The influence of different lipid emulsions on specific immune cells function in head and neck cancer patients receiving supplemental parenteral nutrition: an exploratory analysis

The impact of diet on immune responses is an area of intense investigation. Dietary lipids have been shown to differently influence and fine-tune the reactivity of immune cell subsets, thus potentially affecting clinical outcomes. Patients with head and neck squamous cell carcinoma face malnutrition, due to swallowing impairment related to the tumor site or to treatment sequaelae, and may need supplemental parenteral nutrition (SPN) in addition to oral feeding when enteral nutrition is not feasible. Additionally, immune depression is a well-known complication in these patients. Parenteral nutrition (PN) bags contain amino acids, minerals, electrolytes and mostly lipids that provide calories in a concentrated form and are enriched with essential fatty acids. Here, we show the results of the first exploratory study investigating the effects of two different PN lipid emulsions on specific immune cells function of patients with advanced head and neck squamous carcinoma. Omega3-enriched fish oil-based- and ω6- and ω9-enriched olive oil-based-SPN was administered to two groups of patients for one week in the context of an observational multicentric study and polychromatic flow cytometry was used to investigate multiple subsets of leukocytes, with a special focus on cellular populations endowed with antitumor activity. We found that patients treated with olive oil-based PN showed an increase in the function of the innate (NK cells and monocytes) and adaptive (both CD4 and CD8 cells) arms of the immune response, which may favour anti-tumoral responses