Intralipid Fatty Acids: The Code of Life ?
By Joseph Eldor
()
About this ebook
Intralipid® 20% (A 20% I.V. Fat Emulsion) Pharmacy Bulk Package is a sterile, non pyrogenic fat emulsion intended as a source of calories and essential fatty acids for use in a pharmacy ad mixture program. It is made up of 20% Soybean Oil, 1.2% Egg Yolk Phospholipids, 2.25% Glycerin, and Water for Injection. In addition, sodium hydroxide has been added to adjust the pH so that the final product pH is 8. pH range is 6 to 8.9.
The soybean oil is a refined natural product consisting of a mixture of neutral triglycerides of predominantly unsaturated fatty acids.
The major component fatty acids are linoleic acid (44-62%), oleic acid (19-30%), palmitic acid (7-14%), a-linolenic acid (4-11%) and stearic acid (1.4-5.5%).(1).
It means that the various effects of Intralipid are based 63% to 92% on linoleic acid and oleic acid.
Are these 2 fatty acids the Code of Life ?
In order to find the answer the medical literature was searched for each fatty acid's effects on the following .subjects :
1. Cancer
2. Cardioprotection
3. Alzheimer Disease
4. Oocytes
5. Spermatozoa
6. Hemolysis
7. Bone cement
8. Spinal injury
9. Brain injury
10. Amniotic fluid
Read more from Joseph Eldor
Quantum Consciousness Rating: 0 out of 5 stars0 ratingsCombined Spinal-Epidural Anesthesia Rating: 0 out of 5 stars0 ratingsIntralipid Is a Magic Bullet Rating: 0 out of 5 stars0 ratingsMatch Cognitive Brain Test Rating: 0 out of 5 stars0 ratingsIntralipid and other Lipid Emulsions Rating: 0 out of 5 stars0 ratingsIntralipid Rating: 0 out of 5 stars0 ratingsSerendipity Based Medicine (SBM) : To Infinity and Beyond Rating: 0 out of 5 stars0 ratingsIntralipid infusion for Myelin Sheath Repair in Multiple Sclerosis and Trigeminal Neuralgia? Rating: 0 out of 5 stars0 ratingsIntralipid-Iodine for Imaging Rating: 0 out of 5 stars0 ratingsThe Spectrum of Amniotic Fluid Embolism: Is Intralipid the solution ? Rating: 0 out of 5 stars0 ratingsBread Fat Rating: 0 out of 5 stars0 ratingsIntralipid is a Magic Bullet in Cancer treatment? Rating: 0 out of 5 stars0 ratings
Related to Intralipid Fatty Acids
Related ebooks
Intralipid Rating: 0 out of 5 stars0 ratingsThe Spectrum of Amniotic Fluid Embolism: Is Intralipid the solution ? Rating: 0 out of 5 stars0 ratingsThe HDL Handbook: Biological Functions and Clinical Implications Rating: 0 out of 5 stars0 ratingsBiochemistry of Lipids, Lipoproteins and Membranes Rating: 5 out of 5 stars5/5Handbook of Lipids in Human Function: Fatty Acids Rating: 0 out of 5 stars0 ratingsTextbook of Nephro-Endocrinology Rating: 0 out of 5 stars0 ratingsLipid Mediators Rating: 0 out of 5 stars0 ratingsOligonucleotide-Based Drugs and Therapeutics: Preclinical and Clinical Considerations for Development Rating: 0 out of 5 stars0 ratingsBioactive Food as Dietary Interventions for Cardiovascular Disease: Bioactive Foods in Chronic Disease States Rating: 0 out of 5 stars0 ratingsPolar Lipids: Biology, Chemistry, and Technology Rating: 0 out of 5 stars0 ratingsLipid Biochemistry: For Medical Sciences Rating: 0 out of 5 stars0 ratingsTextbook of Veterinary Physiological Chemistry Rating: 0 out of 5 stars0 ratingsBrain Lipids in Synaptic Function and Neurological Disease: Clues to Innovative Therapeutic Strategies for Brain Disorders Rating: 0 out of 5 stars0 ratingsLipid Signaling and Metabolism Rating: 0 out of 5 stars0 ratingsCellular, Molecular, and Environmental Contribution in Cardiac Remodeling: From Lab Bench Work to its Clinical Perspective Rating: 0 out of 5 stars0 ratingsLiposomes in Nanomedicine Rating: 0 out of 5 stars0 ratingsDietary Interventions in Liver Disease: Foods, Nutrients, and Dietary Supplements Rating: 5 out of 5 stars5/5Fast Facts: Long-Chain Fatty Acid Oxidation Disorders for Patients Rating: 0 out of 5 stars0 ratingsEdible Oleogels: Structure and Health Implications Rating: 0 out of 5 stars0 ratingsFish and Fish Oil in Health and Disease Prevention Rating: 0 out of 5 stars0 ratingsCellular Lipid in Health and Disease Rating: 0 out of 5 stars0 ratingsMetabolic Syndrome: Underlying Mechanisms and Drug Therapies Rating: 0 out of 5 stars0 ratingsPreclinical Biochemistry and Medical Genetics Review 2023: For USMLE Step 1 and COMLEX-USA Level 1 Rating: 0 out of 5 stars0 ratingsNutraceuticals and Human Blood Platelet Function: Applications in Cardiovascular Health Rating: 0 out of 5 stars0 ratingsThe Scientist's Guide to Cardiac Metabolism Rating: 0 out of 5 stars0 ratingsNutrition and Behaviour: Lecture Note Bundle Rating: 0 out of 5 stars0 ratingsMitochondria in Obesity and Type 2 Diabetes: Comprehensive Review on Mitochondrial Functioning and Involvement in Metabolic Diseases Rating: 0 out of 5 stars0 ratingsPlasma Lipids: Optimal Levels for Health Rating: 0 out of 5 stars0 ratingsThe Liver: Oxidative Stress and Dietary Antioxidants Rating: 0 out of 5 stars0 ratingsFrontiers in Clinical Drug Research - CNS and Neurological Disorders: Volume 9 Rating: 0 out of 5 stars0 ratings
Medical For You
The Hormone Reset Diet: Heal Your Metabolism to Lose Up to 15 Pounds in 21 Days Rating: 4 out of 5 stars4/5Mediterranean Diet Meal Prep Cookbook: Easy And Healthy Recipes You Can Meal Prep For The Week Rating: 5 out of 5 stars5/5Mating in Captivity: Unlocking Erotic Intelligence Rating: 4 out of 5 stars4/5Holistic Herbal: A Safe and Practical Guide to Making and Using Herbal Remedies Rating: 4 out of 5 stars4/5The Vagina Bible: The Vulva and the Vagina: Separating the Myth from the Medicine Rating: 5 out of 5 stars5/5The 40 Day Dopamine Fast Rating: 4 out of 5 stars4/5What Happened to You?: Conversations on Trauma, Resilience, and Healing Rating: 4 out of 5 stars4/5Passionista: The Empowered Woman's Guide to Pleasuring a Man Rating: 4 out of 5 stars4/5Women With Attention Deficit Disorder: Embrace Your Differences and Transform Your Life Rating: 5 out of 5 stars5/5Adult ADHD: How to Succeed as a Hunter in a Farmer's World Rating: 4 out of 5 stars4/5Peptide Protocols: Volume One Rating: 4 out of 5 stars4/5The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally Rating: 4 out of 5 stars4/5Gut: The Inside Story of Our Body's Most Underrated Organ (Revised Edition) Rating: 4 out of 5 stars4/5Living Daily With Adult ADD or ADHD: 365 Tips o the Day Rating: 5 out of 5 stars5/5David D. Burns’ Feeling Good: The New Mood Therapy | Summary Rating: 4 out of 5 stars4/5Period Power: Harness Your Hormones and Get Your Cycle Working For You Rating: 4 out of 5 stars4/5ATOMIC HABITS:: How to Disagree With Your Brain so You Can Break Bad Habits and End Negative Thinking Rating: 5 out of 5 stars5/5The Amazing Liver and Gallbladder Flush Rating: 5 out of 5 stars5/5Lifting the Fog: A specific guide to inattentive ADHD in adults Rating: 4 out of 5 stars4/5The Song of the Cell: An Exploration of Medicine and the New Human Rating: 4 out of 5 stars4/5A Letter to Liberals: Censorship and COVID: An Attack on Science and American Ideals Rating: 3 out of 5 stars3/5Woman: An Intimate Geography Rating: 4 out of 5 stars4/5The Emperor of All Maladies: A Biography of Cancer Rating: 5 out of 5 stars5/5"Cause Unknown": The Epidemic of Sudden Deaths in 2021 & 2022 Rating: 5 out of 5 stars5/5
Reviews for Intralipid Fatty Acids
0 ratings0 reviews
Book preview
Intralipid Fatty Acids - Joseph Eldor
INTRALIPID Fatty Acids:
The Code of Life?
Joseph Eldor, MD
INTRALIPID Fatty Acids:
The Code of Life?
Joseph Eldor, MD
Theoretical Medicine Institute, Jerusalem, Israel
csen_international@csen.com
Copyright ©2018 by Joseph Eldor, MD
Smashwords Edition
All rights reserved. No part of this book may be used or reproduced in any manner whatsoever without written permission, except in the case of brief quotations embodied in critical articles or reviews. Please do not participate in or encourage the piracy of copyrighted materials in violation of the author’s rights. Purchase only authorized editions.
Contents
1. Introduction
2. Preface : Lipid Emulsion effects on mitochondria and intracellular calcium
3. Linoleic acid
4. Oleic acid
5. Linoleic acid and Cancer
6. Oleic acid and Cancer
7. Linoleic acid and Cardioprotection
8. Oleic acid and Cardioprotection
9. Linoleic acid and Alzheimer Disease
10. Oleic acid and Alzheimer Disease
11. Linoleic acid and Oocytes
12. Oleic acid and Oocytes
13. Linoleic acid and Spermatozoa
14. Oleic acid and Spermatozoa
15. Linoleic acid and Hemolysis
16. Oleic acid and Hemolysis
17. Linoleic acid and Bone cement
18. Oleic acid and Bone cement
19. Linoleic acid and Spinal injury
20. Oleic acid and Spinal injury
21. Linoleic acid and Brain injury
22. Oleic acid and Brain injury
23. Linoleic acid and Amniotic fluid
24. Oleic acid and Amniotic fluid
Introduction
Intralipid® 20% (A 20% I.V. Fat Emulsion) Pharmacy Bulk Package is a sterile, non pyrogenic fat emulsion intended as a source of calories and essential fatty acids for use in a pharmacy ad mixture program. It is made up of 20% Soybean Oil, 1.2% Egg Yolk Phospholipids, 2.25% Glycerin, and Water for Injection. In addition, sodium hydroxide has been added to adjust the pH so that the final product pH is 8. pH range is 6 to 8.9.
The soybean oil is a refined natural product consisting of a mixture of neutral triglycerides of predominantly unsaturated fatty acids.
The major component fatty acids are linoleic acid (44-62%), oleic acid (19-30%), palmitic acid (7-14%), a-linolenic acid (4-11%) and stearic acid (1.4-5.5%).(1).
It means that the various effects of Intralipid are based 63% to 92% on linoleic acid and oleic acid.
Are these 2 fatty acids the Code of Life ?
In order to find the answer the medical literature was searched for each fatty acid's effects on the following .subjects :
1. Cancer
2. Cardioprotection
3. Alzheimer Disease
4. Oocytes
5. Spermatozoa
6. Hemolysis
7. Bone cement
8. Spinal injury
9. Brain injury
10. Amniotic fluid
PREFACE: Lipid Emulsion effects on mitochondria and intracellular calcium
Local anesthetic toxicity is thought to be mediated partly by inhibition of cardiac mitochondrial function. Intravenous (i.v.) lipid emulsion may overcome this energy depletion, but doses larger than currently recommended may be needed for rescue effect. In this randomized study with anesthetized pigs, we (2) compared the effect of a large dose, 4 mL/kg, of i.v. 20% Intralipid® ( n = 7) with Ringer's acetate ( n = 6) on cardiovascular recovery after a cardiotoxic dose of bupivacaine. We also examined mitochondrial respiratory function in myocardial cell homogenates analyzed promptly after needle biopsies from the animals. Bupivacaine plasma concentrations were quantified from plasma samples. Arterial blood pressure recovered faster and systemic vascular resistance rose more rapidly after Intralipid than Ringer's acetate administration ( p < 0.0001), but Intralipid did not increase cardiac index or left ventricular ejection fraction. The lipid-based mitochondrial respiration was stimulated by approximately 30% after Intralipid ( p < 0.05) but unaffected by Ringer's acetate. The mean (standard deviation) area under the concentration-time curve (AUC) of total bupivacaine was greater after Intralipid (105.2 (13.6) mg•min/L) than after Ringer's acetate (88.1 (7.1) mg•min/L) ( p = 0.019). After Intralipid, the AUC of the lipid-un-entrapped bupivacaine portion (97.0 (14.5) mg•min/L) was 8% lower than that of total bupivacaine ( p < 0.0001). To conclude, 4 mL/kg of Intralipid expedited cardiovascular recovery from bupivacaine cardiotoxicity mainly by increasing systemic vascular resistance. The increased myocardial mitochondrial respiration and bupivacaine entrapment after Intralipid did not improve cardiac function (2).
Lipid emulsions have been used to treat various drug toxicities and for total parenteral nutrition therapy. Their usefulness has also been confirmed in patients with local anesthetic-induced cardiac toxicity. The purpose of this study was to measure the hemodynamic and composition effects of lipid emulsions and to elucidate the mechanism associated with changes in intracellular calcium levels in myocardiocytes.
We (3) measured hemodynamic effects using a digital analysis system after Intralipid® and Lipofundin® MCT/LCT were infused into hearts hanging in a Langendorff perfusion system. We measured the effects of the lipid emulsions on intracellular calcium levels in H9c2 cells by confocal microscopy.
Infusion of Lipofundin® MCT/LCT 20% (1 ml/kg) resulted in a significant increase in left ventricular systolic pressure compared to that after infusing modified Krebs-Henseleit solution (1 ml/kg) (P = 0.003, 95% confidence interval [CI], 2.4-12.5). Lipofundin® MCT/LCT 20% had a more positive inotropic effect than that of Intralipid® 20% (P = 0.009, 95% CI, 1.4-11.6). Both lipid emulsion treatments increased intracellular calcium levels. Lipofundin® MCT/LCT (0.01%) increased intracellular calcium level more than that of 0.01% Intralipid® (P < 0.05, 95% CI, 0.0-1.9).
These two lipid emulsions had different inotropic effects depending on their triglyceride component. The inotropic effect of lipid emulsions could be related with intracellular calcium level (3).
Accidental intravascular or high-dose injection of local anesthetics (LA) can result in serious, potentially life-threatening complications. Indeed, adequate supportive measures and the administration of lipid emulsions are required in such complications. The study's objectives were threefold: (i) evaluate the myocardial toxicity of levobupivacaine when administered intravenously; (ii) investigate levobupivacaine toxicity on cardiomyocytes mitochondrial functions and cellular structure; (iii) assess the protective effects of a lipid emulsion in the presence or absence of myocardial ischemia. Domestic pigs randomized into two groups of 24 animals each, with either preserved coronary circulation or experimental myocardial ischemia. Six animals from each group received either: (i) single IV injection of saline, (ii) lipid emulsion (Intralipid(®) ), (iii) levobupivacaine, (iv) combination levobupivacaine-Intralipid(®) . Serially measured endpoints included: heart rate, duration of the monophasic action potentials (dMAP), mean arterial pressure, and peak of the time derivative of left ventricular pressure (LV dP/dtmax ). In addition, the following cardiomyocytes mitochondrial functions were measured: reactive oxygen species (ROS) production, oxidative phosphorylation, and calcium retention capacity (CRC) as well as the consequences of ROS production on lipids, proteins, and DNA. IV injection of levobupivacaine induced sinus bradycardia and reduced dMAP and LV dP/dtmax . At the mitochondrial level, oxygen consumption and CRC were decreased. In contrast, ROS production was increased leading to enhanced lipid peroxidation and structural alterations of proteins and DNA. Myocardial ischemia was associated with global worsening of all changes. Intralipid(®) quickly improved haemodynamics. However, beneficial effects of Intralipid(®) were less clear after myocardial ischemia (4).
Cocaine intoxication leads to over 500,000 emergency department visits annually in the United States and ethanol cointoxication occurs in 34% of those cases. Cardiotoxicity is an ominous complication of cocaine and cocaethylene overdose for which no specific antidote exists. Because infusion of lipid emulsion (Intralipid) can treat lipophilic local anesthetic toxicity and cocaine is an amphipathic local anesthetic, the authors (5) tested whether lipid emulsion could attenuate cocaine cardiotoxicity in vivo. The effects of lipid emulsion were compared with the metabolically inert sulfobutylether-β-cyclodextrin (SBE-β-CD; Captisol) in an isolated heart model of cocaine and cocaethylene toxicity to determine if capture alone could exert similar benefit as lipid emulsion, which exhibits multimodal effects. The authors then tested if cocaine and cocaethylene, like bupivacaine, inhibit lipid-based metabolism in isolated cardiac mitochondria.
For whole animal experiments, Sprague-Dawley rats were anesthetized, instrumented, and pretreated with lipid emulsion followed by a continuous infusion of cocaine to assess time of onset of cocaine toxicity. For ex vivo experiments, rat hearts were placed onto a nonrecirculating Langendorff system perfused with Krebs-Henseleit solution. Heart rate, left ventricle maximum developed pressure (LVdevP), left ventricle diastolic pressure, maximum rate of contraction (+dP/dtmax), maximum rate of relaxation (-dP/dtmax), rate-pressure product (RPP = heart rate × LVdevP), and line pressure were monitored continuously during the experiment. A dose response to cocaine (10, 30, 50, and 100 μmol/L) and cocaethylene (10, 30, and 50 μmol/L) was generated in the absence or presence of either 0.25% lipid emulsion or SBE-β-CD. Substrate-specific rates of oxygen consumption were measured in interfibrillar cardiac mitochondria in the presence of cocaine, cocaethylene, ecgonine, and benzoylecgonine.
Treatment with lipid emulsion delayed onset of hypotension (140 seconds vs. 279 seconds; p = 0.008) and asystole (369 seconds vs. 607 seconds; p = 0.02) in whole animals. Cocaine and cocaethylene induced dose-dependent decreases in RPP, +dP/dtmax, and -dP/dtmaxabs (p < 0.0001) in Langendorff hearts; line pressure was increased by cocaine and cocaethylene infusion, but not altered by treatment. Lipid emulsion attenuated cocaine- and cocaethylene-induced cardiac depression. SBE-β-CD alone evoked a mild cardiodepressant effect (p < 0.0001) but attenuated further cocaine- and cocaethylene-induced decrements in cardiac contractility at high concentrations of drug (100 μmol/L; p < 0.001). Finally, both cocaine and cocaethylene, but not ecgonine and benzoylecgonine, inhibited lipid-dependent mitochondrial respiration by blocking carnitine exchange (p < 0.05).
A commercially available lipid emulsion was able to delay progression of cocaine cardiac toxicity in vivo. Further, it improved acute cocaine- and cocaethylene-induced cardiac toxicity in rat isolated heart while SBE-β-CD was effective only at the highest cocaine concentration. Further, both cocaine and cocaethylene inhibited lipid-dependent mitochondrial respiration. Collectively, this suggests that scavenging-independent effects of lipid emulsion may contribute to reversal of acute cocaine and cocaethylene cardiotoxicity, and the beneficial effects may involve mitochondrial lipid processing (5).
We (6) hypothesized that acute lipid-induced insulin resistance would be attenuated in high-oxidative muscle of lean trained (LT) endurance athletes due to their enhanced metabolic flexibility and mitochondrial capacity. Lean sedentary (LS), obese sedentary (OS), and LT participants completed two hyperinsulinemic euglycemic clamp studies with and without (glycerol control) the coinfusion of Intralipid. Metabolic flexibility was measured by indirect calorimetry as the oxidation of fatty acids and glucose during fasted and insulin-stimulated conditions, the latter with and without lipid oversupply. Muscle biopsies were obtained for mitochondrial and insulin-signaling studies. During hyperinsulinemia without lipid, glucose infusion rate (GIR) was lowest in OS due to lower rates of nonoxidative glucose disposal (NOGD), whereas state 4 respiration was increased in all groups. Lipid infusion reduced GIR similarly in all subjects and reduced state 4 respiration. However, in LT subjects, fat oxidation was higher with lipid oversupply, and although glucose oxidation was reduced, NOGD was better preserved compared with LS and OS subjects. Mitochondrial performance was positively associated with better NOGD and insulin sensitivity in both conditions. We conclude that enhanced mitochondrial performance with exercise is related to better metabolic flexibility and insulin sensitivity in response to lipid overload (6).
Linoleic acid
Linoleic acid (C18H32O2 ).
A carboxylic acid, is a polyunsaturated omega-6 fatty acid, an 18-carbon chain with two double bonds in cisconfiguration. A shorthand notation like 18:2 (n-6)
or "18:2 cis-9,12" may be used in literature (7). It typically occurs in nature as a triglyceride ester; free fatty acids are typically low in foods (8).
Linoleic acid belongs to one of the two families of essential fatty acids, which means that the human body cannot synthesize