Phosphatidylcholine Injections Research Articles

Development of Sustained Release Formulations Based on Lipid-Liquid Crystal to Control the Release of Deoxycholate: In Vitro and In Vivo Assessment

Subcutaneous injections of phosphatidylcholine (PC), sodium deoxycholate (NADC), and a mixture of them were found to be an effective option for treating cellulite. However, it is noteworthy that the injection of NADC may result in inflammation as well as necrosis in the injection area. The preparation of a sustained release formulation based on lipid-liquid crystal that controls the release of NADC could be a potential solution to address the issue of inflammation and necrosis at the site of injection. To present a practical and validated approach for accurately determining the concentration of NADC in LLC formulations, spectrofluorimetry was used based on the International Council for Harmonization (ICH) Q2 guidelines. Based on the validation results, the fluorometric technique has been confirmed as a reliable, efficient, and economical analytical method for quantifying NADC concentrations. The method demonstrated favorable attributes of linearity, precision, and accuracy, with an r2 value of 0.999. Furthermore, it exhibited excellent interday and intraday repeatability, with RSD values below 4%. The recovery percentages ranged from 97 to 100%, indicating the method’s ability to accurately measure NADC concentrations. The subcutaneous injection of the LLC-NADC demonstrated a reduction in inflammation and tissue necrosis in skin tissue, along with an increase in fat lysis within 30 days, when compared to the administration of only NADC solution. Moreover, the histopathological assessment confirmed that the use of the LLC formulation did not result in any detrimental side effects for kidney or heart tissue.

Airway complication associated with injection of phosphatidylcholine and deoxycholic acid into the neck: a case report

The practice of delivering cosmetic injectables in the outpatient setting continues to grow in Australia.1 The increase in demand has seen a dramatic rise in the number of new cosmetic injectable clinics using telehealth prescribing services. Lipodissolve treatment is an example of a non-surgical procedure that aims to improve the appearance of a ‘double chin’ by injection of phosphatidylcholine (PC) and deoxycholic acid (DCA) into submental adipose tissue. We describe a case of an airway complication and hospitalisation secondary to the injection of Lipodissolve in the neck of a 23-year-old female.

Evaluate the Efficacy and Safety of Polyene Phosphatidylcholine Injection (AYP-101) for the Reduction of Submental Fat

Evaluate the Efficacy and Safety of Polyene Phosphatidylcholine Injection (AYP-101) for the Reduction of Submental Fat

Перенос in vivo гена b-галактозидазы с помощью амфифильных и комбинированных липосом

Цель исследования. Получение безопасного и эффективного вектора в целях генной терапии остается актуальной и нерешенной задачей, несмотря на усилия многих лабораторий в мире. Синтез веществ, имеющих сродство к ДНК и стабилизирующих ее спираль, а также обладающих группировками, опознаваемыми клетками нужных органов, является одним из перспективных направлений в таких исследованиях. Целью данной работы было изучение эффективности переноса в различные органы мышей репортерного гена бактериальной b-галактозидазы липосомами, содержащими синтетические холестериновые производные олигоэтиленпропиленимина (дихоленим и трихоленим), а также лактозилированный диглицерид (лактозолипид, LacS). Методика. Предварительно электронномикроскопически была подтверждена способность холенимов образовывать комплексы с ДНК оптимальных для трансфекции размеров (100-200 нм). Проверка холенимов на токсичность in vivo и введение липосом (фосфатидилхолин (ФХ)/дихоленим, ФХ/трихоленим и ФХ/лактозолипид/дихоленим в комплексе с плазмидой pCMV-SPORT-b-gal) в воротную вену печени проводились на самцах мышей линии ICR массой 30-40 г. Контролем служили интактные животные. Результаты. Cпособность холенимов образовывать комплексы с ДНК была подтверждена электронными микрофотографиями. Размеры комплексов (100-200 нм) оказались оптимальными для трансфекции in vivo , а холенимы - нетоксичными. Через 2 сут. после введения комплексов гистохимически на криосрезах внутренних органов животных с Х-Gal (субстрат) обнаружена отчетливо выраженная трансфекция органов, в том числе печени - главного объекта генной терапии. Заключение. Лактозилированный липид LacS и производные олигоэтиленпропиленимина холенимы являются безопасными, не менее и эффективными для достижения экспрессии функционального гена in vivo , чем коммерческие препараты, и перспективными для эффективной адресной доставки генов.The purpose of the work. Receipt of safe and effective vector for the purpose of genetic therapy remains the topical and unsolved problem inspite of many laboratories efforts in the world. Synthesis of substances which have affinity to DNA and stabilize its helix and also have the moieties recognized with the cells of the desired organs is one of the perspective ways in these investigations. Study of the effectivity of b-galactosidase bacterial reporter gene transfer with liposomes containing synthetic cholesteroyl derivatives of the oligoethylen/propylen/imine dicholenim and tricholenim and also lactosylated diglycerid (lactosolipid, LacS) to mouse organs was the purpose of this work. Methods. Previously ability of cholenims to form complexes with DNA of the optimal for transfection size (100-200 nm) was confirmed by electron microscopy technique. Testing the non-toxicity of cholenims in vivo and injections of phosphatidylcholine(Ph)/dicholenim, Ph/tricholenim and Ph/lactosolipid/dicholenim liposomes complexed with the pCMV-SPORT-b-gal plasmid to the liver portal vein were carried out on the mouse males of the ICR strain of 30-40 g of weight. The intact animals were as a control. Results. The ability of cholenims to form complexes with DNA was confirmed with electron micrographs. Complex sizes (100-200 nm) were optimal for in vivo transfection, and holenims were found non-toxic ones. The well-marked transfection of the animal’s inner organs including liver which is the main target of the genetic therapy was detected in two days after injection of the complexes by histochemical reaction of the cryosections with Х-Gal and the consequent light microscopy of the sections. Conclusion. It is concluded that the lactosylated lipid LacS and the oligoethylen/propylen/imine derivatives cholenims are not less safe and effective for achieving expression of the functional gene in vivo than the commercial ones and are promising for the effective targeted gene delivery.

Skin Necrosis Following Adipocitolitic Solution Injections

Injectable fat-reduction techniques emerged in the world literature in 2001, when Patricia Rittes, a dermatologist in Sao Paulo, Brazil, reported reduction of infraorbital fat after direct, transcutaneous injection of phosphatidylcholine (PC) combined with sodium deoxycholate (DC) solution.1 Despite lack of approval by any regulatory body, PC/DC combinations have been used off-label by healthcare practitioners to reduce subcutaneous fat in selected patients.2,3 In Europe, the only drug with CE marking (approval) for the reduction of localized fat is Aqualyx (Marllor International; San Giovanni in Marignano, Italy).4 Currently, it is approved in approximately 50 countries. Aqualyx is a DC-based solution with a lactose-based delivery system, formulated to control and enhance the action of external ultrasound waves for the microcavitation of adipose tissue.5 It does not contain PC. Aqualyx was designed for the medical treatment (reduction) of localized adipose tissue5 and is sold exclusively to physicians trained in intralipotherapy, the injection technique for its insertion.6 The product has been in clinical use since 2009 for the nonsurgical reduction of localized adiposity, lipohypertrophy, subcutaneous lipohyperplasia, and “buffalo hump”.6-8 Aqualyx is an aqueous microgelatinous solution comprised of the following: polymer of 3:6-anhydro-L-galactose and D-galactose; buffer systems; 3-alpha-12alpha-dihydroxy-5-beta-24-oico cholanic acid sodium salt; and saline solution.7,8 The solution appears similar in composition to DC, but it is considered a medical device—not a drug. A claim regarding this matter has been submitted to the Italian Ministry of the Health.8 Aqualyx is marketed as a 2-step product: immediately following injection (step 1), it is recommended that external ultrasonography be performed (step 2).5 However, …

Effect of subcutaneous phosphatidylcholine injection used in the treatment of localized obesity on the histological structures of human skin and subcutaneous tissue

Background Multiple clinical trials have supported the idea that subcutaneously injected phosphatidylcholine (PPC) leads to a reduction in localized fat collection. However, only a few histological studies that explain the mechanism of action of PPC have been published. Aim This study aimed to evaluate the clinical and detailed histological changes in the skin and subcutaneous tissue after PPC injection. Patients and methods Ten female patients with local fat deposits (upper outer thigh) were assessed after a single session of subcutaneous injection with PPC on the basis of thigh circumference measurement, and histological examination of skin biopsy specimens was carried out before and 1 and 2 months after treatment. Histological sections were stained with H&E, Masson’s trichrome (for collagen fibers), and by aldehyde fuchsin (for elastic fibers), followed by morphometric study and statistical analysis. Results Two months after injection, a statistically significant reduction in thigh circumference was found (P=0.045), with leathery tight skin texture at the injected area. Histological examination revealed dermal inflammatory responses 1 month after injection, with destruction of fat cells. These observations were reduced after 2 months with evidence of regenerating fat cells. Statistical analysis showed a significant increase in collagen area% (P=0.025) and statistically nonsignificant increase in elastic fiber area% at the end of the study. Conclusion A single session of subcutaneous PPC injection had an evident lipolytic effect, with noticeable contouring and skin tightening due to regenerative effect on skin connective tissue, particularly dermal collagen. However, lipolytic effect was partially temporary because of regeneration of fat cells.

Injection of phosphatidylcholine and deoxycholic acid regulates gene expression of lipolysis-related factors, pro-inflammatory cytokines, and hormones on mouse fat tissue

Injection of phosphatidylcholine (PC) and deoxycholic acid (DA) preparation is widely used as an alternative to liposuction for the reduction of subcutaneous fat. Nevertheless, its physiological effects and mechanism of action are not yet fully understood. In this report, PC and deoxycholic acid (DA) were respectively injected into adipose tissue. PC decreased tissue mass on day 7, but DA did not. On the other hand, a decrement of DNA mass was observed only in DA-injected tissue on day 7. Both PC and DA reduced the mRNA expression of adipose tissue hormones, such as adiponectin, leptin, and resistin. In lipolysis-related gene expression profiles, PC increased hormone-sensitive lipase (HSL) transcription and decreased the expression other lipases, perilipin, and the lipogenic marker peroxisome proliferator-activated receptor-γ (PPARγ); DA treatment diminished them all, including HSL. Meanwhile, the gene expression of pro-inflammatory cytokines and a chemokine was greatly elevated in both PC-injected and DA-injected adipose tissue. Microscopic observation showed that PC induced lipolysis with mild PMN infiltration on day 7. However, DA treatment did not induce lipolysis but induced much amount of PMN infiltration. In conclusion, PC alone might induce lipolysis in adipose tissue, whereas DC alone might induce tissue damage.

Acute Renal Failure and Liver Dysfunction after Subcutaneous Injection of 3-sn-Phosphatidylcholine (Lipostabil®) - Case Report

Drug-induced tubulointerstitial nephritis and acute tubular necrosis are common, and are often caused by drugs especially antibiotics or non-steroidal anti-inflammatory drugs. Drug-induced liver dysfunction and renal failure after subcutaneous injection of phosphatidylcholine was not reported so far. 3-sn-Phosphatidylcholine has been described as a cell lysis reaction-inducing drug. Its in vitro data indicated a relevant toxicity potential. In particular human cell types such as fibroblast-like preadipocytes, vascular and skeletal muscle cells, or renal epithelial cells react more sensitive than other human cell types. We present a 28-year-old woman who received 3.5 g (70 mL) of 3-sn-phosphatidylcholine (Lipostabil®) at once subcutaneously (s. c.) in both gluteal regions. The drug was originally introduced to prevent fat embolism. Nevertheless, its off-label use in aesthetic therapy for treatment of localized fat deposits through subcutaneous administration is becoming increasingly common. Three hours after injection the patient suffered from severe nausea and emesis. Within 24 hours a dramatic increase of liver enzymes and a beginning liver dysfunction were observed. Subsequently, renal function deteriorated two days later making a temporary haemodialysis necessary. Hepatic improvement was observed after three days of treatment. Renal function was fully recovered after two weeks. To the best of our knowledge, this is the first reported patient presenting with acute liver dysfunction and renal failure after subcutaneous injection of 3-sn-phosphatidyl-choline (Lipostabil®) indicating the risk of an off-label use of this drug.

In Vitro Studies Investigating the Effect of Subcutaneous Phosphatidylcholine Injections in the 3T3-L1 Adipocyte Model: Lipolysis or Lipid Dissolution?

The demand for lipolytic injection therapies for aesthetic indications increases continuously. The substance most frequently discussed in this context is phosphatidylcholine solubilized in sodium deoxycholate, a composition known in Europe as Lipostabil (Artesan Pharma, Lüchow, Germany). The evidence for its lipolytic effect is based mainly on clinical studies that suggest a decrease in adipose tissue volume after subcutaneous injections. However, neither the actual effect nor the effective supplemental effect of Lipostabil has been clearly identified so far. The purpose of this study was to investigate the effects caused by lipolytic formulations on adipocytes using an in vitro model. 3T3-L1 adipocytes in 12-well plates were exposed to varying doses of isolated phosphatidylcholine, deoxycholate, and the combination of both (Lipostabil). Subsequently, changes in the cell membrane integrity were evaluated microscopically, and assays measuring the amount of glycerol as a biochemical lipolysis substrate (lipolysis assay) together with dimethyl thiazolyl diphenyl tetrazolium assays were performed to quantify the lipolytic effect and the cell viability. Deoxycholate reduced cell viability significantly (p < 0.05), even at low concentrations. Neither phosphatidylcholine nor deoxycholate led to a significant (p < 0.05) induction of a lipolytic pathway. Lipostabil, the combination of deoxycholate and phosphatidylcholine, led to a significant (p < 0.05) decrease in cell viability at low doses and to a highly significant (p < 0.01) reduction at high doses. The loss in cell viability is attributable to changes in the cell membrane integrity. These results suggest that no enzymatic lipolytic pathway is induced. The decrease in volume after Lipostabil injections is likely attributable to the detergent effect of deoxycholate.

Mesotherapy for Benign Symmetric Lipomatosis

Benign symmetric lipomatosis, also known as Madelung disease, is a rare disorder characterized by fat distribution around the shoulders, arms, and neck in the context of chronic alcoholism. Complete excision of nonencapsulated lipomas is difficult. However, reports describing conservative therapeutic measures for lipomatosis are rare. The authors present the case of a 42-year-old man with a diagnosis of benign symmetric lipomatosis who had multiple, large, symmetrical masses in his neck. Multiple phosphatidylcholine injections in the neck were administered 4 weeks apart, a total of seven times to achieve lipolysis. The patient's lipomatosis improved in response to the injections, and he achieved good cosmetic results. Intralesional injection, termed mesotherapy, using phosphatidylcholine is a potentially effective therapy for benign symmetric lipomatosis that should be reconsidered as a therapeutic option for this disease.

Action of Sodium Deoxycholate on Subcutaneous Human Tissue: Local and Systemic Effects

Phosphatidylcholine injections have been used as a nonsurgical alternative to the surgical removal of undesired fat. Studies in cell culture suggest that sodium deoxycholate (SD) has a detergent action in fat reduction. The objective was to study SD in subcutaneous human tissue. Thirty volunteers underwent four sessions of subcutaneous abdominal injections of diluted 2.5 or 1% SD stock solutions or placebo. Clinical, hematologic, and ultrasonographic evaluations were performed for 3 months and histology at 3 and 6 months. Both concentrations of SD induced an inflammatory response at the injection site, with dose-dependent adipocyte lysis. Patients reported mild, localized heat, erythema, swelling, and intense pain. Microscopic evaluation revealed necrosis of adipose tissue with adipocyte lysis, fat dissolution, acute lymphomononuclear inflammatory reaction, and intense phagocytosis of fat cells by macrophages. Fibrosis was observed only at the 6-month biopsy. Nodules at the injection sites, compatible with areas of inflammation, were detected by ultrasonography 2 weeks after the first injection. Placebo injections induced no histologic changes. SD induces an inflammatory reaction in subcutaneous human fat and dose-dependent adipocyte lysis with acute pain and fibrosis. No systemic effects were detected. Further studies will establish the best dose-result ratio, frequency of application, and long-term safety.

Clinical experience and safety using phosphatidylcholine injections for the localized reduction of subcutaneous fat: a multicentre, retrospective UK study

Phosphatidylcholine has been in safe use for over 30 years. Subcutaneous injections of phosphatidylcholine have now become used internationally for localized subcutaneous fat reduction on the face and body, but concerns about the safety of this treatment have arisen. To assess retrospectively treatment outcomes and adverse effects associated with subcutaneous phosphatidylcholine use. Thirty-nine UK doctors specifically trained and experienced in this treatment completed questionnaires, focusing on outcome and adverse effects experienced by patients. Ten thousand five hundred and eighty-one treatments had been administered over a mean duration of 13.1 months. Localized adverse effects (swelling, erythema, burning/stinging, pain, tenderness and bruising) were described by most patients as "very mild' (18.4%) or "mild" (39.2%). The total incidence of systemic side-effects was 3%: diarrhoea, nausea, dizziness/light-headedness and intermenstrual bleeding were described by most patients as "very mild" (36%) or "mild" (55%). Only 15 (0.14%) "unexpected, unusually severe or prolonged" adverse reactions (commonly pain and/or swelling) were reported. These were all self-limiting and none were judged as serious. 73.8% of patients were either "very satisfied" or "satisfied" with treatment. This treatment appears to be associated with minimal risks when used by specifically trained and experienced doctors. The possible risks associated with this treatment should be balanced against the risks of other treatment options.

Injection of Phosphatidylcholine in Fat Tissue: Experimental Study of Local Action in Rabbits

Subcutaneous phosphatidylcholine to cause local lipolysis has been performed effectively and safely in the nonsurgical treatment of periorbital fat pads and also in the treatment of localized fat deposits in the abdomen, neck, arms and thighs. However, the studies do not explain the mechanism through which injectable phosphatidylcholine causes localized fat reduction. This study aimed to compare the local action of a phosphatidylcholine formulation with that of a physiologic saline solution in a histologic study investigating the fat tissue of rabbits. Using a randomized, blind approach, 10 rabbits were injected with an experimental assay of phosphatidylcholine (the biologic model), and another 10 rabbits were injected with physiologic saline. A histologic study was conducted, and the Mann-Whitney test was applied. A marked difference was observed between the two groups with respect to necrosis, inflammatory exudation, and fibrosis. Necrosis of the fat cells in all the phosphatidylcholine-injected animals was observed. Further studies should be performed to clarify and determine the mechanisms of action.

Histologic Response to Injected Phosphatidylcholine in Fat Tissue: Experimental Study in a New Rabbit Model

The application of phosphatidylcholine to the fat tissue of humans for aesthetic purposes has recently been in evidence, despite the sparse literature corroboration of this practice. The authors developed a new experimental model to study injection of substances in fat tissue in rabbits. The objective of this particular study was to verify the possible effects of phosphatidylcholine injected in the animals. The animal weight, the fat pad weight, the presence of inflammatory infiltrate, and fibrosis and necrosis at the application sites were observed. Two groups of rabbits received five weekly applications to the dorsal fat pad. The control group received saline solution 0.9%, and the study group received phosphatidylcholine. The removed fat tissue was evaluated 3, 7, 14, and 21 days after the fifth application was completed. The phosphatidylcholine group presented more intense inflammatory infiltrate and fibrosis than the control group (p = 0.05). Necrosis was not observed in any animal. There was no statistically significant difference with regard to the weights of the animal or the fat pad. On the basis of this study, the injection of phosphatidylcholine is relatively safe, but no effect was observed regarding the reduction of fat tissue volume. New studies with higher doses are needed to justify the clinical use of this substance.

Mesotherapy and Phosphatidylcholine Injections

BACKGROUND Mesotherapy was originally conceived in Europe as a method of utilizing cutaneous injections containing a mixture of compounds for the treatment of local medical and cosmetic conditions. Although mesotherapy was traditionally employed for pain relief, its cosmetic applications, particularly fat and cellulite removal, have recently received attention in the United States. Another treatment for localized fat reduction, which was popularized in Brazil and uses injections of phosphatidylcholine, has been erroneously considered synonymous with mesotherapy. Despite their attraction as purported “fat-dissolving” injections, the safety and efficacy of these novel cosmetic treatments remain ambiguous to most patients and physicians. OBJECTIVE To distinguish mesotherapy from phosphatidylcholine injections by reviewing their history and the relevant experimental or clinical findings. METHODS A comprehensive search of Medline indexed literature and conference proceedings. RESULTS All the published studies evaluating the clinical efficacy of traditional mesotherapy currently originate from Europe. These reports focus primarily on musculoskeletal pain and vascular disease, rather than cosmetic applications. Although experimental data suggest that a number of traditional mesotherapy ingredients may theoretically reduce fat, these effects have not been supported in peer-reviewed studies. An increasing number of reports demonstrate that subcutaneous injections of a formula containing phosphatidylcholine combined with its emulsifier, deoxycholate, are effective in removing small collections of adipose tissue. Cell lysis, resulting from the detergent action of deoxycholate, may account for this clinical effect. CONCLUSIONS Mesotherapy is distinct from a method of treating adipose tissue with subcutaneous injections of deoxycholate alone or in combination with phosphatidylcholine. Additional clinical and experimental studies are necessary to more definitively establish the safety and efficacy of these treatments.

Mesotherapy and Phosphatidylcholine Injections: Historical Clarification and Review

Mesotherapy was originally conceived in Europe as a method of utilizing cutaneous injections containing a mixture of compounds for the treatment of local medical and cosmetic conditions. Although mesotherapy was traditionally employed for pain relief, its cosmetic applications, particularly fat and cellulite removal, have recently received attention in the United States. Another treatment for localized fat reduction, which was popularized in Brazil and uses injections of phosphatidylcholine, has been erroneously considered synonymous with mesotherapy. Despite their attraction as purported "fat-dissolving" injections, the safety and efficacy of these novel cosmetic treatments remain ambiguous to most patients and physicians. To distinguish mesotherapy from phosphatidylcholine injections by reviewing their history and the relevant experimental or clinical findings. A comprehensive search of Medline indexed literature and conference proceedings. All the published studies evaluating the clinical efficacy of traditional mesotherapy currently originate from Europe. These reports focus primarily on musculoskeletal pain and vascular disease, rather than cosmetic applications. Although experimental data suggest that a number of traditional mesotherapy ingredients may theoretically reduce fat, these effects have not been supported in peer-reviewed studies. An increasing number of reports demonstrate that subcutaneous injections of a formula containing phosphatidylcholine combined with its emulsifier, deoxycholate, are effective in removing small collections of adipose tissue. Cell lysis, resulting from the detergent action of deoxycholate, may account for this clinical effect. Mesotherapy is distinct from a method of treating adipose tissue with subcutaneous injections of deoxycholate alone or in combination with phosphatidylcholine. Additional clinical and experimental studies are necessary to more definitively establish the safety and efficacy of these treatments.

Lipomas treated with subcutaneous deoxycholate injections

Lipomas are benign neoplasms of mature fat cells. Current treatments are invasive and carry the risk of scarring. Injections of phosphatidylcholine solubilized with deoxycholate, a bile salt, have been used to reduce unwanted accumulations of fat. Recent in vitro and ex vivo investigations indicate that deoxycholate alone causes adipocyte lysis. We sought to report our experience treating lipomas using subcutaneous deoxycholate injections. A total of 6 patients presenting with 12 lipomas were treated with intralesional injections of sodium deoxycholate (1.0%, 2.5%, and 5.0%) at intervals of 2 to 20 weeks. Tumor size, cutaneous reactions, and patients' subjective responses were recorded before and after treatment. All lipomas decreased in size (mean area reduction, 75%; range, 37%-100%) as determined by clinical measurement (with ultrasound confirmation in one lipoma) after an average of 2.2 treatments. Several lipomas fragmented or became softer in addition to decreasing in volume. Adverse effects, including transient burning, erythema, and local swelling, were associated with higher deoxycholate concentrations but resolved without intervention. There was no clear association between deoxycholate concentration and efficacy. Our clinical experience supports our laboratory investigations demonstrating that deoxycholate, rather than phosphatidylcholine, is the active ingredient in subcutaneously injected formulas used to treat adipose tissue. This small series suggests that low concentration deoxycholate may be a relatively safe and effective treatment for small collections of fat. However, controlled clinical trials will be necessary to substantiate these observations.

Efficacy of injections of phosphatidylcholine into fat deposits-a non-surgical alternative to liposuction in body-contouring

ABSTRACTInjecting phosphatidylcholine has been used in South America as a non-surgical treatment in body contouring. The objective of this study was to demonstrate the efficacy of injecting phosphatidylcholine in the reduction of localised fat deposits. 86 patients were included in the study. Patients received 1-3 treatments in localised fat deposits in various areas of the body using phosphatidylcholine. After treatment with phosphatidylcholine (250 mg / 5 ml), fat deposits show an average circumferential reduction per application of 2.70 cm. No patient showed irregularities, dimples or any serious side effect after treatment. Results remained stable during the time of follow up. All patients showed remarkable reductions of the fat deposits treated with phosphatidylcholine. Using the correct technique, injecting phosphatidylcholine may be a safe and efficacious alternative to liposuction in patients objecting to surgery.

Efficacy of injections of phosphatidylcholine into fat deposits-a non-surgical alternative to liposuction in body-contouring

Injecting phosphatidylcholine has been used in South America as a non-surgical treatment in body contouring. The objective of this study was to demonstrate the efficacy of injecting phosphatidylcholine in the reduction of localised fat deposits. 86 patients were included in the study. Patients received 1-3 treatments in localised fat deposits in various areas of the body using phosphatidylcholine. After treatment with phosphatidylcholine (250 mg / 5 ml), fat deposits show an average circumferential reduction per application of 2.70 cm. No patient showed irregularities, dimples or any serious side effect after treatment. Results remained stable during the time of follow up. All patients showed remarkable reductions of the fat deposits treated with phosphatidylcholine. Using the correct technique, injecting phosphatidylcholine may be a safe and efficacious alternative to liposuction in patients objecting to surgery.

Detergent Effects of Sodium Deoxycholate Are a Major Feature of an Injectable Phosphatidylcholine Formulation Used for Localized Fat Dissolution

BACKGROUND Phosphatidylcholine injections are becoming an increasingly popular technique to treat localized fat accumulation. This formula is composed primarily of phosphatidylcholine and sodium deoxycholate, a bile salt used to solubilize the natural phospholipid in water. The mechanism through which this injectable phosphatidylcholine formulation causes localized fat reduction is unknown. OBJECTIVE To investigate the active component and mechanism of action of an injectable phosphatidylcholine formulation in clinical use. METHODS Cell viability and cell membrane lysis assays were performed on cell cultures and porcine skin after treatment with the phosphatidylcholine formula, isolated sodium deoxycholate, or common laboratory detergents Triton-X 100 and Empigen BB. In addition, we described the histologic changes after injection of these substances into porcine tissue. RESULTS A significant and comparable loss of cell viability, cell membrane lysis, and disruption of fat and muscle architecture was seen in cell cultures and tissue specimens treated with the phosphatidylcholine formula and isolated sodium deoxycholate. These findings were similar to the effects produced after treatment with laboratory detergents. CONCLUSIONS The phosphatidylcholine formula popularly used in subcutaneous injections for fat dissolution works primarily as a detergent causing nonspecific lysis of cell membranes. Our findings suggest that sodium deoxycholate is the major active component responsible for cell lysis. Detergent substances may have a role in eliminating unwanted adipose tissue. It is advised that physicians use caution until adequate safety data are available.