The effects of omega-3 fish oil infusion on the T-regulatory cells in patients with severe acute pancreatitis: A randomised control pilot study

Introduction: A balance between pro-inflammatory and regulatory immune responses determines the outcome in Severe Acute Pancreatitis (SAP). Failure to regulate the inflammatory response can leads to the development of multiple organ dysfunction. Omega-3 has shown to modulate the pro-inflammatory cytokines in SAP. The aim of this study is to examine the role of Omega-3 fish oil on T-regulatory cells. Methods: Forty-four patients with predicted SAP were randomly and blindly allocated to receive daily an omega-3 fish-oil infusion (Lipidem 20%, BBraun)(n1⁄422) or a similar infusion but without omega-3 fish-oil (Lipofundin MCT 20%, BBraun)(n1⁄422). Infusions were initiated within 3 days of the onset of the symptoms and for a maximum of 7 days. A peripheral bloodmononuclear cell (PBMC) was obtained on days 0,1, 3 and 7 of the infusion. Subsequently, T-cells were isolated by flow cytometric cell sorting on a FACSAria (BD Biosciences). Results On admission, there were no significant differences between both groups on the expressions of CD4, CD25, Fox P3, CD4+ CD25+ Fox P3-, CD4+ CD25+ Fox P3+, CD4+ CD25Fox P3+, CD4+ CD25Fox P3+, p1⁄40.259, 0.164, 0.155, 0.934, 0.179, 0.133 and 0.884, respectively. On day 7-post infusion, trends towards positive Fox P3 T-cells phenotypes were observed in the fish-oil group, p1⁄4>0.05. Conclusion: This preliminary study suggests that omega-3 fish can modify T-cells through the expression of the Fox P3+ T-cells phenotypes. Further studies are required to establish these findings. Take-home message: Omega-3 fish oil improves the activity of regulatory cells. Abstract previously presented? no () Any disclosures? yes (D. Al-Leswas: Grant/Research Support from B Braun, W.-Y. Chung: None declared. L. Howells: none declared, A. Eltweri: None declared, A. Arshad: Grant/Research Support from B Braun, C. Pollard: None declared, O. Al-Taan: Grant/Research Support from B Braun, G. Garcea: None declared, M. Metcalfe: Grant/ Research Support from B Braun, A. Dennison: Grant/Research Support from B Braun)