Übersichtsarbeit


Die Bedeutung von Polyenylphosphatidylcholin zur Verringerung von Fettpolstern in Desoxycholat-haltigen Injektionslösungen*

The role of polyenylphosphatidylcholine in reducing fat deposits in deoxycholate-containing injection solutions

Keywords | Summary | Correspondence | Literature

Keywords

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Schlüsselworte

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Summary

A growing number of patients are asking about injection lipolysis for aesthetic treatment instead of surgery. Deoxycholic acid (DC) with or without phosphatidylcholine (PC) is used to reduce the size and number of local fat accumulations and lipomas. DC induces inflammation and reduces adipocytes by necrosis; its benefit without PC is controversially discussed. First, the principle of fat breakdown by injection adipocytolysis (IL) is described and the peculiarity of polyenylphosphatidylcholine (PPC) from soybeans is characterized. In the following, the discourse summarizes the specific significance of PPC for the transport of fat from peripheral tissue via the bloodstream to the liver, for the activity of fat-degrading enzymes, and for mitochondrial performance in fat degradation. The interaction between DC-induced severe inflammation due to rapid adipocytic necrosis and mitochondrial dysfunction is discussed as a building block of reduced ß-fatty acid oxidation, while PPC improves the structural composition and function of mitochondria. In addition to a regulatory influence of PPC on DC-induced increased inflammation and the associated patient symptoms, PPC-induced apoptosis is assumed to be an additional mechanism of action in IL. Finally, PPC reduces the side effect profile of DC and its potential toxicity.

Zusammenfassung

Eine wachsende Zahl von Patienten fragt nach der Injektionslipolyse zur ästhetischen Behandlung anstelle chirurgischer Eingriffe. Die Desoxycholsäure (DC) mit oder ohne Phosphatidylcholin (PC) wird eingesetzt, um die Größe und Zahl lokaler Fettansammlungen und Lipome zu reduzieren. DC induziert Entzündungen und reduziert Adipozyten mittels Nekrose; ihr Nutzen ohne PC wird kontrovers diskutiert. Zuerst wird das Prinzip des Fettabbaus durch Injektionsadipozytolyse (IL) beschrieben und die Besonderheit des Polyenylphosphatidylcholins (PPC) aus der Sojabohne charakterisiert. Im Folgenden fasst der Diskurs die spezifische Bedeutung von PPC für den Transport von Fett aus dem peripheren Gewebe über die Blutbahn zur Leber, für die Aktivität Fett abbauender Enzyme und die mitochondriale Leistung beim Fettabbau zusammen. Die Wechselwirkung zwischen DC-induzierter starker Entzündung durch schnell ablaufende adipozytäre Nekrose und mitochondriale Dysfunktion wird als ein Baustein verringerter ß-Fettsäurenoxidation diskutiert, während PPC die strukturelle Zusammensetzung und Funktion der Mitochondrien verbessert. Über einen regulierenden Einfluss von PPC auf die durch DC induzierte verstärkte Entzündung und die damit verbundene Patientensymptomatik hinaus wird eine durch PPC ausgelöste Apoptose als zusätzlicher Wirkmechanismus bei der IL angenommen. Schließlich verringert PPC das Nebenwirkungsprofil von DC sowie seine potentielle Toxizität.

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Korrespondenz-Adresse

Adj. Prof. Dr. Dr. Karl-Josef Gundermann
GunderMannConsulting
Kornelimünsterstr.28
D-50933 Köln
gmc-gundermann@netcologne.de

Conflict of Interests

Keine finanziellen Interessen

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