1
|
Pham TT, Heidari AE, Hong EM, Steward E, Qu Y, Chen LY, Dunn BS, Seo SH, Syed A, Dilley K, Lee L, Hutchison DM, Hansen KD, Patel U, Kim S, Hill MG, Wong BJF. Electrochemical Lipolysis Induces Adipocyte Death and Fat Necrosis: In Vivo Pilot Study in Pigs. Plast Reconstr Surg 2024; 153:334e-347e. [PMID: 37163479 DOI: 10.1097/prs.0000000000010645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Current minimally invasive fat reduction modalities use equipment that can cost thousands of U.S. dollars. Electrochemical lipolysis (ECLL), using low-cost battery and electrodes (approximately $10), creates acid/base within fat (width, approximately 3 mm), damaging adipocytes. Longitudinal effects of ECLL have not been studied. In this pilot study, the authors hypothesize that in vivo ECLL induces fat necrosis, decreases adipocyte number/viability, and forms lipid droplets. METHODS Two female Yorkshire pigs (50 to 60 kg) received ECLL. In pig 1, 10 sites received ECLL, and 10 sites were untreated. In pig 2, 12 sites received ECLL and 12 sites were untreated. For ECLL, two electrodes were inserted into dorsal subcutaneous fat and direct current was applied for 5 minutes. Adverse effects of excessive pain, bleeding, infection, and agitation were monitored. Histology, live-dead (calcein, Hoechst, ethidium homodimer-1), and morphology (Bodipy and Hoechst) assays were performed on day 0 and postprocedure days 1, 2, 7, 14 (pig 1 and pig 2), and 28 (pig 2). Average particle area, fluorescence signal areas, and adipocytes and lipid droplet numbers were compared. RESULTS No adverse effects occurred. Live-dead assays showed adipocyte death on the anode on days 0 to 7 and the cathode on days 1 to 2 (not significant). Bodipy showed significant adipocyte loss at all sites ( P < 0.001) and lipid droplet formation at the cathode site on day 2 ( P = 0.0046). Histology revealed fat necrosis with significant increases in average particle area at the anode and cathode sites by day 14 (+277.3% change compared with untreated, P < 0.0001; +143.4%, P < 0.0001) and day 28 (+498.6%, P < 0.0001; +354.5%, P < 0.0001). CONCLUSIONS In vivo ECLL induces fat necrosis in pigs. Further studies are needed to evaluate volumetric fat reduction. CLINICAL RELEVANCE STATEMENT In vivo ECLL induces adipocyte death and fat necrosis. ECLL has the potential to be utilized in body fat contouring.
Collapse
Affiliation(s)
- Tiffany T Pham
- From the Beckman Laser Institute & Medical Clinic
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado, School of Medicine
| | - Andrew E Heidari
- From the Beckman Laser Institute & Medical Clinic
- Department of Biomedical Engineering
| | - Ellen M Hong
- From the Beckman Laser Institute & Medical Clinic
| | | | - Yueqiao Qu
- From the Beckman Laser Institute & Medical Clinic
- Department of Biomedical Engineering
| | - Lily Y Chen
- From the Beckman Laser Institute & Medical Clinic
| | - Brandyn S Dunn
- From the Beckman Laser Institute & Medical Clinic
- Otolaryngology-Head and Neck Surgery, University of California, Irvine, School of Medicine
| | - Soo Hong Seo
- Department of Dermatology, Korea University, College of Medicine
| | - Adeela Syed
- Department of Developmental and Cell Biology, University of California, Irvine
| | | | - Lauren Lee
- From the Beckman Laser Institute & Medical Clinic
| | | | | | - Urja Patel
- From the Beckman Laser Institute & Medical Clinic
| | - Sehwan Kim
- Beckman Laser Institute-Korea, Dankook University
| | | | - Brian J F Wong
- From the Beckman Laser Institute & Medical Clinic
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado, School of Medicine
- Departments of Surgery
| |
Collapse
|
2
|
Park AC, Chan CK, Hutchison DM, Patel U, Hong EM, Steward E, Dilley KK, Sterritt NL, Kim S, Hill MG, You JS, Wong BJF. In vivo electrochemical lipolysis of fat in a Yucatan pig model: A proof of concept study. Lasers Surg Med 2023; 55:135-145. [PMID: 36511512 DOI: 10.1002/lsm.23620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/01/2022] [Accepted: 11/26/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Traditional fat contouring is now regularly performed using numerous office- based less invasive techniques. However, some limitations of these minimally invasive techniques include high cost or limited selectivity with performing localized contouring and reduction of fat. These shortcomings may potentially be addressed by electrochemical lipolysis (ECLL), a novel approach that involves the insertion of electrodes into tissue followed by application of a direct current (DC) electrical potential. This results in the hydrolysis of tissue water creating active species that lead to fat necrosis and apoptosis. ECLL can be accomplished using a simple voltage-driven system (V-ECLL) or a potential-driven feedback cell (P-ECLL) both leading to water electrolysis and the creation of acid and base in situ. The aim of this study is to determine the long-lasting effects of targeted ECLL in a Yucatan pig model. METHODS A 5-year-old Yucatan pig was treated with both V-ECLL and P-ECLL in the subcutaneous fat layer using 80:20 platinum:iridium needle electrodes along an 8 cm length. Dosimetry parameters included 5 V V-ECLL for 5, 10, and 20 minutes, and -1.5 V P-ECLL, -2.5 V P-ECLL, -3.5 V P-ECLL for 5 minutes. The pig was assessed for changes in fat reduction over 3 months with digital photography and ultrasound. After euthanasia, tissue sections were harvested and gross pathology and histology were examined. RESULTS V-ECLL and P-ECLL treatments led to visible fat reduction (12.1%-27.7% and 9.4%-40.8%, respectively) and contour changes across several parameters. An increased reduction of the superficial fat layer occurred with increased dosimetry parameters with an average charge transfer of 12.5, 24.3, and 47.5 C transferred for 5 V V-ECLL for 5, 10, and 20 minutes, respectively, and 2.0, 11.5, and 24.0 C for -1.5 V P-ECLL, -2.5 V P-ECLL, -3.5 V P-ECLL for 5 minutes, respectively. These dose-dependent changes were also evidenced by digital photography, gross pathology, ultrasound imaging, and histology. CONCLUSIONS ECLL results in selective damage and long-lasting changes to the adipose layer in vivo. These changes are dose-dependent, thus allowing for more precise contouring of target areas. P-ECLL has greater efficiency and control of total charge transfer compared to V-ECLL, suggesting that a low-voltage potentiostat treatment can result in fat apoptosis equivalent to a high-voltage DC system.
Collapse
Affiliation(s)
- Asher C Park
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, California, USA
| | - Carmen K Chan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of California-Irvine, Orange, California, USA
| | - Dana M Hutchison
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, California, USA
| | - Urja Patel
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, California, USA
| | - Ellen M Hong
- School of Medicine, Hackensack Meridian, Nutley, New Jersey, USA
| | - Earl Steward
- Department of Surgery, School of Medicine, University of California-Irvine, Orange, California, USA
| | - Katelyn K Dilley
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, California, USA
| | - Naya L Sterritt
- Department of Biomedical Engineering, University of California-Irvine, Irvine, California, USA
| | - Sehwan Kim
- Department of Biomedical Engineering, Beckman Laser Institute, Korea, Dankook University, Cheonan-si, Chungnam, Republic of Korea
| | - Michael G Hill
- Department of Chemistry, Occidental College, Los Angeles, California, USA
| | - Joon S You
- eLysis Inc., Laguna Niguel, California, USA
| | - Brian J F Wong
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, California, USA.,Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of California-Irvine, Orange, California, USA.,Department of Biomedical Engineering, University of California-Irvine, Irvine, California, USA
| |
Collapse
|
3
|
Dilley KK, Borden PA, Qu Y, Heidari AE, Prasad KR, Li Y, Sun CH, Chen Z, Kim S, Hill MG, Wong BJF. Potential-Driven Electrochemical Clearing of Ex Vivo Alkaline Corneal Injuries. Transl Vis Sci Technol 2022; 11:32. [PMID: 35061010 PMCID: PMC8787648 DOI: 10.1167/tvst.11.1.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose Corneal chemical injuries (CCI) obscure vision by opacifying the cornea; however, current treatments may not fully restore clarity. Here, we investigated potential-driven electrochemical treatment (P-ECT) to restore clarity after alkaline-based CCI in ex vivo rabbit corneas and examined collagen fiber orientation changes using second harmonic generation (SHG). Methods NaOH was applied to the corneas of intact New Zealand white rabbit globes. P-ECT was performed on the opacified cornea while optical coherence tomography (OCT) imaging (∼35 frames per second) was simultaneously performed. SHG imaging evaluated collagen fiber structure before NaOH application and after P-ECT. Irrigation with water served as a control. Results P-ECT restored local optical clarity after NaOH exposure. OCT imaging shows both progression of NaOH injury and the restoration of clarity in real time. Analysis of SHG z-stack images show that collagen fibril orientation is similar between control, NaOH-damaged, and post-P-ECT corneas. NaOH-injured corneas flushed with water (15 minutes) show no restoration of clarity. Conclusions P-ECT may be a means to correct alkaline CCI. Collagen fibril orientation does not change after NaOH exposure or P-ECT, suggesting that no irreversible matrix level fiber changes occur. Further studies are required to determine the mechanism for corneal clearing and to ascertain the optimal electrical dosimetry parameters and electrode designs. Translational Relevance Our findings suggest that P-ECT is a potentially effective, low-cost treatment for alkaline CCI.
Collapse
Affiliation(s)
- Katelyn K Dilley
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, CA, USA.,Department of Biomedical Engineering, University of California-Irvine, Irvine, CA, USA
| | - Pamela A Borden
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, CA, USA.,Department of Biomedical Engineering, University of California-Irvine, Irvine, CA, USA
| | - Yueqiao Qu
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, CA, USA.,Department of Biomedical Engineering, University of California-Irvine, Irvine, CA, USA
| | - Andrew E Heidari
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, CA, USA.,Department of Biomedical Engineering, University of California-Irvine, Irvine, CA, USA
| | - Karthik R Prasad
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, CA, USA.,School of Medicine, University of California-Irvine, Irvine, CA, USA
| | - Yan Li
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, CA, USA.,Department of Biomedical Engineering, University of California-Irvine, Irvine, CA, USA
| | - Chung Ho Sun
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, CA, USA
| | - Zhongping Chen
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, CA, USA.,Department of Biomedical Engineering, University of California-Irvine, Irvine, CA, USA
| | - Sehwan Kim
- Beckman Laser Institute-Korea, Department of Biomedical Engineering, Dankook University, Cheonan-si, Chungnam, Republic of Korea
| | - Michael G Hill
- Department of Chemistry, Occidental College, Los Angeles, CA, USA
| | - Brian J F Wong
- Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, CA, USA.,Department of Biomedical Engineering, University of California-Irvine, Irvine, CA, USA.,Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, School of Medicine, Orange, CA, USA
| |
Collapse
|
4
|
Heidari AE, Hong EM, Park A, Pham TT, Steward E, Chen LY, Qu Y, Dunn BS, Seo SH, Patel U, Dilley K, Hakimi AA, Syed A, Kim S, Hill MG, You JS, Wong BJF. Exploring feedback-controlled versus open-circuit electrochemical lipolysis in ex vivo and in vivo porcine fat: A feasibility study. Lasers Surg Med 2022; 54:157-169. [PMID: 34412154 PMCID: PMC8770526 DOI: 10.1002/lsm.23466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Minimally invasive fat sculpting techniques are becoming more widespread with the development of office-based devices and therapies. Electrochemical lipolysis (ECLL) is a needle-based technology that uses direct current (DC) to electrolyze tissue water creating acid and base in situ. In turn, fat is saponified and adipocyte cell membrane lysis occurs. The electrolysis of water can be accomplished using a simple open-loop circuit (V-ECLL) or by incorporating a feedback control circuit using a potentiostat (P-ECLL). A potentiostat utilizes an operational amplifier with negative feedback to allow users to precisely control voltage at specific electrodes. To date, the variation between the two approaches has not been studied. The aim of this study was to assess current and charge transfer variation and lipolytic effect created by the two approaches in an in vivo porcine model. METHODS Charge transfer measurements from ex vivo V-ECLL and P-ECLL treated porcine skin and fat were recorded at -1 V P-ECLL, -2 V P-ECLL, -3 V P-ECLL, and -5 V V-ECLL each for 5 min to guide dosimetry parameters for in vivo studies. In follow-up in vivo studies, a sedated female Yorkshire pig was treated with both V-ECLL and P-ECLL across the dorsal surface over a range of dosimetry parameters, including -1.5 V P-ECLL, -2.5 V P-ECLL, -3.5 V P-ECLL, and 5 V V-ECLL each treated for 5 min. Serial biopsies were performed at baseline before treatment, 1, 2, 7, 14, and 28 days after treatment. Tissue was examined using fluorescence microscopy and histology to compare the effects of the two ECLL approaches. RESULTS Both V-ECLL and P-ECLL treatments induced in-vivo fat necrosis evident by adipocyte membrane lysis, adipocyte denuclearization, and an acute inflammatory response across a 28-day longitudinal study. However, -1.5 V P-ECLL produced a smaller spatial necrotic effect compared to 5 V V-ECLL. In addition, 5 V V-ECLL produced a comparable necrotic effect to that of -2.5 V and -3.5 V P-ECLL. CONCLUSIONS V-ECLL and P-ECLL at the aforementioned dosimetry parameters both achieved fat necrosis by adipocyte membrane lysis and denuclearization. The -2.5 V and -3.5 V P-ECLL treatments created spatially similar fat necrotic effects when compared to the 5 V V-ECLL treatment. Quantitatively, total charge transfer between dosimetry parameters suggests that -2.5 V P-ECLL and 5 V V-ECLL produce comparable electrochemical reactions. Such findings suggest that a low-voltage closed-loop potentiostat-based system is capable of inducing fat necrosis to a similar extent compared to that of a higher voltage direct current system.
Collapse
Affiliation(s)
- Andrew E. Heidari
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA,Department of Biomedical Engineering, University of California - Irvine, Irvine, CA 92697, USA
| | - Ellen M. Hong
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA
| | - Asher Park
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA
| | - Tiffany T. Pham
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA
| | - Earl Steward
- Department of Surgery, University of California - Irvine, School of Medicine, Orange, CA 92868, USA
| | - Lily Y. Chen
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA
| | - Yueqiao Qu
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA,Department of Biomedical Engineering, University of California - Irvine, Irvine, CA 92697, USA
| | - Brandyn S. Dunn
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA,Department of Otolaryngology - Head and Neck Surgery, University of California - Irvine, School of Medicine, Orange, CA 92868, USA
| | - Soo Hong Seo
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA,Department of Dermatology, Korea University, College of Medicine, Seoul, 02841, Republic of Korea
| | - Urja Patel
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA,Department of Biomedical Engineering, University of California - Irvine, Irvine, CA 92697, USA
| | - Katelyn Dilley
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA,Department of Biomedical Engineering, University of California - Irvine, Irvine, CA 92697, USA
| | - Amir A. Hakimi
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA
| | - Adeela Syed
- Department of Developmental and Cell Biology, University of California - Irvine, CA 92697, USA
| | - Sehwan Kim
- Beckman Laser Institute-Korea, Department of Biomedical Engineering, Dankook University, Cheonan-si, Chungnam 31116, Republic of Korea
| | - Michael G. Hill
- Department of Chemistry, Occidental College, Los Angeles, CA 90041, USA
| | | | - Brian J. F. Wong
- Beckman Laser Institute & Medical Clinic, University of California - Irvine, CA 92612, USA,Department of Biomedical Engineering, University of California - Irvine, Irvine, CA 92697, USA,Department of Otolaryngology - Head and Neck Surgery, University of California - Irvine, School of Medicine, Orange, CA 92868, USA
| |
Collapse
|