Treatment of Parenteral Nutrition-Associated Liver Disease: The Role of Lipid Emulsions

被引:50
作者
Nandivada, Prathima [1 ]
Carlson, Sarah J. [1 ]
Chang, Melissa I. [1 ]
Cowan, Eileen [1 ]
Gura, Kathleen M. [1 ]
Puder, Mark [1 ]
机构
[1] Boston Childrens Hosp, Boston, MA 02115 USA
关键词
SHORT-BOWEL SYNDROME; FISH-OIL; FATTY-ACIDS; HEPATIC STEATOSIS; ENDOTHELIAL-CELLS; CHOLESTASIS; INFANTS; PHYTOSTEROLS; SITOSTEROL; EXPRESSION;
D O I
10.3945/an.113.004770
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Parenteral nutrition is a life-saving therapy for infants with intestinal failure. However, long-term parenteral nutrition carries the risk of progressive liver disease. Substantial data has implicated components of parenteral soybean oil in the pathogenesis of parenteral nutrition-associated liver disease (PNALD). Elevated serum concentrations of phytosterols, an abundance of omega-6 polyunsaturated fatty acids, and a relative paucity of a-tocopherol have been associated with the risk of cholestasis and hepatic injury observed in PNALD. Currently available treatment strategies include the reduction of the dose of administered parenteral soybean oil and/or the replacement of parenteral soybean oil with alternative parenteral lipid emulsions. The purpose of this review is to provide an overview of the pathogenetic mechanisms associated with the development of PNALD and the data evaluating currently available treatment strategies.
引用
收藏
页码:711 / 717
页数:7
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