{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T05:03:01Z","timestamp":1793163781783,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T00:00:00Z","timestamp":1611792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Sepsis is an important determinant of the outcome of acute\u2010on\u2010chronic liver failure (ACLF) patients. Omega\u20103 fatty acids (FAs) are known to suppress inflammation, reduce morbidity, and mortality in postoperative and critically ill patients. We aimed to evaluate the effect of intravenous omega\u20106 and omega\u20103 FA lipid emulsions in ACLF patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety ACLF patients were randomly allocated to three groups: Gr. A received no lipid emulsions, Gr. B received omega\u20106 FAs, and Gr. C received omega\u20103 FAs. The primary and secondary aims were to compare the effects of lipid emulsions on immune modulation, the incidence of bacterial sepsis, and mortality at day 28.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The baseline characteristics of the patients were comparable. Serum endotoxin levels remained suppressed by 22% in Gr. C compared with a 4% and 12% rise in Gr. B and A (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Omega\u20103 FAs also suppressed C\u2010reactive protein levels and neutrophil\u2010to\u2010lymphocyte ratio in Gr. C. Compared with Gr. A, omega\u20103 FAs reduced sepsis by 86% (HR, 0.14; 95% CI 0.04\u20130.43; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Omega\u20103 FAs significantly increased the expression of TLR2 and TLR4 on both CD14<jats:sup>+<\/jats:sup> and CD16<jats:sup>+<\/jats:sup> monocytes, and TLR4, on macrophages and neutrophils. There were no serious adverse events, except transient flushing in 20% and 16.6% of patients receiving omega\u20106 FAs and omega\u20103 FAs, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Omega\u20103 FAs are safe and effective in reducing systemic inflammation, endotoxemia, and sepsis in patients with ACLF. These lipid emulsions could also be considered as effective sources of immunonutrition in such sick patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15400","type":"journal-article","created":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T00:36:57Z","timestamp":1610757417000},"page":"1953-1961","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Omega\u20103 fatty acid lipid emulsions are safe and effective in reducing endotoxemia and sepsis in acute\u2010on\u2010chronic liver failure: An open\u2010label randomized controlled trial"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1240-1675","authenticated-orcid":false,"given":"Anand V","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Department of Hepatology Institute of Liver and Biliary Sciences  New Delhi 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