title: Action of sodium deoxycholate on subcutaneous human tissue: local and systemic effects.
abstract: 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
  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.
authors.affiliation: Department of Dermatology, School of Medicine, University of Santo Amaro, São Paulo, Brazil. marina.odo@uol.com.br
authors.forename: Marina Emiko
authors.initials: ME
authors.lastname: Yagima Odo
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Cucé
authors.forename: Lílian Mayumi
authors.initials: LM
authors.lastname: Odo
authors.forename: Andréa
authors.initials: A
authors.lastname: Natrielli
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000187:drug effects*; D000328:Adult; D000368:Aged; D003840:Deoxycholic Acid / Q000008:administration & dosage / Q000494:pharmacology*; D003902:Detergents / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008875:Middle Aged; D040521:Subcutaneous Tissue / Q000000981:diagnostic imaging / Q000187:drug effects*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D003902:Detergents; D003840:Deoxycholic Acid