Beckman Laser Institute & Medical Clinic, University of California-Irvine, Irvine, California, USA.
Department of Biomedical Engineering, University of California-Irvine, Irvine, California, USA.
Lasers Surg Med. 2022 Jan;54(1):157-169. doi: 10.1002/lsm.23466. Epub 2021 Aug 19.
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.
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.
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.
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.
随着基于办公室的设备和疗法的发展，微创脂肪雕刻技术越来越普及。电化学脂肪分解（ECLL）是一种基于针的技术，它使用直流电（DC）电解组织水，在原位产生酸和碱。反过来，脂肪被皂化，脂肪细胞的细胞膜裂解。水的电解可以通过简单的开环电路（V-ECLL）或通过使用电位计（P-ECLL）来结合反馈控制电路来完成。电位计利用具有负反馈的运算放大器，使用户能够精确地控制特定电极的电压。迄今为止，这两种方法之间的差异尚未得到研究。本研究的目的是评估两种方法在体内猪模型中产生的电流和电荷转移变化以及脂肪分解效果。
记录离体 V-ECLL 和 P-ECLL 处理的猪皮和脂肪的电荷转移测量值，在 -1 V P-ECLL、-2 V P-ECLL、-3 V P-ECLL 和 -5 V V-ECLL 下各处理 5 分钟，以指导体内研究的剂量学参数。在后续的体内研究中，对一只镇静的雌性约克夏猪进行了 V-ECLL 和 P-ECLL 治疗，在一系列剂量学参数范围内，包括 -1.5 V P-ECLL、-2.5 V P-ECLL、-3.5 V P-ECLL 和 5 V V-ECLL ，每种治疗 5 分钟。在治疗前、治疗后 1、2、7、14 和 28 天进行基线和连续活检。使用荧光显微镜和组织学检查组织，以比较两种 ECLL 方法的效果。
V-ECLL 和 P-ECLL 治疗均诱导体内脂肪坏死，可见脂肪细胞膜裂解、脂肪细胞去核和急性炎症反应，在 28 天的纵向研究中。然而，与 5 V V-ECLL 相比，-1.5 V P-ECLL 产生的空间坏死效应较小。此外，5 V V-ECLL 产生的坏死效应与 -2.5 V 和 -3.5 V P-ECLL 相似。
上述剂量学参数下的 V-ECLL 和 P-ECLL 均通过脂肪细胞膜裂解和去核导致脂肪坏死。与 5 V V-ECLL 治疗相比，-2.5 V 和 -3.5 V P-ECLL 治疗产生的空间脂肪坏死效应相似。定量地，剂量学参数之间的总电荷转移表明 -2.5 V P-ECLL 和 5 V V-ECLL 产生相似的电化学反应。这些发现表明，基于低电压闭环电位计的系统能够诱导脂肪坏死，其程度与高电压直流系统相似。
