Action of sodium deoxycholate on subcutaneous human tissue: local and systemic effects.
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.
Yagima Odo
Marina Emiko
ME
Department of Dermatology, School of Medicine, University of Santo Amaro, São Paulo, Brazil. marina.odo@uol.com.br
Cucé
Luiz Carlos
LC
Odo
Lílian Mayumi
LM
Natrielli
Andréa
A
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
D003902:Detergents; D003840:Deoxycholic Acid