Phosphatidylcholine in the treatment of localized fat

Journal of Drugs in Dermatology, Oct, 2003 by Doris Hexsel, Marcio Serra, Rosemari Mazzuco, Taciana Dal'Forno, Debora Zechmeister

All tests performed before and after treatments showed no significant alterations in either the hepatic function or the lipid profile. Wider studies are needed to ensure drug safety when injected subcutaneously. In the authors' experience, phosphatidylcholine has not been shown to be hepatotoxic and did not cause alterations in the lipid metabolism when used in the reduction of the subcutaneous thickness and in the used doses. Some patients may present alterations in the laboratory examinations, such as those suffering from diabetes, dyslipidosis, morbid obesity, and endocrine diseases, and those who already have some degree of hepatic overload. For these patients, caution and extensive laboratory control are necessary in choosing to treat with phosphatidylcholine injections.

The alterations in the lipids found in some HIV/AIDS patients, such as increases or decreases in total triglycerides and both HDL and LDL cholesterol, may not be related to the treatment with phosphatidylcholine but rather to dyslipidosis, common to the FRS caused by some anti-retrovirals; for the same reason the CD4 and CD8 cell counting were compatible with the moment of treatment in the HIVAIDS patients.

The greatest obstacle to phosphatidylcholine use is the limited knowledge of its pharmacology in the subcutaneous tissue. Another is the potential for overuse, which may alter the medical status of the substance, encouraging widespread skepticism in the medical community and leading to the prohibition of its use, making research and clinical experiment impossible.

While not drawing a direct comparison, the authors would like to point out that similar cases have occurred with other drugs, such as botulinum toxin, which has been used for cosmetic purposes since 1990. However, the permitted off-label use allowed physicians to study the drug and its benefits in wrinkle treatment for over 10 years before the FDA finally approved its cosmetic use in 2002.

Conclusions

Phosphatidylcholine was shown to be efficacious and safe in the indications described, and can substitute for liposuction in some specific indications. Its use by medical and experienced professionals is crucial for safety and good results.

As with any other medication, it needs wide investigation protocols for new indications and long-term studies, so that the recommended dose and safe application technique can be standardized.

Liposuction and excision surgery have been the standard alternatives for treating humps and lipomas in HIV/AIDS patients. It should be considered that these lesions recur frequently and consequent ly the procedures need to be repeated. Thus, phosphatidylcholine injections may represent a safer alternative treatment for lesions caused by fat accumulation in these individuals. It is a low cost, efficacious, and easy application method as compared to surgical alternatives.

References

(1.) Strayer L. Estrutura e Dinamica das Membranas. Bioquimica, Third Edition. Guanabara Koogan, Rio de Janeiro,1996; 246-247.