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Updated: Jul 4, 2026
A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
Published on: September 20, 2019
Immunologic properties differ in preterm infants fed olive oil vs soy-based lipid emulsions during parenteral
Agnieszka Gawecka1, Jacek Michalkiewicz, Maria Katarzyna Kornacka
1Department of Neonatology, Medical Academy, Warsaw, Poland. maat@maat.pl
Insights
Soybean oil (SO) lipid emulsions (LEs) may increase interleukin-6 (IL-6) production in premature infants compared to olive oil (OO) LEs. OO appears to be more immunologically neutral for parenteral nutrition in neonates.
Area of Science:
- Neonatal immunology
- Parenteral nutrition
- Lipid emulsions
Background:
- Premature infants require parenteral nutrition, including lipid emulsions (LEs).
- LEs can modulate the immune system in parenterally fed infants.
- This study compares immune responses to two types of LEs in premature infants.
Purpose of the Study:
- To compare the production of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and IL-10.
- To assess cytokine production in peripheral blood mononuclear cells (PBMCs) of premature infants.
- To evaluate the immunological effects of olive oil (OO) versus soybean oil (SO) based LEs.
Main Methods:
- Randomized, double-blind study of premature infants (<32 weeks gestation, <1500 g birth weight).
- Infants received either OO-based or SO-based LEs within 48 hours of birth.
- PBMCs were isolated at baseline and after 14 days, then cultured with and without anti-CD3 antibodies to measure cytokine production.
Main Results:
- No significant differences in cytokine profiles were observed between groups at baseline.
- Nonstimulated PBMC cytokine levels (TNF-alpha, IL-6, IL-10) remained unchanged over 14 days in both groups.
- IL-6 production was significantly higher in infants receiving SO-based LEs, particularly with anti-CD3 stimulation.
Conclusions:
- Soybean oil (SO)-based lipid emulsions may lead to elevated IL-6 production.
- This effect is more pronounced with T cell-dependent activation of PBMCs.
- Olive oil (OO) emulsion appears to be a more immunologically neutral option for parenteral nutrition in premature infants.
Background:
In the first period of life, premature infants need parenteral nutrition. Lipid emulsions (LEs), which are a part of parenteral nutrition, are known as potent immunological modulators and may therefore influence the immune status of parenterally fed infants. The aim of the study was to compare tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-10 production in the peripheral blood mononuclear cells (PBMCs) of premature infants parenterally fed with 2 LEs: olive oil (OO) and soybean oil (SO).
Methods:
Premature infants born at <32 weeks' gestation and with a birth weight <1500 g were randomized in a double-blind method within the first 48 hours of life to receive 1 of 2 LEs: OO based or SO based. At baseline and after 14 days, blood samples were collected, and PBMCs were isolated and then cultured for 48 hours in medium only and in the presence of anti-CD3 antibodies.
Results:
Of 44 recruited infants, 38 completed the study, 18 in the OO group and 20 in the SO group. The cytokine synthesis profile before the LE introduction was the same in both groups (nonstimulated and anti-CD3-induced PBMC). In the succeeding 14 days of parenteral nutrition, TNF-alpha, IL-6, and IL-10 levels in nonstimulated PBMCs remained unchanged in both groups. In contrast, IL-6 production was significantly higher in the SO group.
Conclusions:
SO-based LE may promote an excess of IL-6 production, especially in the T cell-dependent way of PBMC activation (via anti-CD3). OO emulsion seems to be immunologically more neutral than SO emulsion.
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