{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:12:42Z","timestamp":1790727162772,"version":"4.1.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>Cytokine release syndrome (CRS) is a serious adverse effect often seen following the administration of cancer immunotherapy, particularly with chimeric antigen receptor (CAR) T cell therapy. Recently, we proposed the administration of precise amounts of the primary active ingredients found in fish oil (EPA + DHA) in combination with medium chain triglycerides (MCTs). Although there is a commercial injectable emulsion containing a refined-only fish oil, it is indicated as a nutritional supplement because it contains highly variable concentrations of the primary active ingredients (\u00b150% of EPA + DHA). We suggested the application of a refined and enriched fish oil in order to provide the desired pharmacological doses according to the typical limits for drugs, i.e., EPA + DHA, within \u00b110% of the labeled amount. This tight tolerance is not achievable with \u201crefined-only\u201d fish oil indicated for nutrition support. The purpose of this review is to further describe the details of such a dosage form, with particular focus on other active ingredients in the proposed formulation. They play important roles in delivering a safe final product with multiple therapeutic targets for the acute systemic inflammatory response from CRS, as well as addressing chronic inflammation within the tumor microenvironment (TME).<\/jats:p>","DOI":"10.3389\/fphar.2025.1673290","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T05:29:11Z","timestamp":1758518951000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The physiological and pharmaceutical roles of MCTs and other ingredients in intravenous emulsions containing omega-3 enriched fish oil designed to mitigate cytokine release syndrome"],"prefix":"10.3389","volume":"16","author":[{"given":"David F.","family":"Driscoll","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce R.","family":"Bistrian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"5346","DOI":"10.1182\/bloodadvances.2023012549","article-title":"Optimizing the post-CAR T monitoring period in recipients of axicabtagene, ciloleucel, tisagenlecleucel, and lisocabtagene maraleucel","volume":"8","author":"Ahmed","year":"2024","journal-title":"Blood Adv."},{"key":"B3","doi-asserted-by":"publisher","first-page":"246","DOI":"10.3945\/ajcn.112.046573","article-title":"Three short perioperative infusions of n-3 PUFAs reduce systemic inflammation induced by cardiopulmonary bypass surgery: a randomized controlled trial","volume":"97","author":"Berger","year":"2013","journal-title":"Am. 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