Influence of preoperative administration of ω-3 fatty acid-enriched supplement on inflammatory and immune responses in patients undergoing major surgery for cancer

Polyunsaturated fatty acid supplementation may produce beneficial effects after surgery. We investigated the influence of preoperative administration of a supplement rich in arginine, ω-3 fatty acids, and RNA, Impact (Japan), on inflammatory and immune responses in patients undergoing major surgery for cancer. Patients in the supplement group ( n = 12) received 1 L/d of Impact (Japan) for 5 d before surgery, and those in the control group ( n = 14) received an ordinary diet without Impact (Japan) before surgery. Plasma levels of ω-3 and ω-6 fatty acids, thromboxane B 2, prostaglandin E 2, inflammatory markers, nutritional markers, cytokines, and cytokine receptors were obtained 5 d before the operation at the starting point of supplementation in the supplement group. Samples were collected on postoperative days (PODs) 0, 1, 3, and 7. After taking the supplement, significant increases in ω-3 fatty acids and rapid turnover proteins were found the day after ending supplementation (POD-0), whereas thromboxane B 2 levels and the ratio of ω-6 fatty acids to ω-3 fatty acids were significantly lower than before supplementation ( P < 0.001). On POD-0 only, inflammatory markers and cytokine receptors in the supplement group showed low levels in comparison with the control group ( P < 0.05). On POD-1 and POD-3, remarkable decreases in polymorphonuclear leukocyte-elastase and interleukin-8 in the supplement group were observed. Our findings suggest that oral administration of a supplement rich in ω-3 fatty acids for 5 d before surgery may improve not only preoperative nutritional status but also preoperative and postoperative inflammatory and immune responses in patients who have cancer.