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[Members Only] J.Jpn. Surg. Soc.. 119(6): 652-657, 2018
Feature topic
EFFICACY OF OMEGA-3 FATTY ACID LIPID EMULSION IN CHILDREN WITH INTESTINAL FAILURE-ASSOCIATED LIVER DISEASE
Intestinal failure-associated liver disease (IFALD) is a lethal complication in short-bowel syndrome due to neonatal surgical diseases. IFALD occurs in 60％ of children who are dependent on long-term parenteral nutrition. Among these children, 25-40％ of patients develop end-stage liver disease. Omega-3 fatty acid lipid emulsion (O3FA) with a high polyunsaturated fatty acid content has been reported to ameliorate hyperbilirubinemia in children with IFALD, and we have also confirmed and reported the safety and efficacy of O3FA in our patient series. In the past, the antiinflammatory effect of O3FA was explained as occurring due to its interaction with the eicosanoid synthetic enzyme of arachidonic acid synthesis in a competitive manner and acting to inhibit inflammatory eicosanoid production. More recently, novel antiinflammatory lipid mediators such as resolvins have been identified, and their physiology has attracted attention. O3FA can be used safely without adverse effects even in immature and low birth-weight infants. Clinical trials, multicenter studies, or the development of additional O3FA agents are urgent issues to receive regulatory pharmaceutical approval.
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