be partly caused by changes in the immune response following surgery [4]. Among factors known to influence the clinical course of patients after surgery are nutritional status and specific biologically active nutrients [2,6,7,8,9,10] that might include the marine omega-3 fatty acids (n-3 FA) with the main biologically active n-3 FAs being eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Consumption of fish and fish oils oil increases the concentration of EPA and DHA in blood, cells and tissues [11,12] and alters the physical properties of cell membranes and the function of membrane proteins, including receptors, transporters and signalling proteins [13,14]

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Discussion

Conclusion