The acute-phase protein response is associated with accelerated weight loss and shortened survival in cancer. This may be due to hepatic protein synthesis increasing demand for amino acids. An n-3 fatty-acid-enriched nutritional supplement will moderate aspects of cachexia in cancer patients. The present study examined the effect of such a supplement on hepatic synthesis of albumin and fibrinogen. Albumin and fibrinogen synthesis were measured in the fed and fasting state in eight weight-losing patients with pancreatic cancer by an intravenous flooding dose technique. Tracer incorporation into proteins was measured by GC/MS. Patients were restudied after 3 weeks of oral supplement enriched with fish oil (providing 2510 kJ/day and 2 g of eicosapentaenoic acid/day). At baseline, all patients were losing weight (median, 2.4 kg/month). After 3 weeks of consumption of the fish-oil-enriched nutritional supplement, patients′ weight stabilized (median change, +1 kg; P=0.01). At baseline, albumin and fibrinogen synthesis rates were stimulated in the fed compared with the fasting state [14.2 compared with 11.3 g/day (29% rise; P=0.01) and 4.5 compared with 3.3 g/day (38% rise; P=0.01) respectively]. After 3 weeks of the supplement, this stimulation in the fed state was no longer observed for albumin and was reduced for fibrinogen [11.2 compared with 10.5 g/day (3% rise; P=0.21) and 3.7 compared with 2.9 g/day (17% rise; P=0.01) respectively]. After 3 weeks, the combined albumin plus fibrinogen synthetic rate tended to fall in the fasting state (14.7 compared with 12.3 g/day; P=0.09) and was significantly reduced in the fed state (18.7 compared with 14.6 g/day; P=0.01). Modulation of hepatic export protein synthesis with feeding may have contributed to the net whole-body anabolism observed with administration of the n-3 fatty-acid-enriched oral supplement.
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April 2004
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Research Article|
April 01 2004
Modulation of the liver export protein synthetic response to feeding by an n−3 fatty-acid-enriched nutritional supplement is associated with anabolism in cachectic cancer patients
Matthew D. BARBER;
Matthew D. BARBER
*Department of Clinical and Surgical Sciences (Surgery), The University of Edinburgh, Royal Infirmary, Edinburgh EH16 4SA, Scotland, U.K.
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Tom PRESTON;
Tom PRESTON
†Isotope Biochemistry Laboratory, Scottish Universities Environmental Research Centre, East Kilbride G75 0QF, Scotland, U.K.
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Donald C. McMILLAN;
Donald C. McMILLAN
‡Department of Surgery, Glasgow Royal Infirmary, Glasgow G31 2ER, Scotland, U.K.
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Christine SLATER;
Christine SLATER
§Division of Developmental Medicine, University of Glasgow, Yorkhill Hospitals, Glasgow G3 8SJ, Scotland, U.K.
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James A. ROSS;
James A. ROSS
*Department of Clinical and Surgical Sciences (Surgery), The University of Edinburgh, Royal Infirmary, Edinburgh EH16 4SA, Scotland, U.K.
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Kenneth C. H. FEARON
*Department of Clinical and Surgical Sciences (Surgery), The University of Edinburgh, Royal Infirmary, Edinburgh EH16 4SA, Scotland, U.K.
Correspondence: Professor K. C. H. Fearon (e-mail k.fearon@ed.ac.uk).
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Clin Sci (Lond) (2004) 106 (4): 359–364.
Article history
Received:
September 12 2003
Revision Received:
November 10 2003
Accepted:
November 18 2003
Accepted Manuscript online:
November 18 2003
Citation
Matthew D. BARBER, Tom PRESTON, Donald C. McMILLAN, Christine SLATER, James A. ROSS, Kenneth C. H. FEARON; Modulation of the liver export protein synthetic response to feeding by an n−3 fatty-acid-enriched nutritional supplement is associated with anabolism in cachectic cancer patients. Clin Sci (Lond) 1 April 2004; 106 (4): 359–364. doi: https://doi.org/10.1042/CS20030301
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