PN-Associated Liver Disease (PNALD) is a life-threatening complication of the administration of parenteral nutrition (PN). The development of PNALD may be partly due to the composition of the lipid emulsion administered with PN: soy-based lipid emulsions (SOLE) are associated with liver disease, while fish oil-based lipid emulsions (FOLE) are associated with prevention and improvement of liver disease.

The objective of this study was to determine how the choice of lipid emulsion modified the production of bioactive lipid mediators. We utilized a mouse model of steatosis to study the differential effect of FOLE and SOLE.

We subsequently validated these results in serum samples obtained from a small cohort of human infants transitioning from SOLE to FOLE.

In mice, FOLE was associated with the production of anti-inflammatory, pro-resolving lipid mediators; SOLE was associated with increased production of inflammatory lipid mediators.

In human infants, the transition from SOLE to FOLE was associated with a shift towards a pro-resolving lipidome.

Together, these results demonstrate that the composition of the lipid emulsion directly modifies inflammatory homeostasis.