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

• Published in: Dermatologic surgery Vol. 33; no. 2; pp. 178 - 189
• Main Authors: YAGIMA ODO, MARINA EMIKO, CUCÉ, LUIZ CARLOS, ODO, LÍLIAN MAYUMI, NATRIELLI, ANDRÉA
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.02.2007; by the American Society for Dermatologic Surgery, Inc; Blackwell
• Subjects: Adipose Tissue - diagnostic imaging; Adipose Tissue - drug effects; Adult; Aged; Biological and medical sciences; Deoxycholic Acid - administration & dosage; Deoxycholic Acid - pharmacology; Dermatology; Detergents - administration & dosage; Detergents - pharmacology; Female; Humans; Injections, Subcutaneous; Medical sciences; Middle Aged; Skin plastic surgery; Subcutaneous Tissue - diagnostic imaging; Subcutaneous Tissue - drug effects; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surveys and Questionnaires; Treatment Outcome; Ultrasonography; Human; Treatment; Sodium; Dermatology; Surgery; Systemic; Disseminated; Subcutaneous tissue; Local effect
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1111/j.1524-4725.2006.33036.x

BACKGROUND 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. OBJECTIVE The objective was to study SD in subcutaneous human tissue. METHODS AND MATERIALS 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. RESULTS 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. CONCLUSIONS 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.