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The Metabolic Impact of Two Different Parenteral Nutrition Lipid Emulsions in Children after Hematopoietic Stem Cell Transplantation: A Lipidomics Investigation.

ABSTRACT: Hematopoietic stem cell transplantation (HSCT) involves the infusion of either bone marrow or blood cells preceded by toxic chemotherapy. However, there is little knowledge about the clinical benefits of parenteral nutrition (PN) in patients receiving high-dose chemotherapy during HSCT. We investigated the lipidomic profile of plasma and the targeted fatty acid profiles of plasma and erythrocytes in children after HSCT using PN with either a fish oil-based lipid emulsion or a classic soybean oil emulsion. An untargeted liquid chromatography high-resolution mass spectrometry platform connected with a novel in silico annotation algorithm was utilized to determine the most relevant chemical subclasses affected. In addition, we explored the interrelation between the lipidomics profile in plasma, the targeted fatty acid profile in plasma and erythrocytes, several biomarkers of inflammation, and antioxidant defense using an innovative data integration analysis based on Latent Components. We observed that the fish oil-based lipid emulsion had an impact in several lipid subclasses, mainly glycerophosphocholines (PC), glycerophosphoserines (PS), glycerophosphoethanolamines (PE), oxidized PE (O-PE), 1-alkyl,2-acyl PS, lysophosphatidylethanolamines (LPE), oxidized PS (O-PS) and dicarboxylic acids. In contrast, the classic soybean oil emulsion did not. Several connections across the different blocks of data were found and aid in interpreting the impact of the lipid emulsions on metabolic health.

SUBMITTER: Rangel-Huerta OD

PROVIDER: S-EPMC8998446 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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The Metabolic Impact of Two Different Parenteral Nutrition Lipid Emulsions in Children after Hematopoietic Stem Cell Transplantation: A Lipidomics Investigation.

Rangel-Huerta Oscar Daniel OD de la Torre-Aguilar María José MJ Mesa María Dolores MD Flores-Rojas Katherine K Pérez-Navero Juan Luis JL Baena-Gómez María Auxiliadora MA Gil Angel A Gil-Campos Mercedes M

International journal of molecular sciences 20220327 7

Hematopoietic stem cell transplantation (HSCT) involves the infusion of either bone marrow or blood cells preceded by toxic chemotherapy. However, there is little knowledge about the clinical benefits of parenteral nutrition (PN) in patients receiving high-dose chemotherapy during HSCT. We investigated the lipidomic profile of plasma and the targeted fatty acid profiles of plasma and erythrocytes in children after HSCT using PN with either a fish oil-based lipid emulsion or a classic soybean oil ...[more]

PMID: 35409026

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Project description:Background: Mixed lipid emulsions (LE) containing fish oil present several advantages compared to the sole soybean oil LE, but little is known about the safety of essential fatty acids (EFA) profile in paediatric patients on long-term Parenteral Nutrition (PN). Aim of the study: to assess glycerophosfolipid polyunsaturated fatty acids (PUFA) levels on plasma and red blood cell (RBC) membrane of children on long term PN with composite LE containing fish oil (SMOF), and to compare it with a group receiving olive oil LE (Clinoleic®) and to the reference range for age, previously determined on a group of healthy children. Results: A total of 38 patients were enrolled, median age 5.56 (0.9-21.86) years, 15 receiving Clinoleic®, 23 receiving SMOF. Patients on SMOF showed significantly higher levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lower levels of arachidonic acid (ARA) and Mead acid (MEAD)/ARA ratio in plasma and RBC compared with patients on Clinoleic® and with healthy children. Triene:tetraene (T:T) ratio of both groups of patients did not differ from that of healthy children-median plasma (MEAD/ARA: 0.01, interquartile rage (IQR) 0.01, p = 0.61 and 0.02, IQR 0.02, p = 0.6 in SMOF and Clinoleic® patients, respectively), and was considerably lower than Holman index (>0.21). SMOF patients showed no statistically significant differences in growth parameters compared with Clinoleic® patients. Patients of both groups showed stiffness class F0-F1 of liver stiffness measure (LSM) 5.6 (IQR 0.85) in SMOF patients and 5.3 (IQR 0.90) in Clinoleic® patients, p = 0.58), indicating absence of liver fibrosis. Conclusions: Fatty acids, measured as concentrations (mg/L), revealed specific PUFA profile of PN patients and could be an accurate method to evaluate nutritional status and eventually to detect essential fatty acid deficiency (EFAD). SMOF patients showed significantly higher EPA, DHA and lower ARA concentrations compared to Clinoleic® patients. Both LEs showed similar hepatic evolution and growth.

Project description:BackgroundHematopoietic stem cell transplantation (HSCT) patients often receive consecutive intensive chemotherapy, which can lead to gastrointestinal complications and acute graft-versus-host disease (GVHD), placing patients at high nutritional risk.AimThis retrospective study aimed to evaluate the benefits of nutritional support in maintaining nutritional status, reducing weight loss without increasing the incidence of catheter-related bloodstream infections (CRBSI) or liver dysfunction, and improving clinical outcomes in HSCT patients at high nutritional risk.MethodsA total of 526 patients who underwent HSCT were included in the study. Based on the Nutrition Risk Screening-2002 (NRS-2002) and propensity score matching, 70 patients were assigned to the control group (without parenteral nutrition) and 70 to the enhanced nutrition group (with parenteral nutrition) between 2012 and 2022. We compared data between the two groups at different time points (days 3, 7, 10, and 14 after transplantation and the day before discharge) on the following: (1) effectiveness: weight loss, albumin, and prealbumin levels; (2) safety: incidence of CRBSI and conjugated bilirubin levels; and (3) clinical outcomes: hospital stay duration, rate of rehospitalization, hospitalization costs, and survival rates.ResultsOur results showed that total parenteral nutrition (TPN) effectively mitigated weight loss on days 10 and 14 and the day before discharge, while also improving albumin (33.41 ± 4.57 in the control group, 34.87 ± 4.08 in the TPN group, p < 0.05; 33.72 ± 3.52 in the control group, 35.27 ± 4.04 in the TPN group, p < 0.05; 34.09 ± 4.44 in the control group, 35.55 ± 3.87 in the TPN group, p < 0.05) and prealbumin (245.18 ± 79.94 in the control group, 274.26 ± 86.73 in the TPN group, p < 0.05; 233.27 ± 79.57 in the control group, 279.34 ± 80.20 in the TPN group, p < 0.01; 247.24 ± 83.29 in the control group, 280.65 ± 100.22 in the TPN group, p < 0.05) levels during the same periods. In addition, there were no significant differences in CRBSI incidence or liver function between the non-TPN and TPN groups. Furthermore, the TPN group experienced a shorter length of hospital stay (48.06 ± 13.90 in the control group, 42.13 ± 14.22* in the TPN group, p < 0.05) and lower rates of unexpected rehospitalization (37.1% in the control group, 21.4% in the TPN group, p < 0.05).ConclusionThis study demonstrated that effective TPN formulations improved nutritional status, ensured patient safety, and contributed to better clinical outcomes in HSCT patients at high nutritional risk. These findings support the use of nutritional interventions in hematologic malignancy patients receiving induction therapy prior to transplantation.

Dataset Information

The Metabolic Impact of Two Different Parenteral Nutrition Lipid Emulsions in Children after Hematopoietic Stem Cell Transplantation: A Lipidomics Investigation.

Publications

The Metabolic Impact of Two Different Parenteral Nutrition Lipid Emulsions in Children after Hematopoietic Stem Cell Transplantation: A Lipidomics Investigation.

Similar Datasets

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