Abstract

BackgroundLiver cirrhosis is associated with profound immunodysfunction, i.e. a parallel presence of chronic systemic inflammation and immunosuppression, which can result in acute-on-chronic liver failure (ACLF). Omega-3 fatty acids are precursors of pro-resolving mediators and support the resolution of inflammation.ObjectiveThe aim of this study was to determine plasma levels of omega-3 fatty acids in patients with liver cirrhosis and ACLF.MethodsPatients with liver cirrhosis with and without ACLF were enrolled in a prospective cohort study and analyzed post-hoc for the present sub-study. Clinical data and biomaterials were collected at baseline and at day 7, 28 and after 3 months of follow-up. Plasma concentrations of arachidonic acid (ARA) and docosahexaenoic acid (DHA), which represent key omega-6 and -3 fatty acids, respectively, were quantified and associated with markers of systemic inflammation and severity of liver cirrhosis.ResultsA total of 117 patients were included in the present analyses. Of those, 26 (22.2%), 51 (43.6%) and 40 (34.2%) patients had compensated or decompensated liver cirrhosis, and ACLF. Plasma levels of ARA and DHA were similar in patients with compensated cirrhosis, decompensated cirrhosis, and ACLF. Furthermore, no significant association between plasma ARA or DHA and C-reactive protein or peripheral blood leukocytes were observed (P>0.05).ConclusionIn our study plasma levels of key omega-3 and omega-6 fatty acid are neither associated with the severity of liver cirrhosis nor with liver-cirrhosis-associated systemic inflammation.

Highlights

  • Polyunsaturated fatty acids (PUFA) are important for the structure and function of cell membranes and have additional important functions in regulating immune and inflammatory responses as precursors of eicosanoids, resolvins and other lipid mediators[1]

  • Plasma levels of arachidonic acid (ARA) and docosahexaenoic acid (DHA) were similar in patients with compensated cirrhosis, decompensated cirrhosis, and acute-onchronic liver failure (ACLF)

  • Eicosanoids, resolvins and other mediators derived from omega-3 fatty acids such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) support the resolution of inflammation [1,2]

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Summary

Introduction

Polyunsaturated fatty acids (PUFA) are important for the structure and function of cell membranes and have additional important functions in regulating immune and inflammatory responses as precursors of eicosanoids, resolvins and other lipid mediators[1]. Eicosanoids (for example prostaglandins and leukotrienes) which are derived from arachidonic acid (ARA) and associated omega-6 PUFAs exhibit pro-inflammatory and pro-coagulatory functions. Eicosanoids, resolvins and other mediators derived from omega-3 fatty acids such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) support the resolution of inflammation [1,2]. Omega-3 PUFAs may reduce hepatic lipogenesis, inflammation and hepatic fibrosis[11,12,13]. A recent meta-analysis conducted by Yan et al suggests that omega-3 PUFA supplementation may decrease liver fat and hepatic enzyme parameters in patients with non-alcoholic fatty liver disease[14]

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