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Updated: Jul 17, 2026
Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation
Published on: January 28, 2021
Influence of different intravenous lipid emulsions on hepatobiliary dysfunction in a rabbit model
Martina Kohl1, Thilo Wedel, Andreas Entenmann
1Department of Pediatrics, University Hospital, Luebeck, Germany.
Insights
New lipid emulsions for long-term total parenteral nutrition (TPN) did not prevent liver damage in rabbits. Long-term use of omega-3 fatty acids in TPN increased liver fibrosis, suggesting fish oil should be avoided.
Area of Science:
- Hepatology
- Pediatric Nutrition
- Lipid Metabolism
Background:
- Long-term total parenteral nutrition (TPN) in children can lead to cholestasis, fibrosis, and liver failure.
- High doses of intravenous lipids are suspected contributors to TPN-associated hepatobiliary dysfunction.
Purpose of the Study:
- To evaluate if two novel lipid emulsions could mitigate liver damage in TPN.
- To assess the impact of different lipid compositions on liver histology and fibrosis.
Main Methods:
- Prepubescent rabbits received TPN with soybean oil, olive oil, or soybean oil with n-3 fatty acids for 21 days.
- Enterally fed rabbits served as controls.
- Liver damage was assessed histologically, and biochemical parameters were analyzed.
Main Results:
- Hydropic degeneration was the primary histological finding across all lipid groups, indicating toxic liver injury.
- Fibrosis extent did not differ significantly among groups, except for the n-3 fatty acid group showing increased fibrosis compared to controls.
- Biochemical markers did not correlate with the severity of liver damage.
Conclusions:
- A lipid emulsion with reduced polyunsaturated fatty acids offered no advantage over standard soybean oil emulsion in this TPN model.
- Long-term administration of n-3 fatty acids was linked to exacerbated liver fibrosis.
- Intravenous lipid preparations containing n-3 fatty acids (fish oil) are not recommended for long-term TPN.
Objectives:
Long-term total parenteral nutrition (TPN) in children is often complicated by the development of cholestasis, liver fibrosis, and liver failure. High doses of intravenous lipids may be involved in the pathogenesis of hepatobiliary dysfunction. The purpose of this study was to determine whether the use of 2 newly developed lipid emulsions could reduce liver damage.
Materials And Methods:
Three groups of prepubescent rabbits received TPN including a lipid emulsion either based on soybean oil, olive oil, or soybean oil with n-3 fatty acids added. Enterally fed animals served as controls. After 21 d the animals were killed. Serum samples were obtained at the beginning and end of the study period. Specimens were processed for histological evaluation using a specific score to assess the severity of liver damage.
Results:
Biochemical parameters did not predict the extent of liver damage. Hydropic degeneration as an indicator of toxic liver injury was the predominant histological alteration regardless of the type of lipids infused. The extent of fibrosis did not significantly differ among treatment groups except for animals infused with n-3 fatty acids exhibiting increased fibrotic transformation as compared with controls.
Conclusion:
In our animal model, the use of a lipid emulsion with a reduced amount of polyunsaturated fatty acids was not superior to a lipid emulsion based on soybean oil. Long-term application of n-3 fatty acids was associated with more extensive fibrosis. Therefore, intravenous n-3 fatty acids containing lipid preparations (fish oil) should not be used in patients for long-term TPN.
