Klein Silvan M, Schreml Stephan, Nerlich Michael, Prantl Lukas
Regensburg, Germany From the Department of Traumatology, Division of Plastic Surgery, and the Department of Dermatology, University Hospital of Regensburg.
Plast Reconstr Surg. 2009 Aug;124(2):419-427. doi: 10.1097/PRS.0b013e3181adce61.
The demand for lipolytic injection therapies for aesthetic indications increases continuously. The substance most frequently discussed in this context is phosphatidylcholine solubilized in sodium deoxycholate, a composition known in Europe as Lipostabil (Artesan Pharma, Lüchow, Germany). The evidence for its lipolytic effect is based mainly on clinical studies that suggest a decrease in adipose tissue volume after subcutaneous injections. However, neither the actual effect nor the effective supplemental effect of Lipostabil has been clearly identified so far. The purpose of this study was to investigate the effects caused by lipolytic formulations on adipocytes using an in vitro model.
3T3-L1 adipocytes in 12-well plates were exposed to varying doses of isolated phosphatidylcholine, deoxycholate, and the combination of both (Lipostabil). Subsequently, changes in the cell membrane integrity were evaluated microscopically, and assays measuring the amount of glycerol as a biochemical lipolysis substrate (lipolysis assay) together with dimethyl thiazolyl diphenyl tetrazolium assays were performed to quantify the lipolytic effect and the cell viability.
Deoxycholate reduced cell viability significantly (p < 0.05), even at low concentrations. Neither phosphatidylcholine nor deoxycholate led to a significant (p < 0.05) induction of a lipolytic pathway. Lipostabil, the combination of deoxycholate and phosphatidylcholine, led to a significant (p < 0.05) decrease in cell viability at low doses and to a highly significant (p < 0.01) reduction at high doses. The loss in cell viability is attributable to changes in the cell membrane integrity.
These results suggest that no enzymatic lipolytic pathway is induced. The decrease in volume after Lipostabil injections is likely attributable to the detergent effect of deoxycholate.
用于美容适应症的脂肪分解注射疗法的需求持续增加。在此背景下最常讨论的物质是溶解于脱氧胆酸钠中的磷脂酰胆碱，这种组合物在欧洲被称为Lipostabil（德国吕乔的阿泰桑制药公司）。其脂肪分解作用的证据主要基于临床研究，这些研究表明皮下注射后脂肪组织体积会减小。然而，到目前为止，Lipostabil的实际效果和有效补充效果均未明确确定。本研究的目的是使用体外模型研究脂肪分解制剂对脂肪细胞的影响。
将12孔板中的3T3-L1脂肪细胞暴露于不同剂量的分离磷脂酰胆碱、脱氧胆酸盐以及两者的组合（Lipostabil）。随后，通过显微镜评估细胞膜完整性的变化，并进行测定甘油量作为生化脂肪分解底物的试验（脂肪分解试验）以及二甲基噻唑基二苯基四氮唑试验，以量化脂肪分解作用和细胞活力。
即使在低浓度下，脱氧胆酸盐也显著降低细胞活力（p < 0.05）。磷脂酰胆碱和脱氧胆酸盐均未导致脂肪分解途径的显著（p < 0.05）诱导。脱氧胆酸盐和磷脂酰胆碱的组合Lipostabil在低剂量时导致细胞活力显著（p < 0.05）下降，在高剂量时导致高度显著（p < 0.01）降低。细胞活力的丧失归因于细胞膜完整性的变化。
这些结果表明未诱导酶促脂肪分解途径。Lipostabil注射后体积的减小可能归因于脱氧胆酸盐的去污剂作用。
