title: Compounds used for 'injection lipolysis' destroy adipocytes and other cells found in adipose tissue.
abstract: BACKGROUND
  A widely applied technique to reduce subcutaneous fat pad size involves subcutaneous injection of a phosphatidylcholine preparation ('injection lipolysis'). As the mode of action is mostly unknown, we planned to study cellular effects of the particular drug used in Germany (Lipostabil(R)).
  
  
  METHODS
  Human preadipocytes, adipocytes, vascular and skeletal muscle cells as well as renal epithelial cells were incubated in the compound, morphological changes were described, and cell vitality was measured.
  
  
  RESULTS
  A strong cytolytic effect of the compound was signified by lipid release and acridine orange staining of dying adipocyte nuclei. When the undiluted compound was used, more than 90% of cell death occurred after 90 s in preadipocytes, after 6 min in vascular smooth muscle cells, skeletal myotubes and renal epithelial cells, and after 15 min in adipocytes. Dilution slowed down cytolysis, but still >50% of the cells disappeared during 30 min incubation. Neither osmotic effects nor differences in medium acidity were responsible for cell death.
  
  
  CONCLUSIONS
  Injection lipolysis with phosphatidylcholine as the major injected compound reduces subcutaneous fat pad size through cell and tissue destruction. Beside the lack of a clear risk-benefit analysis, applying this technique represents off-label drug use and application of a drug by a contraindicated route.
authors.affiliation: Experimental and Clinical Research Center, Charité, Universitätsmedizin Berlin - Campus Buch and Max Delbrück Center for Molecular Medicine, Berlin, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Janke
authors.forename: Stefan
authors.initials: S
authors.lastname: Engeli
authors.forename: Kerstin
authors.initials: K
authors.lastname: Gorzelniak
authors.forename: Friedrich C
authors.initials: FC
authors.lastname: Luft
authors.forename: Jens
authors.initials: J
authors.lastname: Jordan
mesh_terms: D000165:Acridine Orange; D017667:Adipocytes / Q000187:drug effects*; D000328:Adult; D016923:Cell Death / Q000187:drug effects; D002478:Cells, Cultured; D004847:Epithelial Cells / Q000187:drug effects; D005260:Female; D006801:Humans; D007267:Injections; D007668:Kidney / Q000166:cytology; D015187:Lipectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000166:cytology; D009131:Muscle, Smooth, Vascular / Q000166:cytology; D010713:Phosphatidylcholines / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D010713:Phosphatidylcholines; C005152:lipostabil; D000165:Acridine Orange