Treatment and/or prevention of sepsis using an enteral composition

Abstract

Treatment and/or prevention of sepsis using an enteral composition containing phospholipids, triglycerides and cholesterol or precursors thereof. With the composition of the invention the natural level of chylomicrons is maintained, in particular in gut associated lymphoid tissue (GALT), which ensures that most of LPS and/or LTA which are released in the body can be neutralized, substantially decreasing the risk of locally occurring high levels of LPS and/or LTA and thus sepsis.

1 . A method for the treatment and/or prevention of sepsis, endotoxemia and/or bacteremia, comprising administering to a human or an animal in need thereof a composition comprising phospholipds, triglycerides and cholesterol or cholesterylester and/or a salt thereof. 
     
     
         2 . The method according to  claim 1 , wherein the phospholipids are administered in a dose of 1 to 75 gram per day. 
     
     
         3 . The method according to  claim 1 , wherein the triglycerides are administered in a dose of 0.6 to 60 gram per day. 
     
     
         4 . The method according to  claim 1 , wherein cholesterol or cholesterylester and/or a salt thereof are administered in a dose of 0.1 to 7 gram per day. 
     
     
         5 . The method according to  claim 1 , wherein sepsis, endotoxemia and/or bacteremia is associated with one of major surgery, critical illness, Inflammatory Bowel Disease (IBD), HELLP syndrome, an enhanced risk for bacterial translocation, major trauma, burns, pneumonia, decubitus during radio/chemotherapy and a compromised immune system. 
     
     
         6 . The method according to  claim 1 , wherein the composition is administered to persons that do not allow intake of large volume selected from the group consisting of patients suffering from anorexia nervosa, patients suffering from cancer, AIDS patients and elderly patients. 
     
     
         7 . The method according to  claim 1 , wherein the composition is administered to neonates. 
     
     
         8 . The method according to  claim 1 , wherein the composition is administered to farm animals or weaning pigs before they are slaughtered. 
     
     
         9 . The method according to  claim 1 , wherein the composition contains 8-120 grams of the combination of cholesterol or cholesterylester and/or a salt thereof; phospholipids and triglycerides, wherein the weight ratio of cholesterol to phospholipids to triglycerides is of 1:3-80:3-90; 5-100 grams of a protein fraction; and 1.2-400 grams of a carbohydrate fraction. 
     
     
         10 . The method according to  claim 1 , wherein the composition comprises from 45% to 91% by weight of the composition of phospholipids, from 0.5% to 8% by weight of the composition of cholesterol or cholesterylester and/or a salt thereof, and wherein the weight ratio of cholesterol to phospholipids to triglycerides is of 1:3-80:3-90. 
     
     
         11 . The method according to  claim 1 , wherein the cholesterol or cholesterylester and/or a salt thereof is present in an amount from 0.5 to 1.5% by weight of the composition. 
     
     
         12 . The method according to  claim 1 , wherein the composition further comprises proteins and/or peptides. 
     
     
         13 . The method according to  claim 1 , wherein the weight ratio cholesterol to phospholipids to triglycerides is 1:20-80:3-80. 
     
     
         14 . The method according to  claim 1 , wherein the phospholipids are in the form of a mixture of phospholipids comprising phosphatidylcholine and one or more of phosphatidylethanolamine, phosphatidylinositol, phosphatidyl serine, phosphatidyl glycerol, and phosphatidic acid. 
     
     
         15 . The method according to  claim 1 , wherein the triglycerides contain at least 50 wt. % long chain fatty acids with at least 18 carbon atoms. 
     
     
         16 . The method according to  claim 1 , wherein the triglycerides are selected from the group consisting of vegetable oils, marine oils, and mixtures thereof. 
     
     
         17 . The method according to  claim 1 , wherein the weight ratio cholesterol to phospholipids to triglycerides is 1:3-20:3-90, preferably 1:6-16:6-60. 
     
     
         18 . The method according to  claim 1 , wherein the weight ratio cholesterol to phospholipids to triglycerides is 1:20-75:20-75. 
     
     
         19 . The method according to  claim 1 , wherein the composition comprises egg or an egg fraction. 
     
     
         20 . The method according to  claim 1 , wherein, the composition further comprises immunoglobulins. 
     
     
         21 . The method according to  claim 1 , wherein the composition comprises soy lecithin. 
     
     
         22 . The method according to  claim 1 , wherein the composition is an oral feeding, tube feeding or infant formula. 
     
     
         23 . The method according to  claim 1  wherein the composition further comprises one or more fat soluble substances selected from the group consisting of vitamin K (menaquinones), ubiquinones, carotenoids, specific fatty acids, lipoic acid, vitamin D and mixtures thereof.