Vitamin E content in fish oil emulsion does not prevent lipoperoxidative effects on human colorectal tumors

EPA and DHA have selective toxicity for PBMCs from multiple myeloma patients in a partly caspase-dependent manner

Poly-unsaturated fatty acids (PUFAs) have been shown to have cytotoxic effects in both solid and non-solid tumors. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are among the most studied PUFAs. The aim of the present study was to evaluate the cytotoxic effects of these two fatty acids (FAs) in the peripheral blood mononuclear cells (PBMCs) obtained from untreated patients (new cases) with confirmed symptomatic multiple myeloma (MM). Our results showed that EPA at the concentration of 100 μM and DHA at 50 and 100 μM induce potent apoptotic effects in the PBMCs of MM patients (P < 0.05) as evidenced by Annexin V and propidium iodide (PI) staining, while they have little or no effects on the PBMCs isolated from healthy donors (P > 0.05). The observed effects were concentration- and time-dependent and 72 h treatment with DHA at a concentration of 100 μM had the strongest effect (P < 0.01). CD138 + cells isolated from MM patients showed great sensitivity to EPA/DHA. EPA- and DHA-induced apoptosis was significantly inhibited by the pan-caspase inhibitor (Z-VAD-FMK), indicating that cell death was at least partly dependent on caspase activation. The results of the present study showed that EPA and DHA have selective toxicities for malignant human plasma cells from MM patients, but not for mononuclear cells of healthy donors. These results warrant further studies with larger study populations to investigate the usefulness of PUFAs as a promising adjunctive therapy in the treatment of MM.

Fish oil decreases the severity of treatment-related adverse events in gastrointestinal cancer patients undergoing chemotherapy: A randomized, placebo-controlled, triple-blind clinical trial

BACKGROUND AND AIMS

Due to its high peroxidizable characteristics, n-3 fatty acids, present in fish oil, could increase tumor cells sensitivity to conventional cancer treatment while non-neoplastic cells remain unaffected, this may lead to an increase in cancer treatment response with no increase on adverse effects. The aim of this study was to evaluate anti-cancer treatment response, performance status and adverse events in gastrointestinal cancer patients supplemented with fish oil. Oxidative stress parameters were investigated in blood non-neoplastic cells as an indicator of cytotoxicity.

METHODS

This is a randomized, triple-blind, placebo-controlled clinical trial. Fish oil group (FOG) received two capsules of fish oil containing 1.55 g of EPA + DHA a day for nine weeks, placebo group (PG) received two capsules containing olive oil. Baseline was set right before the administration of the first chemotherapy, oxidative stress parameters, adverse events presence and grading and performance status were assessed at baseline and after nine weeks of supplementation. Tumor markers, response to treatment and survival were evaluated at baseline and after one year of study inclusion.

RESULTS

76 patients were considered eligible, 56 were randomized, and 51 remained for analysis. After nine weeks, although there were no differences between groups for treatment response and presence of adverse events, PG patients were graded with more severe diarrhea than FOG patients (p = 0.03) and with higher (worse) performance status score (p = 0.02). No differences in lipid peroxidation and activity of antioxidant enzymes were observed between groups.

CONCLUSIONS

Fish oil may lead to a better performance status for gastrointestinal cancer patients undergoing chemotherapy while does not seem to increase treatment-related toxicity. Registered under ClinicalTrials.gov Identifier no. NCT02699047, www.clinicaltrials.gov.

Tocopherol and tocotrienol homologs in parenteral lipid emulsions

Parenteral lipid emulsions, which are made of oils from plant and fish sources, contain different types of tocopherols and tocotrienols (vitamin E homologs). The amount and types of vitamin E homologs in various lipid emulsions vary considerably and are not completely known. The objective of this analysis was to develop a quantitative method to determine levels of all vitamin E homologs in various lipid emulsions. An HPLC system was used to measure vitamin E homologs using a Pinnacle DB Silica normal phase column and an isocratic, n-hexane:1,4 dioxane (98:2) mobile phase. An optimized protocol was used to report vitamin E homolog concentrations in soybean oil-based (Intralipid®, Ivelip®, Lipofundin® N, Liposyn® III, and Liposyn® II), medium- and long-chain fatty acid-based (Lipofundin®, MCT and Structolipid®), olive oil-based (ClinOleic®), and fish oil-based (Omegaven®) and mixture of these oils-based (SMOFlipid®, Lipidem®) commercial parenteral lipid emulsions. Total content of all vitamin E homologs varied greatly between different emulsions, ranging from 57.9 to 383.9 µg/mL. Tocopherols (α, β, γ, δ) were the predominant vitamin E homologs for all emulsions, with tocotrienol content < 0.3%. In all of the soybean emulsions, except for Lipofundin® N, the predominant vitamin E homolog was γ-tocopherol, which ranged from 57–156 µg/mL. ClinOleic® predominantly contained α-tocopherol (32 µg/mL), whereas α-tocopherol content in Omegaven® was higher than most of the other lipid emulsions (230 µg/mL).