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长链多不饱和脂肪酸对新生儿的影响研究进展
Research advances in the effect of long-chain polyunsaturated fatty acids on neonates
充足的长链多不饱和脂肪酸（long-chain polyunsaturated fatty acids，LCPUFAs）供给对新生儿，特别是早产儿可能至关重要，尤其是n-3系列和n-6系列的LCPUFAs，在大脑发育、免疫调节和疾病预防中都有重要的作用。LCPUFAs的缺乏可能会导致神经发育受损，影响新生儿免疫系统发育并导致新生儿疾病的发生。该文综述了LCPUFAs的生理功能及其对新生儿的影响的相关研究进展，以期为临床应用提供参考。
Adequate supply of long-chain polyunsaturated fatty acids (LCPUFAs) is of great importance for neonates, especially preterm infants. In particular, n-3 LCPUFAs and n-6 LCPUFAs play a key role in brain development, immune regulation, and disease prevention. Lack of LCPUFAs may lead to neurodevelopmental impairment, affect the development of neonatal immune system, and result in neonatal diseases. This article reviews related research advances in the physiological function of LCPUFAs and its effect on neonates, so as to provide reference for clinical application.
长链多不饱和脂肪酸 / 支气管肺发育不良 / 早产儿视网膜病 / 胆汁淤积症 / 新生儿
Long-chain polyunsaturated fatty acid / Bronchopulmonary dysplasia / Retinopathy of prematurity / Cholestasis / Neonate
[1] Di Miceli M, Bosch-Bouju C, Layé S. PUFA and their derivatives in neurotransmission and synapses:a new hallmark of synaptopathies[J]. Proc Nutr Soc, 2020, 79(4):388-403. DOI:10.1017/S0029665120000129. PMID:32299516.
[2] Cakiner-Egilmez T. Omega 3 fatty acids and the eye[J]. Insight, 2008, 33(4):20-25; quiz 26-27. PMID:19227095.
[3] Christie WW, Harwood JL. Oxidation of polyunsaturated fatty acids to produce lipid mediators[J]. Essays Biochem, 2020, 64(3):401-421. DOI:10.1042/EBC20190082. PMID:32618335. PMCID:PMC7517362.
[4] Araujo P, Belghit I, Aarsæther N, et al. The effect of omega-3 and omega-6 polyunsaturated fatty acids on the production of cyclooxygenase and lipoxygenase metabolites by human umbilical vein endothelial cells[J]. Nutrients, 2019, 11(5):966. DOI:10.3390/nu11050966. PMID:31035600. PMCID:PMC6567278.
[5] Samuchiwal SK, Boyce JA. Role of lipid mediators and control of lymphocyte responses in type 2 immunopathology[J]. J Allergy Clin Immunol, 2018, 141(4):1182-1190. DOI:10.1016/j.jaci.2018.02.006. PMID:29477727.
[6] Serhan CN, Chiang N, Dalli J. New pro-resolving n-3 mediators bridge resolution of infectious inflammation to tissue regeneration[J]. Mol Aspects Med, 2018, 64:1-17. DOI:10.1016/j.mam.2017.08.002. PMID:28802833. PMCID:PMC5832503.
[7] Serhan CN. Discovery of specialized pro-resolving mediators marks the dawn of resolution physiology and pharmacology[J]. Mol Aspects Med, 2017, 58:1-11. DOI:10.1016/j.mam.2017.03.001. PMID:28263773. PMCID:PMC5582020.
[8] Calder PC. Intravenous lipid emulsions to deliver bioactive omega-3 fatty acids for improved patient outcomes[J]. Mar Drugs, 2019, 17(5):274. DOI:10.3390/md17050274. PMID:31072006. PMCID:PMC6563008.
[9] McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient:Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)[J]. JPEN J Parenter Enteral Nutr, 2016, 40(2):159-211. DOI:10.1177/0148607115621863. PMID:26773077.
[10] Bougnoux P, Hajjaji N, Maheo K, et al. Fatty acids and breast cancer:sensitization to treatments and prevention of metastatic re-growth[J]. Prog Lipid Res, 2010, 49(1):76-86. DOI:10.1016/j.plipres.2009.08.003. PMID:19715726.
[11] De Cicco P, Catani MV, Gasperi V, et al. Nutrition and breast cancer:a literature review on prevention, treatment and recurrence[J]. Nutrients, 2019, 11(7):1514. DOI:10.3390/nu11071514. PMID:31277273. PMCID:PMC6682953.
[12] Goupille C, Vibet S, Frank PG, et al. EPA and DHA fatty acids induce a remodeling of tumor vasculature and potentiate docetaxel activity[J]. Int J Mol Sci, 2020, 21(14):4965. DOI:10.3390/ijms21144965. PMID:32674321. PMCID:PMC7404030.
[13] Lewis RM, Childs CE, Calder PC. New perspectives on placental fatty acid transfer[J]. Prostaglandins Leukot Essent Fatty Acids, 2018, 138:24-29. DOI:10.1016/j.plefa.2018.10.001. PMID:30392577.
[14] Kuipers RS, Luxwolda MF, Offringa PJ, et al. Fetal intrauterine whole body linoleic, arachidonic and docosahexaenoic acid contents and accretion rates[J]. Prostaglandins Leukot Essent Fatty Acids, 2012, 86(1-2):13-20. DOI:10.1016/j.plefa.2011.10.012. PMID:22115845.
[15] Bernhard W, Raith M, Koch V, et al. Developmental changes in polyunsaturated fetal plasma phospholipids and feto-maternal plasma phospholipid ratios and their association with bronchopulmonary dysplasia[J]. Eur J Nutr, 2016, 55(7):2265-2274. DOI:10.1007/s00394-015-1036-5. PMID:26363610.
[16] Bernard JY, Tint MT, Aris IM, et al. Maternal plasma phosphatidylcholine polyunsaturated fatty acids during pregnancy and offspring growth and adiposity[J]. Prostaglandins Leukot Essent Fatty Acids, 2017, 121:21-29. DOI:10.1016/j.plefa.2017.05.006. PMID:28651694. PMCID:PMC5501311.
[17] Ostadrahimi A, Salehi-Pourmehr H, Mohammad-Alizadeh-Charandabi S, et al. The effect of perinatal fish oil supplementation on neurodevelopment and growth of infants:a randomized controlled trial[J]. Eur J Nutr, 2018, 57(7):2387-2397. DOI:10.1007/s00394-017-1512-1. PMID:28752418.
[18] Campoy C, Escolano-Margarit MV, Ramos R, et al. Effects of prenatal fish-oil and 5-methyltetrahydrofolate supplementationon cognitive development of children at 6.5 y of age[J]. Am J Clin Nutr, 2011, 94(6 Suppl):1880S-1888S. DOI:10.3945/ajcn.110.001107. PMID:21849596.
[19] Gould JF, Treyvaud K, Yelland LN, et al. Seven-year follow-up of children born to women in a randomized trial of prenatal DHA supplementation[J]. JAMA, 2017, 317(11):1173-1175. DOI:10.1001/jama.2016.21303. PMID:28324081.
[20] Andrew MJ, Parr JR, Montague-Johnson C, et al. Neurodevelopmental outcome of nutritional intervention in newborn infants at risk of neurodevelopmental impairment:the dolphin neonatal double-blind randomized controlled trial[J]. Dev Med Child Neurol, 2018, 60(9):897-905. DOI:10.1111/dmcn.13914. PMID:29806081.
[21] Ramiro-Cortijo D, López de Pablo ÁL, López-Giménez MR, et al. Plasma oxidative status in preterm infants receiving LCPUFA supplementation:a pilot study[J]. Nutrients, 2020, 12(1):122. DOI:10.3390/nu12010122. PMID:31906339. PMCID:PMC7019959.
[22] Hasselmann M, Reimund JM. Lipids in the nutritional support of the critically ill patients[J]. Curr Opin Crit Care, 2004, 10(6):449-455. DOI:10.1097/01.ccx.0000144767.81163.6d. PMID:15616385.
[23] Martin CR, Dasilva DA, Cluette-Brown JE, et al. Decreased postnatal docosahexaenoic and arachidonic acid blood levels in premature infants are associated with neonatal morbidities[J]. J Pediatr, 2011, 159(5):743-749.e2. DOI:10.1016/j.jpeds.2011.04.039. PMID:21658712. PMCID:PMC3701520.
[24] Hsiao CC, Lin HC, Chang YJ, et al. Intravenous fish oil containing lipid emulsion attenuates inflammatory cytokines and the development of bronchopulmonary dysplasia in very premature infants:a double-blind, randomized controlled trial[J]. Clin Nutr, 2019, 38(3):1045-1052. DOI:10.1016/j.clnu.2018.06.929. PMID:29941233.
[25] 饶红萍, 周玉祥. 二十二碳六烯酸对早产儿主要并发症的预防价值的研究[J]. 中国医学创新, 2019, 16(33):134-138. DOI:10.3969/j.issn.1674-4985.2019.33.034.
[26] Collins CT, Makrides M, McPhee AJ, et al. Docosahexaenoic acid and bronchopulmonary dysplasia in preterm infants[J]. N Engl J Med, 2017, 376(13):1245-1255. DOI:10.1056/NEJMoa1611942. PMID:28355511.
[27] Wang Q, Zhou B, Cui QL, et al. Omega-3 long-chain polyunsaturated fatty acids for bronchopulmonary dysplasia:a meta-analysis[J]. Pediatrics, 2019, 144(1):e20190181. DOI:10.1542/peds.2019-0181. PMID:31164440.
[28] Löfqvist CA, Najm S, Hellgren G, et al. Association of retinopathy of prematurity with low levels of arachidonic acid:a secondary analysis of a randomized clinical trial[J]. JAMA Ophthalmol, 2018, 136(3):271-277. DOI:10.1001/jamaophthalmol.2017.6658. PMID:29423508. PMCID:PMC5885898.
[29] Hellström A, Nilsson AK, Wackernagel D, et al. Effect of enteral lipid supplement on severe retinopathy of prematurity:a randomized clinical trial[J]. JAMA Pediatr, 2021, 175(4):359-367. DOI:10.1001/jamapediatrics.2020.5653. PMID:33523106. PMCID:PMC7851754.
[30] Vayalthrikkovil S, Bashir RA, Rabi Y, et al. Parenteral fish-oil lipid emulsions in the prevention of severe retinopathy of prematurity:a systematic review and meta-analysis[J]. Am J Perinatol, 2017, 34(7):705-715. DOI:10.1055/s-0036-1597131. PMID:27992937.
[31] Najm S, Löfqvist C, Hellgren G, et al. Effects of a lipid emulsion containing fish oil on polyunsaturated fatty acid profiles, growth and morbidities in extremely premature infants:a randomized controlled trial[J]. Clin Nutr ESPEN, 2017, 20:17-23. DOI:10.1016/j.clnesp.2017.04.004. PMID:29072164. PMCID:PMC5784264.
[32] Singh P, Ochoa-Allemant P, Brown J, et al. Effect of polyunsaturated fatty acids on postnatal ileum development using the fat-1 transgenic mouse model[J]. Pediatr Res, 2019, 85(4):556-565. DOI:10.1038/s41390-019-0284-0. PMID:30653193. PMCID:PMC6397682.
[33] Charpentier C, Chan R, Salameh E, et al. Dietary n-3 PUFA may attenuate experimental colitis[J]. Mediators Inflamm, 2018, 2018:8430614. DOI:10.1155/2018/8430614. PMID:29670469. PMCID:PMC5833476.
[34] Gobbetti T, Ducheix S, le Faouder P, et al. Protective effects of n-6 fatty acids-enriched diet on intestinal ischaemia/reperfusion injury involve lipoxin A4 and its receptor[J]. Br J Pharmacol, 2015, 172(3):910-923. DOI:10.1111/bph.12957. PMID:25296998. PMCID:PMC4301698.
[35] Fares S, Sethom MM, Kacem S, et al. Plasma arachidonic and docosahexaenoic acids in Tunisian very low birth weight infants:status and association with selected neonatal morbidities[J]. J Health Popul Nutr, 2015, 33:1. DOI:10.1186/s41043-015-0011-3. PMID:26825799. PMCID:PMC5026025.
[36] Singer P, Theilla M, Fisher H, et al. Benefit of an enteral diet enriched with eicosapentaenoic acid and gamma-linolenic acid in ventilated patients with acute lung injury[J]. Crit Care Med, 2006, 34(4):1033-1038. DOI:10.1097/01.CCM.0000206111.23629.0A. PMID:16484911.
[37] Suganuma H, Arai Y, Kitamura Y, et al. Maternal docosahexaenoic acid-enriched diet prevents neonatal brain injury[J]. Neuropathology, 2010, 30(6):597-605. DOI:10.1111/j.1440-1789.2010.01114.x. PMID:20408962.
[38] 林慧佳, 沈晓霞, 倪映华, 等. 多种油脂肪乳在超低出生体重儿中应用的疗效分析[J]. 中国当代儿科杂志, 2021, 23(3):229-235. DOI:10.7499/j.issn.1008-8830.2011029. PMID:33691914. PMCID:PMC7969195.
[39] Yildizdas HY, Poyraz B, Atli G, et al. Effects of two different lipid emulsions on antioxidant status, lipid peroxidation and parenteral nutrition-related cholestasis in premature babies, a randomized-controlled study[J]. Pediatr Neonatol, 2019, 60(4):359-367. DOI:10.1016/j.pedneo.2018.07.012. PMID:30177465.
[40] Fousekis FS, Mitselos IV, Christodoulou DK. New insights into intestinal failure-associated liver disease in adults:a comprehensive review of the literature[J]. Saudi J Gastroenterol, 2021, 27(1):3-12. DOI:10.4103/sjg.sjg_551_20. PMID:33642350. PMCID:PMC8083246.
[41] Uberos J, Jiménez-Montilla S, Molina-Oya M, et al. Morbidity outcomes of very low birth weight neonates receiving parenteral nutrition with fish oil enriched lipid emulsion or lipid emulsion with soybean oil:an observational study[J]. Am J Perinatol, 2020. DOI:10.1055/s-0039-1701026. PMID:31986542. Epub ahead of print.
