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Alteration of plasma phospholipid fatty acid profile in patients with septic shock
Institution:1. Metabolism and Genetics Group, Research Institute for Medicines and Pharmaceutical Sciences, iMed.UL, Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal;2. Department of Biochemistry and Human Biology, Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal;3. Laboratory Genetic Metabolic Diseases, Department Clinical Chemistry and Pediatrics, University of Amsterdam, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;1. Department of Rheumatology and Inflammation Research, University of Gothenburg, Gothenburg, Sweden;2. Department of Drug Design and Pharmacology, University of Copenhagen, Denmark;3. Bioscience Cardiovascular, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden;1. Laboratory for Radiopharmacy, KU Leuven, Belgium;2. MoSAIC, Molecular Small Animal Imaging Centre, KU Leuven, Belgium;3. Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, The Netherlands;4. Janssen Research & Development, Beerse, Belgium;5. Janssen Research & Development, Toledo, Spain;6. Division of Nuclear Medicine, KU Leuven and University Hospital Leuven, Belgium;1. Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan;2. Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan;3. Department of Biochemistry, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan;4. Department of Advanced Therapeutics for Cardiovascular Disease, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
Abstract:In septic shock patients, alterations of plasma phospholipid fatty acid profile have never been described. The purpose of this monocentric, non-interventional, observational prospective study was to describe this fatty acid profile in the early phase of septic shock in intensive care unit. Thirty-seven adult patients with septic shock were included after the first day of stay in intensive care unit, before any form of artificial nutritional support. Plasma phospholipid fatty acid composition was determined by gas chromatography. All biological data from patients with septic shock were compared with laboratory reference values. Patients presented hypocholesterolemia and hypertriglyceridemia. They had low concentrations of phospholipid fatty acids specifically n-6 and n-3 polyunsaturated fatty acids (PUFAs) with a high n-6/n-3 ratio. Plasma phospholipid PUFA concentrations were strongly correlated with cholesterolemia. PUFAs/SFAs (saturated fatty acids) and PUFAs/MUFAs (monounsaturated fatty acids) ratios were low because of low percentage of n-6 and n-3 PUFAs and high percentage of SFAs and MUFAs. Low levels of plasma long chain PUFAs (≥20 carbons) were significantly associated with mortality at 28th day. In conclusion, plasma phospholipid FA profile of septic patients is very characteristic, close to that of acute respiratory distress syndrome and mortality is associated with long chain PUFA decrease. This profile could be explained by numerous non-exclusive physio-pathological processes 1) an activation of hepatic de novo lipogenesis that could contribute to hepatic steatosis, 2) an elevated adipose tissue lipolysis, 3) an increased free radical attack of FA by oxidative stress, 4) an over-production of inflammatory lipid mediators.
Keywords:Septic shock  Intensive care unit  Plasma fatty acids  Phospholipid fatty acids  Lipogenesis  Mortality  FA"}  {"#name":"keyword"  "$":{"id":"kwrd0045"}  "$$":[{"#name":"text"  "_":"fatty acid  SFA"}  {"#name":"keyword"  "$":{"id":"kwrd0055"}  "$$":[{"#name":"text"  "_":"saturated fatty acid  MUFA"}  {"#name":"keyword"  "$":{"id":"kwrd0065"}  "$$":[{"#name":"text"  "_":"mono-unsaturated fatty acid  PUFA"}  {"#name":"keyword"  "$":{"id":"kwrd0075"}  "$$":[{"#name":"text"  "_":"polyunsaturated fatty acid  ARDS"}  {"#name":"keyword"  "$":{"id":"kwrd0085"}  "$$":[{"#name":"text"  "_":"acute respiratory distress syndrome  PL"}  {"#name":"keyword"  "$":{"id":"kwrd0095"}  "$$":[{"#name":"text"  "_":"phospholipid  ICU"}  {"#name":"keyword"  "$":{"id":"kwrd0105"}  "$$":[{"#name":"text"  "_":"intensive care unit  BMI"}  {"#name":"keyword"  "$":{"id":"kwrd0115"}  "$$":[{"#name":"text"  "_":"body mass index  SAPS"}  {"#name":"keyword"  "$":{"id":"kwrd0125"}  "$$":[{"#name":"text"  "_":"simplified acute physiology score  SOFA"}  {"#name":"keyword"  "$":{"id":"kwrd0135"}  "$$":[{"#name":"text"  "_":"sepsis-related organ failure assessment
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