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Choi S, Lee IY, Kim MJ, Lee SK, Lee KY. Multi-Functional Polymer Nanoparticles with Enhanced Adipocyte Uptake and Adipocytolytic Efficacy. Macromol Biosci 2024; 24:e2300312. [PMID: 37902246 DOI: 10.1002/mabi.202300312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/27/2023] [Indexed: 10/31/2023]
Abstract
Multi-functional polymer nanoparticles have been widely utilized to improve cellular uptake and enhance therapeutic efficacy. In this study, it is hypothesized that the cellular uptake of poly(D,L-lactide-co-glycolide) (PLG) nanoparticles loaded with calcium carbonate minerals into adipocytes can be improved by covalent modification with nona-arginine (R9 ) peptide. It is further hypothesized that the internalization mechanism of R9 -modified PLG nanoparticles by adipocytes may be contingent on the concentration of R9 peptide present in the nanoparticles. R9 -modified PLG nanoparticles followed the direct penetration mechanism when the concentration of R9 peptide in the nanoparticles reached 38 µM. Notably, macropinocytosis is the major endocytic mechanism when the R9 peptide concentration is ≤ 26 µM. The endocytic uptake of the nanoparticles effectively generated carbon dioxide gas at an endosomal pH, resulting in significant adipocytolytic effects in vitro, which are further supported by the findings in an obese mouse model induced by high-fat diet. Gas-generating PLG nanoparticles, modified with R9 peptide, demonstrated localized reduction of adipose tissue (reduction of 13.1%) after subcutaneous injection without significant side effects. These findings highlight the potential of multi-functional polymer nanoparticles for the development of effective and targeted fat reduction techniques, addressing both health and cosmetic considerations.
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Affiliation(s)
- Suim Choi
- Department of Bioengineering, Hanyang University, Seoul, 04763, Republic of Korea
| | - In Young Lee
- Department of Bioengineering, Hanyang University, Seoul, 04763, Republic of Korea
| | - Min Ju Kim
- Department of Bioengineering, Hanyang University, Seoul, 04763, Republic of Korea
| | - Sang-Kyung Lee
- Department of Bioengineering, Hanyang University, Seoul, 04763, Republic of Korea
- Institute for Bioengineering and Biopharmaceutical Research, Hanyang University, Seoul, 04763, Republic of Korea
| | - Kuen Yong Lee
- Department of Bioengineering, Hanyang University, Seoul, 04763, Republic of Korea
- Institute for Bioengineering and Biopharmaceutical Research, Hanyang University, Seoul, 04763, Republic of Korea
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2
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Alizadeh Z, Halabchi F, Bodaghabadi Z, Zarandi MM, Abolhasani M, Seifi V, Khazaei R, Ghanadi S, Mazaheri R, Tabesh MR. Non-invasive Body Contouring Technologies: An Updated Narrative Review. Aesthetic Plast Surg 2024; 48:659-679. [PMID: 37749418 DOI: 10.1007/s00266-023-03647-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 08/29/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION Nowadays, a lot of body contouring devices and methods are introduced all over the world. The object of the present narrative review was to update and classify existing evidence on these methods and devices. METHODS We searched databases including PubMed, Cochrane, and Google Scholar for 11 essential keywords, including cryolipolysis, high-intensity focused ultrasound (HIFU), shock wave, low-level laser therapy (LLLT), radiofrequency (RF), capacitive resistive electrical transfer (TECAR), high-intensity focused electromagnetic (HIFEM), electromyostimulation (EMS), carboxytherapy, mesotherapy, and acupuncture and their abbreviations, in addition to obesity, overweight, cellulite, subcutaneous fat, and body contouring. RESULTS Totally 193 references were used in 11 main topics. CONCLUSION In order to help physicians with finding the best evidence in different methods, the data were summarised in 11 topics. Furthermore, FDA-approved devices, side effects and common protocols were described in each section. LEVEL OF EVIDENCE I This journal requires that authors 39 assign a level of evidence to each article. For a full 40 description of these Evidence-Based Medicine ratings, 41 please refer to the Table of Contents or the online 42 Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Zahra Alizadeh
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farzin Halabchi
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Bodaghabadi
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Maryam Abolhasani
- Cardiovascular Diseases Research Centre, Cardiac primary prevention research center, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Seifi
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Khazaei
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Ghanadi
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mazaheri
- Department of Sports and Exercise Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mastaneh Rajabian Tabesh
- Cardiac Primary Prevention Research Center (CPPRC), Heart Centre Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Kouhjani M, Saberi A, Hadizadeh F, Khodaverdi E, Karimi M, Gholizadeh E, Kamali H, Nokhodchi A. Development of Sustained Release Formulations Based on Lipid-Liquid Crystal to Control the Release of Deoxycholate: In Vitro and In Vivo Assessment. AAPS PharmSciTech 2023; 24:224. [PMID: 37946092 DOI: 10.1208/s12249-023-02677-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023] Open
Abstract
Subcutaneous injections of phosphatidylcholine (PC), sodium deoxycholate (NADC), and a mixture of them were found to be an effective option for treating cellulite. However, it is noteworthy that the injection of NADC may result in inflammation as well as necrosis in the injection area. The preparation of a sustained release formulation based on lipid-liquid crystal that controls the release of NADC could be a potential solution to address the issue of inflammation and necrosis at the site of injection. To present a practical and validated approach for accurately determining the concentration of NADC in LLC formulations, spectrofluorimetry was used based on the International Council for Harmonization (ICH) Q2 guidelines. Based on the validation results, the fluorometric technique has been confirmed as a reliable, efficient, and economical analytical method for quantifying NADC concentrations. The method demonstrated favorable attributes of linearity, precision, and accuracy, with an r2 value of 0.999. Furthermore, it exhibited excellent interday and intraday repeatability, with RSD values below 4%. The recovery percentages ranged from 97 to 100%, indicating the method's ability to accurately measure NADC concentrations. The subcutaneous injection of the LLC-NADC demonstrated a reduction in inflammation and tissue necrosis in skin tissue, along with an increase in fat lysis within 30 days, when compared to the administration of only NADC solution. Moreover, the histopathological assessment confirmed that the use of the LLC formulation did not result in any detrimental side effects for kidney or heart tissue.
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Affiliation(s)
- Maryam Kouhjani
- Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran
| | - Arezoo Saberi
- Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran
| | - Farzin Hadizadeh
- Department of Medicinal Chemistry, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Khodaverdi
- Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran
- Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Karimi
- Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran
| | - Elaheh Gholizadeh
- Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran
| | - Hossein Kamali
- Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran.
- Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Ali Nokhodchi
- Pharmaceutics Research Laboratory, School of Life Sciences, University of Sussex, Brighton, UK.
- Lupin Research Inc., Coral Springs, FL, USA.
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Han YK, Jeong EJ, Seo Y, Lee IY, Choi S, Lee H, Kim C, Rhim T, Lee KY. Adipocytolytic Polymer Nanoparticles for Localized Fat Reduction. ACS NANO 2023; 17:70-83. [PMID: 36534969 DOI: 10.1021/acsnano.2c04108] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The demand for body fat reduction is increasing. However, conventional lipolytic approaches fail to control adipose tissue reduction and cause severe side effects in adjacent nonadipose tissues. A strategy to specifically reduce subcutaneous fat using adipocytolytic polymer nanoparticles in a minimally invasive manner is reported here. The polymer nanoparticles are designed to generate carbon dioxide gas when selectively absorbed by adipocytes. The carbon dioxide gas generated within late endosomes/lysosomes induces adipocytolysis, thereby reducing the number of cells. Localized injection of the adipocytolytic nanoparticles substantially reduces subcutaneous fat in a high-fat diet-induced obese mouse model, without significant changes in hematological or serum biochemical parameters. The adipocytolytic efficacy of the nanoparticles is also evaluated in a porcine model. This strategy addresses the need to develop safe and effective adipocytolytic agents using functional polymer nanoparticles.
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Affiliation(s)
- Young Kyoung Han
- Department of Bioengineering and Institute of Nano Science and Technology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul04763, Republic of Korea
| | - Eun Ju Jeong
- Supernova Bio, 67 Seobinggo-ro, Yongsan-gu, Seoul04385, Republic of Korea
| | - Yerang Seo
- Supernova Bio, 67 Seobinggo-ro, Yongsan-gu, Seoul04385, Republic of Korea
| | - In Young Lee
- Department of Bioengineering and Institute of Nano Science and Technology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul04763, Republic of Korea
| | - Suim Choi
- Department of Bioengineering and Institute of Nano Science and Technology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul04763, Republic of Korea
| | - Hyewon Lee
- Department of Bioengineering and Institute of Nano Science and Technology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul04763, Republic of Korea
| | - Choonggu Kim
- Department of Bioengineering and Institute of Nano Science and Technology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul04763, Republic of Korea
| | - Taiyoun Rhim
- Department of Bioengineering and Institute of Nano Science and Technology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul04763, Republic of Korea
| | - Kuen Yong Lee
- Department of Bioengineering and Institute of Nano Science and Technology, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul04763, Republic of Korea
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Yang Y, Li S, Zhang L, Fu H, Zhou G, Chen M. Skin and soft tissue infection of Nontuberculous mycobacterium after injection lipolysis. J Cosmet Dermatol 2023; 22:1207-1212. [PMID: 36606392 DOI: 10.1111/jocd.15591] [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: 09/23/2022] [Revised: 11/18/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Injection lipolysis is used for body and face contouring due to its minimal invasiveness and cost-effectiveness, but related complications such as nontuberculous mycobacterium infection significantly affect its clinical application. AIMS This study aimed to review the literature on NTM infection after injection lipolysis. METHODS We conducted a literature review of scientific journals published in Medline and PubMed up to September 2022 on patients with NTM skin and soft tissue infections. We used the keywords: nontuberculous mycobacterium, infection, injection lipolysis, and lipolytic solution in various combinations with the Boolean operators AND, OR, and NOT. Only articles available in English and full version publications were considered for this review. Here, we reviewed the relevant mechanisms and drugs for injectable lipolysis and analyzed the possible correlation between NTM infection and injection lipolysis. We also summarize methods for the diagnosis and treatment of NTM infections and present some perspectives on this therapy. RESULTS Many patients with NTM infections had a history of fat-related surgery or therapy. NTM infection after injection lipolysis may be related to inadequate disinfection and sterilization of injection equipment and clinical procedures, the unqualified medication itself and free fatty acids released during injection lipolysis. Currently, diagnosis and treatment of NTM infection after lipolysis injections remains challenging. CONCLUSIONS Injection lipolysis represents a helpful option for local fat reduction. Doctors should strictly abide by the aseptic operation standards and use qualified products for there is a correlation between skin and soft tissue infection of nontuberculous mycobacterium and injection lipolysis. Providers should understand the mechanism, indications, and associated risks of injection lipolysis when injecting fat-dissolving drugs to reduce localized fat.
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Affiliation(s)
- Yi Yang
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing, China.,Chinese PLA Medical School, Beijing, China
| | - Shiyi Li
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing, China.,Chinese PLA Medical School, Beijing, China
| | - Lixia Zhang
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing, China.,Chinese PLA Medical School, Beijing, China
| | - Huijuan Fu
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing, China.,Chinese PLA Medical School, Beijing, China
| | - Guiwen Zhou
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing, China
| | - Minliang Chen
- Senior Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing, China
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Fan Z, Kernan KF, Sriram A, Benos PV, Canna SW, Carcillo JA, Kim S, Park HJ. Deep neural networks with knockoff features identify nonlinear causal relations and estimate effect sizes in complex biological systems. Gigascience 2022; 12:giad044. [PMID: 37395630 PMCID: PMC10316696 DOI: 10.1093/gigascience/giad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/31/2023] [Accepted: 05/29/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Learning the causal structure helps identify risk factors, disease mechanisms, and candidate therapeutics for complex diseases. However, although complex biological systems are characterized by nonlinear associations, existing bioinformatic methods of causal inference cannot identify the nonlinear relationships and estimate their effect size. RESULTS To overcome these limitations, we developed the first computational method that explicitly learns nonlinear causal relations and estimates the effect size using a deep neural network approach coupled with the knockoff framework, named causal directed acyclic graphs using deep learning variable selection (DAG-deepVASE). Using simulation data of diverse scenarios and identifying known and novel causal relations in molecular and clinical data of various diseases, we demonstrated that DAG-deepVASE consistently outperforms existing methods in identifying true and known causal relations. In the analyses, we also illustrate how identifying nonlinear causal relations and estimating their effect size help understand the complex disease pathobiology, which is not possible using other methods. CONCLUSIONS With these advantages, the application of DAG-deepVASE can help identify driver genes and therapeutic agents in biomedical studies and clinical trials.
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Affiliation(s)
- Zhenjiang Fan
- Department of Computer Science, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Kate F Kernan
- Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Center for Critical Care Nephrology and Clinical Research Investigation and Systems Modeling of Acute Illness Center, University of Pittsburgh, Pittsburgh, PA 15260,USA
| | - Aditya Sriram
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Panayiotis V Benos
- Department of Epidemiology, University of Florida, Gainesville, FL 32610, USA
| | - Scott W Canna
- Pediatric Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Joseph A Carcillo
- Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Center for Critical Care Nephrology and Clinical Research Investigation and Systems Modeling of Acute Illness Center, University of Pittsburgh, Pittsburgh, PA 15260,USA
| | - Soyeon Kim
- Division of Pediatric Pulmonary Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Hyun Jung Park
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA 15213, USA
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7
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Sena MM, Marreira M, de Almeida GP, Teixeira M, D'Amico MM, Pavani C. Can the use of photobiomodulation for localized fat reduction induce changes in lipid profile? A critical integrative review. Lasers Med Sci 2022; 38:23. [PMID: 36564660 DOI: 10.1007/s10103-022-03662-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 10/22/2022] [Indexed: 12/25/2022]
Abstract
The objective of this study is to clarify whether PBM for measures reduction can cause significant changes in the lipid profile. This is an integrative review and only original articles, both in vivo and clinical trials, that were published between 2010 and 2022 were selected. The article references were also analyzed to identify additional studies. A total of 15 articles were critically analyzed. The wavelength used ranged from 532 nm (green) to 956 nm (near infrared), and many authors failed to describe dosimetric parameters properly, as well as other important characteristics for the reproducibility of those found. Although it is not fully clear about the PBM interference level on the lipid profile, in general, there was no significant difference in lipid parameters when PBM was used alone, and when associated with techniques that promote beta-oxidation, there was an improvement in these biochemical variables. PBM use for localized fat reduction do not affect lipid serum levels. Clinical trials using standardized parameters are crucial to obtain more reliable results.
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Affiliation(s)
- Michelle Mota Sena
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP, São Paulo, SP, 01504-001, Brazil
| | - Marcelo Marreira
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP, São Paulo, SP, 01504-001, Brazil
| | | | - Mariely Teixeira
- Medicine and Scientific Initiation Research, Universidade Nove de Julho, UNINOVE, São Paulo, SP, Brazil
| | | | - Christiane Pavani
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho, UNINOVE, R. Vergueiro, 235/249, CEP, São Paulo, SP, 01504-001, Brazil.
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8
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Frątczak A, Polak K, Szczepanek M, Waliczek M, Bergler-Czop B. Injection lipolysis with phosphatidylcholine and sodium deoxycholate-Is it really worth the risk? Dermatol Ther 2022; 35:e15805. [PMID: 36068992 DOI: 10.1111/dth.15805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 07/11/2022] [Accepted: 08/30/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Karina Polak
- Doctoral School, Medical University of Silesia, Katowice, Poland
| | - Michał Szczepanek
- Department of Dermatology, Medical University of Silesia, Katowice, Poland
| | - Martyna Waliczek
- Department of Dermatology, Medical University of Silesia, Katowice, Poland
| | - Beata Bergler-Czop
- Department of Dermatology, Medical University of Silesia, Katowice, Poland
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9
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Koh IS, Kim JW, Yun JY, Chung EH, Yang YI, Sun H. Bilateral symmetrical lipoma of the buccal fat pad as an incidental finding in a woman with weight gain after tamoxifen: a case report. Arch Craniofac Surg 2022; 22:329-332. [PMID: 34974689 PMCID: PMC8721432 DOI: 10.7181/acfs.2021.00514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/09/2021] [Indexed: 11/11/2022] Open
Abstract
Although lipoma is a common benign tumor, it occurs relatively infrequently in the oral and maxillofacial areas, and only 31 cases of lipoma in the buccal fat pad have been reported. Herein, we present an extremely rare case of symmetric lipomas in both buccal fat pads. These masses were incidentally discovered during a facelift procedure in a 50-year-old woman with a 4-year history of tamoxifen use. during which she had gained 10 kg. The patient stated that cheek protrusion had developed concomitantly with weight gain and was exacerbated by an injection lipolysis procedure she had received 1 year previously. This case underscores the importance of paying careful attention to the patient’s medication use and surgical history when evaluating suspected cases of lipoma, and sheds light on tamoxifen use and subcutaneous injections of phosphatidylcholine and deoxycholate as potential risk factors for lipoma development.
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Affiliation(s)
- In Suk Koh
- Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Jin Woo Kim
- Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Ji Young Yun
- Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Eui Han Chung
- Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Young Il Yang
- Department of Pathology, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Hook Sun
- Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
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Muskat A, Pirtle M, Kost Y, McLellan BN, Shinoda K. The Role of Fat Reducing Agents on Adipocyte Death and Adipose Tissue Inflammation. Front Endocrinol (Lausanne) 2022; 13:841889. [PMID: 35399925 PMCID: PMC8988282 DOI: 10.3389/fendo.2022.841889] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/28/2022] [Indexed: 01/02/2023] Open
Abstract
Deoxycholic Acid (DCA), which is an FDA-approved compound for the reduction of submental fat, has evolved through an unanticipated and surprising sequence of events. Initially, it was used as a solvent for Phosphatidylcholine (PDC), which was thought to promote lipolysis, but it was later proven to be the bioactive component of the formula and is currently widely used as Kybella. It has also been used off-label to treat other types of fat deposits like lipomas, HIV lipodystrophy, and excess orbital fat. Despite widespread clinical use, there has been no consensus clarifying the mechanisms of DCA and PDC alone or in combination. Furthermore, despite PDC's removal from the FDA-approved formula, some studies do suggest it plays an important role in fat reduction. To provide some clarity, we conducted a PubMed search and reviewed 41 articles using a comprehensive list of terms in three main categories, using the AND operator: 1) Phosphatidylcholines 2) Deoxycholic Acid, and 3) Lipoma. We isolated articles that studied PDC, DCA, and a PDC/DCA compound using cell biology, molecular and genetic techniques. We divided relevant articles into those that studied these components using histologic techniques and those that utilized specific cell death and lipolysis measurement techniques. Most morphologic studies indicated that PDC/DCA, DCA, and PDC, all induce some type of cell death with accompanying inflammation and fibrosis. Most morphologic studies also suggest that PDC/DCA and DCA alone are non-selective for adipocytes. Biochemical studies describing PDC and DCA alone indicate that DCA acts as a detergent and rapidly induces necrosis while PDC induces TNF-α release, apoptosis, and subsequent enzymatic lipolysis after at least 24 hours. Additional papers have suggested a synergistic effect between the two compounds. Our review integrates the findings of this growing body of literature into a proposed mechanism of fat reduction and provides direction for further studies.
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Affiliation(s)
- Ahava Muskat
- Department of Medicine, Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Megan Pirtle
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Yana Kost
- Department of Medicine, Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Beth N. McLellan
- Department of Medicine, Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Kosaku Shinoda
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Medicine, Division of Endocrinology & Diabetes, Albert Einstein College of Medicine, Bronx, NY, United States
- Albert Einstein College of Medicine, Fleischer Institute for Diabetes and Metabolism, Bronx, NY, United States
- *Correspondence: Kosaku Shinoda,
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11
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Lee H, Kim MH, Jin SC, Choi LY, Nam YK, Yang WM. LIPOSA pharmacopuncture, a new herbal formula, affects localized adiposity by regulating lipid metabolism in vivo. Exp Ther Med 2021; 22:1290. [PMID: 34630645 PMCID: PMC8461519 DOI: 10.3892/etm.2021.10725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/03/2020] [Indexed: 12/01/2022] Open
Abstract
Localized adiposity is a serious aesthetic problem and a well-known health risk factor. There is a growing interest in minimally invasive treatment options for excessive fat accumulation, such as pharmacopuncture. LIPOSA is a newly developed pharmacopuncture formula from three natural herbs: The tuber of Pinellia ternata (Thunb.) Breitenb., the whole plant of Taraxacum platycarpum Dahlst. and the root of Astragalus membranaceus Bunge. The present study investigated the effects of pharmacopuncture treatment with LIPOSA on localized adiposity. Male C57BL/6J mice were fed high fat diet for 8 weeks to induce obesity. Then, 100 µl LIPOSA was injected into the left-side inguinal fat pad at various concentrations, including 13.35, 26.7 and 53.4 mg/ml. Normal saline was injected into the right-side inguinal fat pad of each mouse as a control. The treatment was performed three times per week for 2 weeks. The weight and histological changes were analyzed in the inguinal fat pad of the obese mice. The expression levels of adipose triglyceride lipase (ATGL), hormone-sensitive lipase (HSL), autophagy-related gene (ATG)5, ATG7 and LC3-II, as lipophagy-related factors, were evaluated to confirm the lipid-catabolic effects of LIPOSA. LIPOSA pharmacopuncture markedly decreased the weight of the fat tissue and the size of the adipocytes in the inguinal region of the mouse models of obesity in a dose-dependent manner. The expression levels of ATGL, HSL, ATG5, ATG7 and LC3-II were significantly increased by the LIPOSA treatments. In addition, LIPOSA pharmacopuncture was found to decrease the expression levels of ACC, PPAR-γ and PEPCK. The results indicated that subcutaneous injection of LIPOSA can degrade local fat and induce lipophagic and lipase activation effects. In addition, lipid metabolism related to fat accumulation was regulated by the LIPOSA treatment. The present study suggests that LIPOSA pharmacopuncture can be a non-surgical alternative in the treatment of localized adiposity.
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Affiliation(s)
- Haesu Lee
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea.,Boin Bio Convergence Co., Ltd., Seoul 02455, Republic of Korea
| | - Mi Hye Kim
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Seong Chul Jin
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - La Yoon Choi
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Yeon Kyung Nam
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Woong Mo Yang
- Department of Convergence Korean Medical Science, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea.,Boin Bio Convergence Co., Ltd., Seoul 02455, Republic of Korea
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Safety and Efficacy of Deoxycholic Acid Injection for Hypogastric Fat Reduction: A Pilot Study. Dermatol Surg 2021; 47:e132-e137. [PMID: 33795572 DOI: 10.1097/dss.0000000000002823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although deoxycholic acid (DCA) has been proposed for use in other areas, it is used primarily for treating moderate-to-severe fat in the submental area. OBJECTIVE To evaluate the safety and efficacy of DCA for fat reduction in the hypogastric region. MATERIALS AND METHODS A prospective, longitudinal, nonrandomized, open-label, interventional pilot study was performed. Deoxycholic acid was transcutaneously injected in upper right, upper left, lower right, and lower left hypogastric zones. Fat thickness was assessed using calipers, ultrasound, and 3-dimensional scanning. The primary end point safety was evaluated by laboratory tests and the incidence of adverse events. RESULTS Fourteen patients (54 treatment sessions) were included. The mean total volume administered was 26.6 mL. The main local adverse events were edema (94.4%), bruising (90.7%), and erythema (79.6%), all being self-limited (the mean duration 9.6, 7, and 2 days, respectively). A DCA dose was significantly associated with erythema duration (p = .0421) but not with edema duration (p = .1611) or bruising incidence (p = .1013). Measurement using calipers, ultrasound, and 3-dimensional scanning revealed significant fat thickness reduction. Patient-reported outcome measure scores revealed a significant improvement in patient satisfaction. CONCLUSION Deoxycholic acid may be a safe and effective option for reducing fat thickness in the hypogastric region, although given the cost/benefit ratio probably should be reserved for small deposits.
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13
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Nam YK, Park SJ, Kim MH, Choi LY, Yang WM. Pharmacopuncture of Taraxacum platycarpum extract reduces localized fat by regulating the lipolytic pathway. Biomed Pharmacother 2021; 141:111905. [PMID: 34328114 DOI: 10.1016/j.biopha.2021.111905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 12/20/2022] Open
Abstract
Localized fat deposits are associated with health and aesthetic problems that mainly affect a large proportion of individuals. Recently, bioactive constituents of TP have been reported to affect lipid metabolism. In this study, we performed a network pharmacological analysis to assume potential lipolytic effects of TP and investigated the actual lipolytic effects of TP extract injection on local body fat and its underlying mechanism. Using the genes related to active compounds of TP, the network was constructed. Through the Functional Enrichment Analysis, Lipid Metabolism and Fatty Acid Metabolism were expected to be affiliated with the network, which implied possible lipolytic effects of TP. On the comparison between TP network and Obesity-related Gene Sets, about three-fourths of elements were in common with the gene sets, which indicated a high relevance between TP and obesity. Based on the genes in lipolysis-related pathways, Perilipin, CGI-58, ATGL, HSL and MGL were selected to identify the actual lipolytic effects of TP. TP injection reduced the inguinal fat weight. Also, the diameter of the adipocytes was decreased by the TP treatment in HFD-induced obese mice. In addition, TP suppressed lipid accumulation in differentiated 3T3-L1 adipocytes. Moreover, because the expression of Perilipin was increased, CGI-58, ATGL, HSL and MGL were markedly decreased. Furthermore, glycerol release was down-regulated by the TP treatment. TP exerted its lipolytic effects by regulating the lipolysis machinery through stimulation of lipases. Based on the present findings, TP is expected to be a potent component of injection lipolysis for removing localized body fat.
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Affiliation(s)
- Yeon Kyung Nam
- Department of Convergence Korean Medical Science, College of Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Sang Jun Park
- Department of Convergence Korean Medical Science, College of Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Mi Hye Kim
- Department of Convergence Korean Medical Science, College of Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - La Yoon Choi
- Department of Convergence Korean Medical Science, College of Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Woong Mo Yang
- Department of Convergence Korean Medical Science, College of Korean Medicine, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea.
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Kream E, Boen M, Fabi SG, Goldman MP. Nonsurgical Postpartum Abdominal Rejuvenation: A Review and Our Experience. Dermatol Surg 2021; 47:768-774. [PMID: 33867470 DOI: 10.1097/dss.0000000000003003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A significant population of aesthetic patients are postpartum women motivated to achieve a more youthful abdomen. Although traditionally, abdominoplasty was the treatment of choice, minimally invasive procedures have grown in popularity because of minimal downtime and the favorable side effect profile. so many women share concerns regarding their postpartum abdominal appearance, a limited number of studies focus specifically on postpartum abdominal rejuvenation. OBJECTIVE To review pertinent aspects of abdominal anatomy, associated changes with pregnancy, available nonsurgical cosmetic procedures, and to provide our experience to help guide treatment combinations which comprehensively address the concerns of the postpartum patient. MATERIALS AND METHODS A review of the literature surrounding nonsurgical treatment options for postpartum abdominal lipohypertrophy, muscle changes, tissue laxity, and striae gravidarum, along with the authors' experience in this area are provided. CONCLUSION This review summarizes available nonsurgical modalities to address postpartum abdominal defects, including procedures that tone muscles, reduce fat, tighten skin, and improve the appearance of striae. Both the published literature and the authors' experience favor a combination of treatments to address the various lamellae affected by pregnancy. Further clinical trials focusing on the postpartum patient would further help create a standardized approach for postpartum abdominal rejuvenation.
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Affiliation(s)
- Elizabeth Kream
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois
| | - Monica Boen
- Cosmetic Laser Dermatology, A West Dermatology Company, San Diego, California
| | - Sabrina G Fabi
- Cosmetic Laser Dermatology, A West Dermatology Company, San Diego, California
| | - Mitchel P Goldman
- Cosmetic Laser Dermatology, A West Dermatology Company, San Diego, California
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15
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16
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17
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Park SH, Hyun MR, Kim SW. Effect of a Formulation Containing Low-Dose Sodium Deoxycholate on Local Fat Reduction. Aesthetic Plast Surg 2019; 43:1657-1662. [PMID: 31598768 DOI: 10.1007/s00266-019-01514-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Synthetic deoxycholic acid (DCA) has been approved as an injectable drug for the nonsurgical reduction of submental fat. OBJECTIVE In this study, we evaluated the fat-reducing effects of a new formula containing a low dose of DCA and fat dissolution by topical application of DCA. METHODS Sodium deoxycholate (99.1% pure) and the new formulation containing 10% DCA were injected or topically applied to the dorsa of obese mice (induced by a high-fat diet). The rate of change in body weight was evaluated, together with comparisons of micro-computed tomography images, body composition measurements, and histology findings. RESULTS The results showed that the new formula containing low-dose DCA was as effective as the older high-dose formulation with respect to the rate of change in body weight and reductions in subcutaneous fat pad area, body fat weight, and the thickness of the subcutaneous fat layer. Furthermore, topical application of the high-dose, but not the low-dose, formulation yielded promising effects. CONCLUSIONS The development of a better protocol for the high-dose preparation, including dose optimization and application methods that minimize the adverse effects of DCA, merits further study. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors - www.springer.com/00266 .
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Affiliation(s)
- Sang Hoon Park
- Department of Plastic Surgery, Id Hospital, Seoul, Republic of Korea
| | - Mi Ri Hyun
- Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - Sang Wha Kim
- Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.
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18
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Grow JN, Holding J, Korentager R. Assessing the Efficacy of Deoxycholic Acid for the Treatment of Submental Fat: A Three-Dimensional Study. Aesthet Surg J 2019; 39:1400-1411. [PMID: 30272141 DOI: 10.1093/asj/sjy194] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Deoxycholic acid is used for the treatment of excess submental fat, offering a potential alternative to more invasive surgical procedures. However, there is currently an absence of high-level evidence in the literature outside of Phase 3 clinical trials. OBJECTIVES The aim of this study was to evaluate the efficacy of deoxycholic acid for the treatment of submental adiposity by correlating objective 3-dimensional (3D) data with subjective patient assessment scores. METHODS Thirteen patients were prospectively enrolled into the study. 3D images were obtained prior to initial treatment, at 4-week intervals, and in the acute recovery period. Volumetric changes were calculated using Vectra software. Corresponding subjective surveys using the FACE-Q tool evaluated the perceived treatment results and side effects. RESULTS Objectively, there was a significant reduction in submental volume following treatment (P = 0.004), with total rounds of treatment averaging 3.4 (SD: 1.19). During the immediate recovery period, there was a statistically significant increase in submental volume, with an average increase of 8.68% (P = 0.0003). Subjectively, patient satisfaction scores improved significantly for both the aesthetics of the area under the chin and jawline (P < 0.005). Self-resolving paresthesia following treatment occurred in all study participants. There were no major complications. Participant scores of early treatment recovery also improved significantly with subsequent treatments (P < 0.005). CONCLUSIONS This study validates the use of deoxycholic acid for reducing supraplatysmal adiposity in the submental area. Objective volume changes showed positive correlation with subjective improvements in patient satisfaction scores. Recovery and side effect profiles were also described and may aid in future patient education and management. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Jacob Nathaniel Grow
- Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, KS
| | - Julie Holding
- Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, KS
| | - Richard Korentager
- Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, KS
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Konigorski S, Janke J, Drogan D, Bergmann MM, Hierholzer J, Kaaks R, Boeing H, Pischon T. Prediction of Circulating Adipokine Levels Based on Body Fat Compartments and Adipose Tissue Gene Expression. Obes Facts 2019; 12:590-605. [PMID: 31698359 PMCID: PMC6940469 DOI: 10.1159/000502117] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 07/15/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Adipokines are hormones secreted from adipose tissue (AT), and a number of them have been established as risk factors for chronic diseases. However, it is not clear whether and to what extent adiposity, gene expression, and other factors determine their circulating levels. OBJECTIVES To assess to what extent adiposity, as measured by the amount of subcutaneous AT (SAT) and visceral AT (VAT) using magnetic resonance imaging, and gene expression levels in SAT determine plasma concentrations of the adipokines adiponectin, leptin, soluble leptin receptor, resistin, interleukin 6, and fatty acid-binding protein 4 (FABP4). METHODS We performed a cross-sectional analysis of 156 participants from the EPIC Potsdam cohort study and analyzed multiple regression models and partial correlation coefficients. RESULTS For leptin and FABP4 concentrations, 81 and 45% variance were explained by SAT mass, VAT mass, and gene expression in SAT in multivariable regression models. For the remaining adipokines, AT mass and gene expression explained <16% variance of plasma concentrations. Gene expression in SAT was a less important predictor compared to AT mass. SAT mass was a better predictor than VAT mass for leptin (partial correlation r = 0.81, 95% confidence interval 0.75-0.86, vs. r = 0.58, 95% confidence interval 0.46-0.67), while differences between AT compartments were small for the other adipokines. CONCLUSIONS While plasma levels of leptin and FABP4 can be explained in a large and medium part by the amount of AT and SAT gene expression, surprisingly, these predictors explained only little variance for all other investigated adipokines.
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Affiliation(s)
- Stefan Konigorski
- Molecular Epidemiology Research Group, Max Delbrück Center (MDC) for Molecular Medicine in the Helmholtz Association, Berlin, Germany,
- Machine Learning Research Group, Hasso Plattner Institute for Digital Engineering, Potsdam, Germany,
| | - Jürgen Janke
- Molecular Epidemiology Research Group, Max Delbrück Center (MDC) for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Dagmar Drogan
- AOK Research Institute (WIdO), AOK Bundesverband, Berlin, Germany
| | - Manuela M Bergmann
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Nuthetal, Germany
| | - Johannes Hierholzer
- Department of Diagnostic and Interventional Radiology, Clinic Ernst von Bergmann, Potsdam, Germany
| | - Rudolf Kaaks
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DIfE), Nuthetal, Germany
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max Delbrück Center (MDC) for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Charité Universitätsmedizin Berlin, Berlin, Germany
- German Center for Cardiovascular Research (DZHK) partner site Berlin, Berlin, Germany
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20
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ATX-101 (Deoxycholic Acid Injection) for Paradoxical Adipose Hyperplasia Secondary to Cryolipolysis. Dermatol Surg 2018; 44:752-754. [DOI: 10.1097/dss.0000000000001317] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Thomas MK, D'Silva JA, Borole AJ. Injection Lipolysis: A Systematic Review of Literature and Our Experience with a Combination of Phosphatidylcholine and Deoxycholate over a Period of 14 Years in 1269 Patients of Indian and South East Asian Origin. J Cutan Aesthet Surg 2018; 11:222-228. [PMID: 30886477 PMCID: PMC6371720 DOI: 10.4103/jcas.jcas_117_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Phosphatidylcholine and deoxycholate (PC-DC) injections have been used as nonsurgical alternatives to liposuction. DC as a constituent for lipolysis has recently been approved by the US Food and Drug Administration. Aim PC and DC have independently been used in lipolysis. We hereby present a systematic review of literature on injection lipolysis and share our experience of using DC in combination with PC for injection lipolysis. We have retrospectively evaluated the effects of PC-DC treatments in varied age groups, both sexes, and over different target areas. Materials and Methods This study spans over 14 years wherein 1269 patients of different age groups and sex were treated with injection lipolysis with PC-DC combination. The PC-DC cocktail injection was given to all patients for an average four sessions every 4 weeks, and the results were assessed after 8 weeks from the last session. Results The effects were best appreciated over the face (malar, jawline, and submental areas) and upper arm, whereas average effect was observed on the thighs and around the knees. We have also used lipolysis as a primary modality as well as a touch-up modality following liposuction. The results are better appreciated in primary lipolysis. The need for follow-up sessions (1-2 sessions) of lipolysis and the quantification of results in subsequent sessions reveal that maximal improvement is achieved in the first session. Conclusion PC-DC cocktail used for lipolysis as a local administration is effective for reducing unwanted fat. It shows great efficacy in treating localized fat, especially over the face and bra roll in the women of younger age group (20-30 years).
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Affiliation(s)
- Mohan K Thomas
- Department of Plastic Surgery, The Cosmetic Surgery Institute, Mumbai, Maharashtra, India
| | - James A D'Silva
- Department of Plastic Surgery, The Cosmetic Surgery Institute, Mumbai, Maharashtra, India
| | - Ateesh J Borole
- Department of Plastic Surgery, The Cosmetic Surgery Institute, Mumbai, Maharashtra, India
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22
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Auh SL, Iyengar S, Weil A, Bolotin D, Cartee TV, Dover JS, Maher IA, Sobanko JF, Cohen JL, Poon E, Alam M. Quantification of noninvasive fat reduction: A systematic review. Lasers Surg Med 2017; 50:96-110. [DOI: 10.1002/lsm.22761] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 01/06/2023]
Affiliation(s)
- Sogyong L. Auh
- Section of Dermatology; University of Chicago Medicine; Chicago Illinois
| | - Sanjana Iyengar
- Department of Dermatology, Feinberg School of Medicine; Northwestern University; Chicago Illinois
| | - Alexandra Weil
- Department of Dermatology, Feinberg School of Medicine; Northwestern University; Chicago Illinois
| | - Diana Bolotin
- Section of Dermatology; University of Chicago Medicine; Chicago Illinois
| | - Todd V. Cartee
- Department of Dermatology; Penn State Hershey Medical Center; Hershey Pennsylvania
| | - Jeffrey S. Dover
- Department of Dermatology; Brown Medical School; Providence Rhode Island
- Department of Dermatology; Dartmouth Medical School; Hanover New Hampshire
- Department of Dermatology; Yale University School of Medicine; New Haven Connecticut
| | - Ian A. Maher
- Department of Dermatology; Saint Louis University; St. Louis Missouri
| | - Joseph F. Sobanko
- Department of Surgery, Feinberg School of Medicine; Northwestern University; Chicago Illinois
| | - Joel L. Cohen
- AboutSkin Dermatology and DermSurgery; Greenwood Village Colorado
- Department of Dermatology; University of Aurora; Englewood Colorado
- Department of Dermatology; University of California Irvine; Irvine California
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine; Northwestern University; Chicago Illinois
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine; Northwestern University; Chicago Illinois
- Department of Otolaryngology, Feinberg School of Medicine; Northwestern University; Chicago Illinois
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Kim JY, Kwon MS, Son J, Kang SW, Song Y. Selective effect of phosphatidylcholine on the lysis of adipocytes. PLoS One 2017; 12:e0176722. [PMID: 28463991 PMCID: PMC5413042 DOI: 10.1371/journal.pone.0176722] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 04/15/2017] [Indexed: 12/13/2022] Open
Abstract
Obesity, a serious health risk factor, is often associated with depression and negatively affects many aspects of life. Injection of a formula comprising phosphatidylcholine (PPC) and deoxycholate (DC) has emerged as an alternative to liposuction in the reduction of local fat deposits. However, the formula component mainly responsible for this effect and the mechanism behind the actions of the components with respect to fat reduction are unknown. Here, we investigate the specific effects of PPC and DC on adipocyte viability. When exposed to PPC or DC, 3T3L1 preadipocytes and differentiated adipocytes showed dose dependent decrease in cell viability. Interestingly, while DC mediated cell death was non-specific to both preadipocytes and adipocytes, PPC specifically induced a decrease in mature adipocyte viability, but had less effect on preadipocytes. Injection of PPC and DC into inguinal fat pads caused reduction in size. PPC injections preferentially decreased gene expression in mature adipocytes, while a strong inflammatory response was elicited by DC injection. In line with the decreased adipocyte viability, exposure of differentiated adipocytes to PPC resulted in triglyceride release, with a minimal effect on free fatty acids release, suggesting that its fat-reducing effect mediated mainly through the induction of adipocyte cell death rather than lipolysis. Taken together, it appears that PPC specifically affects adipocytes, and has less effect on preadipocyte viability. It can therefore be a promising agent to selectively reduce adipose tissue mass.
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Affiliation(s)
- Ji-Young Kim
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
- Bio-Medical Institute of Technology, University of Ulsan, College of Medicine, Seoul, Korea
| | - Min-Seo Kwon
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
- Bio-Medical Institute of Technology, University of Ulsan, College of Medicine, Seoul, Korea
| | - Junghyun Son
- Department of Biological Chemistry, Korea University of Science and Technology, Daejeon, Korea
- Doping Control Center, Korea Institute of Science and Technology, Seoul, Korea
| | - Sang-Wook Kang
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Youngsup Song
- Department of Biomedical Sciences, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
- * E-mail:
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Reeds DN, Pietka TA, Yarasheski KE, Cade WT, Patterson BW, Okunade A, Abumrad NA, Klein S. HIV infection does not prevent the metabolic benefits of diet-induced weight loss in women with obesity. Obesity (Silver Spring) 2017; 25:682-688. [PMID: 28245099 PMCID: PMC5373981 DOI: 10.1002/oby.21793] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/07/2016] [Accepted: 01/04/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To test the hypothesis that HIV infection impairs the beneficial effects of weight loss on insulin sensitivity, adipose tissue inflammation, and endoplasmic reticulum (ER) stress. METHODS A prospective clinical trial evaluated the effects of moderate diet-induced weight loss on body composition, metabolic function, and adipose tissue biology in women with obesity who were HIV-seronegative (HIV-) or HIV-positive (HIV+). Body composition, multiorgan insulin sensitivity (assessed by using a two-stage hyperinsulinemic-euglycemic clamp procedure with stable isotopically labeled tracer infusions), and adipose tissue expression of markers of inflammation, autophagy, and ER stress were evaluated in 8 HIV- and 20 HIV+ women with obesity before and after diet-induced weight loss of 6% to 8%. RESULTS Although weight loss was not different between groups (∼7.5%), the decrease in fat-free mass was greater in HIV+ than HIV- subjects (-4.4 ± 0.7% vs. -1.7 ± 1.0%, P < 0.05). Weight loss improved insulin sensitivity in adipose tissue (suppression of palmitate rate of appearance [Ra]), liver (suppression of glucose Ra), and muscle (glucose disposal) similarly in both groups. Weight loss did not affect adipose tissue expression of markers of inflammation or ER stress in either group. CONCLUSIONS Moderate diet-induced weight loss improves multiorgan insulin sensitivity in HIV+ women to the same extent as women who are HIV-. However, weight loss causes a greater decline in fat-free mass in HIV+ than HIV- women.
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Affiliation(s)
- Dominic N Reeds
- Center for Human Nutrition, Washington University School of Medicine, St Louis, Missouri, USA
| | - Terri A Pietka
- Center for Human Nutrition, Washington University School of Medicine, St Louis, Missouri, USA
| | - Kevin E Yarasheski
- Center for Human Nutrition, Washington University School of Medicine, St Louis, Missouri, USA
| | - W Todd Cade
- Center for Human Nutrition, Washington University School of Medicine, St Louis, Missouri, USA
| | - Bruce W Patterson
- Center for Human Nutrition, Washington University School of Medicine, St Louis, Missouri, USA
| | - Adewole Okunade
- Center for Human Nutrition, Washington University School of Medicine, St Louis, Missouri, USA
| | - Nada A Abumrad
- Center for Human Nutrition, Washington University School of Medicine, St Louis, Missouri, USA
| | - Samuel Klein
- Center for Human Nutrition, Washington University School of Medicine, St Louis, Missouri, USA
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Kamalpour S, Leblanc K. Injection Adipolysis: Mechanisms, Agents, and Future Directions. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2016; 9:44-50. [PMID: 28210398 PMCID: PMC5300726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Noninvasive procedures targeting the elimination of unwanted adipose tissues have recently been developed. injection adipolysis is the term for the injection of cytotoxic substances into these tissues, with the intent of cosmetic improvement by volume reduction. initial attempts in the field utilized intravenous preparations of sodium deoxycholate and soy-derived phosphatidylcholine, approved for the intravenous treatment of fat emboli and dyslipidemias in countries outside the United States. it was initially purported that the active ingredient in these injections was phosphatidylcholine. Subsequent research discovered that injections of sodium deoxycholate alone were capable of inducing cellular lysis in vitro. These compounds also demonstrated an affinity for adipose tissue, sparing the overlying dermis and epidermis. The United States Food and Drug Administration (FDA) recently approved a formulation of sodium deoxycholate 10mg/mL for subcutaneous injection with the indication of aesthetic improvement of excess submental fat. it has shown moderate efficacy with appropriate patient selection and good patient satisfaction. However, previous research leading to the development of this drug proposed that including phosphatidylcholine to a more appealing cosmetic result, with decreased severity of injection-site reactions. Future drugs in the field of injection adipolysis may attempt to combine these ingredients for improved cosmesis and tolerability.
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Affiliation(s)
| | - Keith Leblanc
- Louisiana State University Dermatology, New Orleans, Louisiana
- Skin Surgery Centre, Metairie and Mandeville, Louisiana
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Duncan DI, Kim THM, Temaat R. Quantification of adipose volume reduction with a prospective study analyzing the application of external radiofrequency energy and high voltage ultrashort pulse duration electrical fields. J COSMET LASER THER 2016; 18:323-9. [PMID: 26985567 DOI: 10.3109/14764172.2016.1157374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To date, there have been no objective measurements of subcutaneous volume loss following treatments with a noninvasive radiofrequency (RF)-based device. Twenty female patients were treated with a suction-coupled bipolar RF device using external RF energy combined with pulsed electromagnetic RF energy for subcutaneous fat reduction. Parameters followed included weight, Vectra measurements of abdominal circumference and torso volume, and high-definition ultrasound measurements of fat thickness. Measurements were taken before treatment and three times following treatment. Analysis of the measured parameters showed that mean circumference reduction of 2.30 cm was noted at three months post-treatment. Independent volumetric analysis showed a mean subcutaneous volume reduction of 428 cc three months following RF treatment. High-resolution ultrasound fat thickness was reduced by a mean of 39.6% three months following the final BodyFX treatment. Independent and paired-sample t-tests showed a p value of < 0.05. Repeated measures of analysis of covariance (ANCOVA) adjusted for differences in age, as well as height and weight (proxy for body mass index) to minimize individual differences and control for extraneous variables that may affect the pre- and post-treatment results were analyzed. No confounding variables were found. All analyses were conducted using IBM SPSS 21.0.
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Affiliation(s)
- Diane Irvine Duncan
- a Plastic Surgical Associates of Fort Collins, Plastic Surgery , Fort Collins , CO , USA
| | | | - Robbin Temaat
- a Plastic Surgical Associates of Fort Collins, Plastic Surgery , Fort Collins , CO , USA
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Pumprla J, Howorka K, Kolackova Z, Sovova E. Non-contact radiofrequency-induced reduction of subcutaneous abdominal fat correlates with initial cardiovascular autonomic balance and fat tissue hormones: safety analysis. F1000Res 2015; 4:49. [PMID: 26069728 PMCID: PMC4431383 DOI: 10.12688/f1000research.5708.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 12/14/2022] Open
Abstract
Background and objective: The non-invasive reduction of subcutaneous abdominal fat became popular in the last decade. Radiofrequency (RF), non-contact, selective-field device Vanquish® has been developed to selectively induce deep fat tissue heating to reduce waist circumference. Our analysis evaluates immediate and sustained effects of this treatment on cardiovascular autonomic function and on selected metabolic parameters. Study design/patients and methods: A retrospective proof-of-concept analysis of RF treatment effects was conducted in 20 individuals with metabolic syndrome, to reduce the subcutaneous abdominal fat. Four 30-minutes treatment sessions (manufacturer´s standard protocol) were performed in 1-week intervals. Vital signs, ECG, lab screening, body composition, subcutaneous fat thickness and spectral analysis of heart rate variability (HRV) have been examined before, after the 1
st and 4
th treatment, and at follow-up visits 1 month and 3 months after the treatment. Results: The RF treatment led to a significant reduction of abdominal circumference after the 4
th session (p<0.001), and during follow-up after 1 and 3 months (p<0.001 and p<0.02, resp.). There was a significant correlation (r=-0.58, p=0.007) between reduction of abdominal circumference and initial very-low frequency (VLF) spectral power at 1 month follow-up. A significant increase of cumulative spectral power in low frequency (p=0.02) and reduction in high frequency (p=0.05) band have been observed immediately (20
+14 minutes) after the treatment. On the contrary, no sustained impact on autonomic balance has been recorded 39
+18 days after the treatment. A significant correlation between the initial adiponectin values and immediate autonomic response to one treatment was observed in VLF and total spectral bands (r>0.59, p<0.04). Conclusions: Our analysis shows that the selective-field RF treatment is safe and efficient for reduction of subcutaneous abdominal fat. While the treatment increases the immediate sympathetic response of the body to deep tissue heating, no sustained change in autonomic function could be recorded at 1 month follow-up. The observed correlation between initial VLF spectral power and waist circumference reduction at follow-up, as well as the association of initial adiponectin values and immediate autonomic response to the treatment might be instrumental for decisions on body contouring strategies.
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Affiliation(s)
- Jiri Pumprla
- International Research Group Functional Rehabilitation & Group Education, Vienna, 1090, Austria ; Vila Krasy Aesthetic Centre, Internal Medicine Outpatient Clinic, Olomouc, 779 00, Czech Republic ; Department of Internal Medicine I and Department of Sports Medicine and Cardiovascular Rehabilitation, University Palacky Medical School, Olomouc, 771 47, Czech Republic
| | - Kinga Howorka
- International Research Group Functional Rehabilitation & Group Education, Vienna, 1090, Austria ; Center of Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, 1090, Austria ; Internal Medicine/Diabetology Clinic, Prevention and Aesthetics Centre, Vienna, 1170, Austria
| | - Zuzana Kolackova
- Vila Krasy Aesthetic Centre, Internal Medicine Outpatient Clinic, Olomouc, 779 00, Czech Republic
| | - Eliska Sovova
- Department of Internal Medicine I and Department of Sports Medicine and Cardiovascular Rehabilitation, University Palacky Medical School, Olomouc, 771 47, Czech Republic
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Abstract
Epidemiological studies show that both the incidence of inflammatory bowel disease (IBD) and the proportion of people with obesity and/or obesity-associated metabolic syndrome increased markedly in developed countries during the past half century. Obesity is also associated with the development of more active IBD and requirement for hospitalization and with a decrease in the time span between diagnosis and surgery. Patients with IBD, especially Crohn's disease, present fat-wrapping or "creeping fat," which corresponds to ectopic adipose tissue extending from the mesenteric attachment and covering the majority of the small and large intestinal surface. Mesenteric adipose tissue in patients with IBD presents several morphological and functional alterations, e.g., it is more infiltrated with immune cells such as macrophages and T cells. All these lines of evidence clearly show an association between obesity, adipose tissue, and functional bowel disorders. In this review, we will show that the mesenteric adipose tissue and creeping fat are not innocent by standers but actively contribute to the intestinal and systemic inflammatory responses in patients with IBD. More specifically, we will review evidence showing that adipose tissue in IBD is associated with major alterations in the secretion of cytokines and adipokines involved in inflammatory process, in adipose tissue mesenchymal stem cells and adipogenesis, and in the interaction between adipose tissue and other intestinal components (immune, lymphatic, neuroendocrine, and intestinal epithelial systems). Collectively, these studies underline the importance of adipose tissue for the identification of novel therapeutic approaches for IBD.
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McDiarmid J, Ruiz JB, Lee D, Lippert S, Hartisch C, Havlickova B. Results from a pooled analysis of two European, randomized, placebo-controlled, phase 3 studies of ATX-101 for the pharmacologic reduction of excess submental fat. Aesthetic Plast Surg 2014; 38:849-60. [PMID: 24984785 PMCID: PMC4175004 DOI: 10.1007/s00266-014-0364-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 05/27/2014] [Indexed: 11/13/2022]
Abstract
BACKGROUND The injectable adipocytolytic drug ATX-101 is the first nonsurgical treatment for the reduction of submental fat (SMF) to undergo comprehensive clinical evaluation. This study aimed to confirm the efficacy and safety of ATX-101 for SMF reduction through a post hoc pooled analysis of two large phase 3 studies. METHODS Patients with unwanted SMF were randomized to receive 1 or 2 mg/cm(2) of ATX-101 or a placebo injected into their SMF during a maximum of four treatment sessions spaced approximately 28 days apart, with a 12-week follow-up period. The proportions of patients with reductions in SMF of one point or more on the Clinician-Reported SMF Rating Scale (CR-SMFRS) and the proportions of patients satisfied with the appearance of their face and chin [Subject Self-Rating Scale (SSRS) score ≥4] were reported overall and in subgroups. Other efficacy measures included improvements in the Patient-Reported SMF Rating Scale (PR-SMFRS), calliper measurements of SMF thickness, and assessment of skin laxity [Skin Laxity Rating Scale (SLRS)]. Adverse events and laboratory test results were recorded. RESULTS Significantly greater proportions of the patients had improvements in clinician-reported measures (≥1-point improvement in CR-SMFRS: 58.8 and 63.8 % of the patients who received ATX-101 1 and 2 mg/cm(2), respectively, and 28.6 % of the placebo recipients; p < 0.001 for both ATX-101 doses vs. placebo) and patient-reported measures (≥1-point improvement in PR-SMFRS: 60.0 and 63.1 % of the patients who received ATX-101 1 and 2 mg/cm(2), respectively, vs. 34.3 % of the placebo recipients; p < 0.001 for both), analyzed alone or in combination, with ATX-101 versus placebo. These improvements correlated moderately with patient satisfaction regarding face and chin appearance (SSRS score ≥4: 60.8 and 65.4 % of the patients who received ATX-101 1 and 2 mg/cm(2), respectively, vs. 29.0 % of the placebo recipients; p < 0.001 for both). In this study, ATX-101 was effective irrespective of gender, age, or body mass index. Reduction in SMF with ATX-101 was confirmed by calliper measurements (p < 0.001 for both doses vs. placebo) and generally did not lead to worsening of skin laxity (SLRS improved or was unchanged: 91.3 and 90.5 % of the patients who received ATX-101 1 and 2 mg/cm(2), respectively, and 91.6 % of the placebo recipients). Adverse events were mostly transient, mild to moderate in intensity, and localized to the treatment area. CONCLUSION The findings show ATX-101 to be an effective and well-tolerated pharmacologic treatment for SMF reduction.
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Affiliation(s)
| | | | - Daniel Lee
- KYTHERA Biopharmaceuticals, Inc., Calabasas, CA USA
| | - Susanne Lippert
- Global Clinical Development Dermatology, Bayer HealthCare, Sellerstrasse 31, 13353 Berlin, Germany
| | - Claudia Hartisch
- Global Clinical Development Dermatology, Bayer HealthCare, Sellerstrasse 31, 13353 Berlin, Germany
| | - Blanka Havlickova
- Global Clinical Development Dermatology, Bayer HealthCare, Sellerstrasse 31, 13353 Berlin, Germany
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Young VL. Response to "Injection lipolysis with phosphatidylcholine and deoxycholate". Aesthet Surg J 2013; 33:1076. [PMID: 24081703 DOI: 10.1177/1090820x13500672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- V Leroy Young
- Dr Young is a plastic surgeon in private practice in St Louis, Missouri
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Hasengschwandtner F, Gundermann KJ. Injection lipolysis with phosphatidylcholine and deoxycholate. Aesthet Surg J 2013; 33:1071-2. [PMID: 24081701 DOI: 10.1177/1090820x13500671] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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