Abstract
To investigate whether there is any effect resulting from preconditioning with nutraceutical supplementation containing arginine and oil mixes with high ω9:ω6 ratio and low ω6:ω3 ratio containing EPA and DHA, ALA fatty acids on inflammatory mediators, antioxidant and lipid profile modulation in surgical trauma. Twenty-six men scheduled for radical prostatectomy were randomized into three groups and treated as follows: Group 1 (skim milk, 0% fat), Group 2 (supplement with ω6:ω3 ratio of 8:1 and arginine) and Group 3 (supplement with high ω9:ω6 ratio of 3.2:1 and low ω6:ω3 ratio of 1.4:1 and arginine). Patients received skin milk or supplements twice a day (200 ml) during five days prior to surgery. Peripheral venous blood samples were collected at three different timepoints: five days before surgery (PRE), before anesthesia induction (IND) and on the 2nd postoperative day (POS). Parameters analyzed included inflammatory cytokines (IL-1β, IL-6, IL-8 and TNF-α), antioxidants (catalase), lipid profile and heat shock protein (HSP-27). There were no significant differences between groups on inflammatory mediators and antioxidant parameters. However, lipid profile values (Cholesterol, LDL, Triglycerides, VLDL), were significantly different. Preconditioning with arginine and oil mixes containing high ω9:ω6 ratio and low ω6:ω3 ratio, has no effects on inflammatory mediators and oxidative stress in patients undergoing radical prostatectomy. Reduction of cholesterol, triglycerides, LDL and VLDL profiles may be related to the trauma effect.
Highlights
MethodsTrauma and surgery trigger the production of proinflammatory cytokines, and can induce severe alterations in the immune system, which results in increased rates of septic and inflammatory complications postoperatively[1]
PURPOSE: To investigate whether there is any effect resulting from preconditioning with nutraceutical supplementation containing arginine and oil mixes with high ω9:ω6 ratio and low ω6:ω3 ratio containing EPA and DHA, ALA fatty acids on inflammatory mediators, antioxidant and lipid profile modulation in surgical trauma
Fatty acids frequently incorporated into membrane phospholipids are the ω-3 eicosapentaenoic (EPA), and docosahexaenoic (DHA) acids, ω-6 arachidonic acid (AA), and ω -9 oleic acid (OA)[9]
Summary
Trauma and surgery trigger the production of proinflammatory cytokines, and can induce severe alterations in the immune system, which results in increased rates of septic and inflammatory complications postoperatively[1]. Perioperative supplementation with immunomodulatory diets is safe and effective in reducing postoperative infections, length of hospital stay and reduce the need for antibiotics, increasing cellular and humoral immunity compared to standard nutrition[2,3,4,5,6,7]. Polyunsaturated fatty acids (PUFAs) influence immune and inflammatory responses, the synthesis of inflammatory modulators (eicosanoids and resolvins) and signal transduction, with greater or lesser production of inflammatory cytokines[10]. Omega-3 fatty acids act as competitor for the same metabolic pathway of arachidonic acid, inhibiting its oxidation and suppressing the production of eicosanoids. The ω3 is a substrate for the synthesis of resolvins associated with potent anti-inflammatory and immunoregulatory activity[12]
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