Introduction: The inflammatory syndrome is a frequent condition in critically ill patients. The
sequence and interaction of proinflammatory mediators is complex and not yet completely
understood. N-3 PUFAs have various non-energetic effects and are supposed to reduce
the production of prostaglandines and leukotrienes. Single intravenous bolus injection
of endotoxin (LPS) is a model generating a sustained inflammatory response (systemic,
metabolic, endocrine changes) in healthy men. By this model we aimed at assessing
the immuno-regulating potential of n3-PUFAs in 15 healthy volunteers, randomized to
receive (n=7) or not (n=8) a 3-week oral n3-PUFA supplementation.
Methods: Subjects were investigated in a 10h experimental protocol once with 2 ng/kg bacterial
LPS i.v. and another time with saline placebo. Systemic parameters (heart rate, temperature,
art. blood pressure), indirect calorimetry and blood samples were assessed. Results
were analysed by ANOVA for repeated measurements, significance-level p<0.05
Results: Temperature raised simultaneously in both groups at 90min, peaking at 240min after
LPS-injection. Fever was significantly lower in n-3 PUFA group from T=240min till
the end of the test. As shown in table 1), ACTH- and cortisol-levels (peak at 240min)
were also significantly lower in n-3 PUFA group (–25% to –50%, p<0.03). IL-6 and TNF-α
did not differ between groups (p=0.3). Heart rate after a peak at 240min was slightly
lower in n-3 PUFA group. Resting energy expenditure, plasma glucose, insulin and glucagon
did not differ between groups. In the n-3 PUFA group, vascular resistances were 10
to 30% lower and cardiac output was 5 to 20% higher than in control group, but mean
arterial pressure was similar in both groups.
Table1: All values for peak at T=240min; mean±SEM
|
Temperature (°C)
|
ACTH (ng/l)
|
cortisol (nmol/l)
|
heart rate (b/min)
|
n-3 PUFA+LPS
|
38.3±0.16
|
412±127
|
750±51
|
93±4.1
|
control + LPS
|
38.5±0.12
|
808±138
|
1003±44
|
97±4.5
|
placebo control
|
37.0±0.10
|
32±7
|
240±35
|
64±2.7
|
p-value
|
<0.04
|
<0.03
|
<10e-3
|
0.08
|
Conclusion: These results suggest that n3-PUFAs decrease the neuro-endocrine answer in healthy
subjects after i.v. LPS. The energy metabolism (Lipid, glucose turnover, glucagon,
insuline) is not affected.