Team finds likely culprit behind liver problems linked to intravenous feeding

Researchers know that feeding some patients intravenously can save their lives – but also can cause liver damage. Now scientists at the University of Colorado and Children's Hospital Colorado have figured out the likely culprit, one of the ingredients in intravenous food, behind the liver problems.

The discovery, published Oct. 9 in Science Translational Medicine, could point the way to better treatments for patients who are medically vulnerable and, often, very young.

"We still have more to learn about the optimal mix of lipids for intravenous nutrition," said Ron Sokol, part of the research team. "Our hope is that this study will lead us to intravenous nutrition that results in less stress on the ."

A life-saving option for some patients with intestinal problems or pancreatitis is to provide food intravenously. But this option, usually used for patients who can't tolerate or absorb food from their intestines, is associated with while helping in other ways.

The risk is especially high for premature infants and children with intestinal failure or short bowel syndrome, who often depend on intravenous feeding – or Parenteral nutrition (PN)—for years. The longer a patient is on PN and the more severe their intestinal problems, the greater the risk of what is called PN-associated liver disease (PNALD).

Clinical evidence had suggested that lipids derived from might be part of the problem. The researchers, also representing University of Cincinnati, Cincinnati Children's Hospital and Emory University, zeroed in on the soy factor.

They found that one derivative of soy – called stigmasterol – appeared to prevent the flow of bile from the liver in experimental mice. They also figured out the chemical mechanism behind that problem, and found that microbes in the gut appeared to contribute to PNALD as well.

"The results of this study may help promote a shift away from solutions containing stigmasterol for dependent on intravenous nutrition," Sokol said.

More information: "Phytosterols Promote Liver Injury and Kupffer Cell Activation in Parenteral Nutrition–Associated Liver Disease," by K.C. El Kasmi et al. Science Translational Medicine, 2013.

Related Stories

New treatment offers hope for short-bowel syndrome patients

Jul 18, 2013

A new drug, teduglutide, offers significant relief for patients with short-bowel syndrome intestinal failure who are reliant on intravenous nutrition, according to a new study in Clinical Gastroenterology and Hepatology, the of ...

Recommended for you

UN says Syria vaccine deaths was an NGO 'mistake'

4 hours ago

The recent deaths of Syrian children after receiving measles vaccinations was the result of a "mistake" by a non-governmental partner who mixed in a muscle relaxant meant for anesthesia, a spokesman for the U.N. secretary-general ...

First US child dies from enterovirus D68

5 hours ago

A child in the northeastern US state of Rhode Island has become the first to die from an ongoing outbreak of a respiratory virus, enterovirus D68, health officials said Wednesday.

US Ebola patient had contact with kids: governor

5 hours ago

A man who was diagnosed with Ebola in virus in Texas came in contact with young children, and experts are monitoring them for any signs of disease, governor Rick Perry said Wednesday.

UN worker dies of suspected Ebola in Liberia

5 hours ago

The United Nations mission in Liberia announced on Wednesday the first suspected victim among its employees of the deadly Ebola epidemic ravaging the impoverished west African nation.

User comments