Children’s Nutrition Research Center Staff Publications

Language

English

Publication Date

5-22-2025

Journal

JCi Insight

DOI

10.1172/jci.insight.189196

PMID

40244694

PMCID

PMC12128955

PubMedCentral® Posted Date

4-17-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Biliary atresia (BA) is a pediatric liver disease that often necessitates parenteral nutrition (PN) to support growth due to impaired liver function. While soy-based lipid emulsions (SLE) are commonly used in PN, they may contribute to cholestatic liver injury. In contrast, mixed lipid emulsions (MLE) show promise in preventing cholestasis in infants without BA, potentially by restoring bile flow. However, their effectiveness in patients of complete bile duct obstruction, as seen in BA, remains uncertain. To explore the potential benefits of MLE in BA, we utilized a neonatal pig model of bile duct ligation (BDL). Pigs underwent either BDL or sham surgery and were subsequently fed either MLE or SLE via PN, or enterally with formula. The MLE-BDL pigs exhibited significantly greater weight gain compared with those fed SLE or formula enterally. Additionally, MLE-BDL pigs showed higher serum bile acid and γ-glutamyl transferase concentrations compared with SLE-BDL pigs. However, no significant differences in liver injury, assessed by ductular reaction or fibrosis, were observed between MLE- and SLE-BDL pigs. Based on weight gain alone, MLE may be a superior lipid emulsion for use in neonates with obstructive cholestasis.

Keywords

Animals, Cholestasis, Animals, Newborn, Swine, Parenteral Nutrition, Disease Models, Animal, Fat Emulsions, Intravenous, Liver, Biliary Atresia, Bile Acids and Salts, Soybean Oil, Female, gamma-Glutamyltransferase, Male, Emulsions, Hepatology, Metabolism, Fibrosis

Published Open-Access

yes

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