Term Paper on "Injections of Phosphatidylcholine Solubilized With Deoxycholate"

Term Paper 15 pages (4199 words) Sources: 15

[EXCERPT] . . . .

Injections of Phosphatidylcholine Solubilized With Deoxycholate Have Been Shown to Reduce Localized Accumulations of Subcutaneous Fat

Cutaneous injections of phosphatidylcholine solubilized with deoxycholate are one of the more popular treatments in Europe for the reduction of unwanted subcutaneous fat deposits. The popularity of these treatments has sparked the interest of U.S. pharmaceutical companies. However, at the present time, this compound is yet to pass the strict criterion of the FDA for acceptance as a treatment for subcutaneous fat. A literature review found that there are many studies that promote the effectiveness of phosphatidylcholine Solubilized with deoxycholate as a treatment option. However, not all studies agree that this substance as to which of these two compounds is responsible for the observe effects. Although a majority of research studies promote the use of phosphatidylcholine Solubilized with deoxycholate as an effective and safe treatment for subcutaneous fat, there are others that question its use due to the inability to determine the active ingredient.

Introduction

The search for a shapely body has led medical science to search for treatments that will provide the fastest results, with the least effort. Mesotherapy was developed in Europe and has become a popular method for containing unwanted fat deposits in the body. The treatment is beginning to spark interest in the United States as well. Mesotherapy to remove fat is cost effective as compared to liposuction and does not require the healing time. Mesotherapy costs between $1,000 to $6,000, as compared to liposuction that costs between $3,00 -$12,000 (Strauss, no date).

The treatment uses vasodialators, nonsteroidal anti-inflammatory drugs, and a combination of enzymes and hormones to reduce fat. One of the most common chemicals used in the treatment lecithin (phosphatidylcholine isoproterenol) (Kopera, Binder, and Topiac, 2006). However, recently it has been discovered that when lecithin is sulubilized with deoxycholate, the active ingredient was the deoxycholate, rather than the lecithin (Bechara, Sand, and Altmeyer, 2006).

In order to gain popularity in the U.S., the treatment protocol will have to undergo extensive testing by the FDA to determine its safety and efficacy for the intended condition. At this point, it appears that small amounts of deoxycholate are a safe and effective treatment for limomas (fat deposits). The use of phosphatidylcholine solubilized with deoxycholate cannot be confused with the practice of mesotherapy itself. Mesotherapy uses a combination of drugs, rather than a single compound. However, phosphatidylcholine solubilized with deoxycholate is one of the compounds used and is the one of greatest interest to the U.S. medical community, but more studies are needed before it will be released as a preferred treatment for fat deposit reduction in the U.S. (Moraru, 2006; Rotunda and Kolodney, 2006).

Literature Review

Mesotherapy using phosphatidylcholine solubolized with deoxycholate for the removal of subcutaneous fat deposits is an accepted practice. Yet, in the United States this form of treatment is only beginning to become recognized as an alternative to traditional methods. The acceptance of new treatments is treated with scrutiny in the U.S. Although treatment with phosphatidylcholine solubolized with deoxycholate is an accepted alternative in Europe, it might still be many years until it gains acceptance in the United States. Concerns over safety top the list of items of concern over this new therapy.

The use of phosphatidylcholine solubolized with deoxycholate for the removal of fat deposits was a side effect of the use of this compound for other conditions. The compound was first used to treat musculoskeletal pain and vascular disease (Moraru, 2006). However, it was soon discovered that the compound could remove small collections of adipose tissue, largely as a result of the detergent action of the compound. Deoxycholate acts as a detergent to dissolve the fat tissue (Moraru, 2006). It is believed that this is the major action responsible for the clinical affects. This study will concentrate on the use of phosphatidylcholine solubolized with deoxycholate on the dissolution of fat in the eyelids, as this represents the most popular use of this treatment to date, as well as the safety and efficacy issues to date.

Lipomas are benign deposits of mature fat cells that cause unsightly bulges in areas of the body such as the eyes, buttocks, and other areas of the body. Phosphatidylcholine solubilized with deoxycholate, a bile salt, have been shown to reduce unwanted accumulations of fat with considerable reliable results (Rotunda, Ablon, and Kolodney, 2006). There is sufficient clinical evidence to support the use of phosphatidylcholine solubolized with deoxycholate for the removal of unwanted fat cells (Hexsel, 2003). However, there is concern over the mechanism that phosphatidylcholine uses to accomplish this.

Thus far, in vitro studies have found that phospholipids increase actions that may help prevent fibrosis and cirrhosis of the liver. Phosphatidylcholine also demonstrates other protective effect in non-alcoholic liver disorders. This includes protection from other toxic substances (Atoba, Ayoola, and Ogunseyinde, 1985). Phosphatidylchoine has also demonstrated promise in These benefits are in addition to the affects observed on dissolving fat.

In the liver, phosphatidylcholine partitions into Sphingomyelin (SM) and Phosphatidylcholine (PC) layers (Ollila and Slotte, 2001). Phosphatidylcholine that contains a high percentage of polyunsaturated fatty acids has a tendency to dissolve cellular membranes. (Hanin and Ansell, 1987). This causes breakdown of cellular membranes and inhibits the repair mechanisms. This mechanism is associated with a number of disorders, including liver disease, neurological diseases, and various cancers (Hanin and Ansell, 1987). This is the primary concern over the use of phosphatidylcholine solubolized with deoxycholate for use in cosmetic procedures.

The use of phosphatidylcholine solubolized with deoxycholate has two sides,. On one side, it has the ability to treat many disease conditions, in addition to the fat reducing characteristics. However, it also demonstrates the potential to cause serious conditions by reducing cell membrane signal transduction (Hanin and Ansell, 1987). The jury is still out as to whether the benefits outweigh the risks of usage of this compound. This research concentrates on the use of phosphatidylcholine solubolized with deoxycholate for cosmetic use. This research will support the thesis that not enough is known about the negative effects of phosphatidylcholine solubolized with deoxycholate to warrant continued usage in cosmetic fat deposit removal.

Methods

This research employed a variety of research techniques. It employed a traditional library search of relevant technical journals. It also involved a search of the PUBMED database online in order to gain the most relevant clinical studies regarding phosphatidylcholine solubolized with deoxycholate. Several newspapers were consulted to gain a perspective on public opinion and acceptance of the procedure. This research technique yielded a wealth of information that presents an overall picture of the public and clinical aspects of the procedure.

This research method yielded a plethora of research studies from highly credible and specialized sources. A majority of the studies focused on the effects of phosphatidylcholine solubolized with deoxycholate on fat reduction. The newspaper articles utilized cited information similar to that found in the research articles. This adds a considerable amount of credibility to the newspaper articles. As this topic is associated with clinical research, many of the journal articles found were conduced in accordance with strict standards. The number and quality of research articles found Is considered to be sufficient to draw conclusion in this literature review. Only recent journal articles will be used in the combined data analysis of the research.

The analytical methods used for the combined analysis of the study will rely on the ability to identify studies that have similar research parameters. For instance, they studies selected have a similar sample population and will be determined to have eliminated or accounted for confounding variables. It is important that only studies with similar parameters will be used in the final analysis of the data. The study will use Excel formulas for computation of basic statistical parameters.

Combined data will be subject to any biases that are identified in the individual studies contained in this research. The researcher in this case, has no control over sample selection methods used in the individual research studies. However, a critical analysis will be necessary in order to identify biases and other factors that will affect the overall combined results of the study.

Research Synthesis

One of the key difficulties in synthesizing research from different studies in this area is that no human studies have been performed to date in the United States. Several animal studies involving rats and rabbits were found, but research into the safety and efficacy of the procedure has not been performed to date. The primary researcher in this area of research is Dr. Hexsel and her many research associates. However, this research only involved a sample group of 18 patients and was not conducted according to FDA protocol (Hexsel, 2003 and Hexsel, et a., 2003).

The introduction of a variable involving the administration of a "preventative" treatment for potential adverse effects significantly impacted the ability of the study in such as way that it must be considered inconclusive. The conclusions drawn by this study do not even meet the minimal requirements for isolation of a dependent variable and… READ MORE

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