Fish oil and parenteral nutrition-associated liver disease

[Guest guest]

This seems like a very significant breakthrough in treatment of

parenteral nutrition-associated liver disease (cholestasis) in

infants with short bowel syndrome:

Gura KM, Lee S, Valim C, Zhou J, Kim S, Modi BP, Arsenault DA,

Strijbosch RA, Lopes S, Duggan C, Puder M (2008) Safety and efficacy

of a fish-oil-based fat emulsion in the treatment of parenteral

nutrition-associated liver disease. Pediatrics 121: e678-e686.

http://www.ncbi.nlm.nih.gov/pubmed/18310188

" Among survivors, the median time to reversal of cholestasis was 9.4

and 44.1 weeks in the fish-oil and historical cohorts, respectively.

Subjects who received fish-oil-based emulsion experienced reversal of

cholestasis 4.8 times faster than those who received soybean

emulsions and 6.8 times faster in analysis adjusted for baseline

bilirubin concentration, gestational age, and the diagnosis of

necrotizing enterocolitis. A total of 2 deaths and 0 liver

transplantations were recorded in the fish-oil cohort and 7 deaths

and 2 transplantations in the historical cohort. "

High dose-ursodeoxycholic acid 30 mg/kg/day has been used in the

treatment of these patients in the past:

De Marco G, Sordino D, Bruzzese E, Di Caro S, Mambretti D, Tramontano

A, Colombo C, Simoni P, Guarino A (2006) Early treatment with

ursodeoxycholic acid for cholestasis in children on parenteral

nutrition because of primary intestinal failure. Aliment Pharmacol

Ther. 24: 387-394.

http://www.ncbi.nlm.nih.gov/pubmed/16842466

One can't help but wonder if the combination of ursodiol and fish oil

emulsion might be better than when used individually?

Best regards,

Dave

(father of (22); PSC 07/03; UC 08/03)