Tissue-Selective Effects of Injected Deoxycholate

Abstract

We report observations that provide a possible explanation for the in vivo preferential fat targeting by DC. Fat tissue, being deficient in cell-associated proteins and interstitial albumin, may be unable to sufficiently neutralize the detergent activity of DC, possibly making fat uniquely sensitive to DC.

Injectable treatments for fat and cellulite

“…Schuller-Petrovic et al [28] extended these laboratory findings into living tissue by performing cell lysis and cell viability studies in vivo (rat adipose tissue) using PC/DC and isolated DC (Figure 4.6). Additional experiments have corroborated the lytic effects of DC on adipocytes in vivo and in vitro [49,50]. This laboratory and animal data has been validated through human studies that demonstrate comparable fat-reducing effects when either DC or PC/DC are injected into lipomas [40,31,44], abdominal [2,29], submental [3], and hip fat [2,3,29,40,41,30].…”

“…Almost immediately, inflammation and edema manifest clinically. Living and ex vivo animal human tissue exposed to DC, as well as PC/DC combinations, demonstrate fat cell lysis; erythrocytes extravasation; and a mixed infiltrate consisting of polymorphonuclear leukocytes, lymphocytes, macrophages, and multinucleated giant cells; and fibrosis [2,5,34,28,29,40,41,31,45,58,49]. The visible gross and histological progression of events that occurs following detergent injection into a lipoma has been documented [31] (Figure 4.9).…”

“…Under certain conditions, deoxycholate appears to indiscriminately target adipose as well as nonadipose cells and tissue [45,48,59,49,50]. One study demonstrated that in vitro, high-dose (5%) DC, as well as PC (5%)/DC (2.5%), induce necrosis of porcine fat and muscle [45].…”

“…Researchers have recently demonstrated that DC's ability to lyse cells is inversely related to the amount of protein surrounding and within tissue with which it comes into contact, sparing the tissue from necrosis (Figure 4.10) [49]. This effect is mediated in large part by the presence of albumin (an abundant, ubiquitous physiologic protein), which has a very high affinity to DC and appears to inhibit the lytic activity of DC (Figure 4.11) [49]. Therefore, albumin's high concentration in vital tissue but relatively low concentration in fat may explain why injections of deoxycholate into fat are relatively safe clinically.…”

“…-has been answered with radioisotope labeled DC injections into fat pads of mice, in an effort to track the body's processing of injected DC [49]. Almost half of the DC injected was transported to the intestinal tract within 24 h of injection into fat tissue.…”