Peripheral Nerve Injury After Deoxycholic Acid (ATX-101) Injection in an Experimental Rat Model
Background: Deoxycholic acid (ATX-101) is a drug administered by subcutaneous injection for local fat reduction. However, ATX-101 treatment has been reported to cause marginal mandibular nerve injury with noticeable functional deficits when targeting submental fat. As a cytolytic agent with some selectivity for adipocytes, ATX-101 may damage the lipid-rich myelin surrounding peripheral nerves.
Objectives: The aim of this study was to characterize nerve injury caused by ATX-101 injection in an experimental rat sciatic nerve model.
Methods: Injuries to the sciatic nerve caused by intrafascicular and extrafascicular injections of ATX-101, and by lidocaine (positive control) and saline (negative control) injections, were compared. Nerves were harvested at a 2-week endpoint for histomorphometric analysis.
Results: The cross-sectional area of nerve injury was significantly increased by ATX-101 injection. The damaged areas amounted to 75% ± 15% with intrafascicular ATX-101 (P < .001), 41% ± 21% with extrafascicular ATX-101 (P < .01), and 38% ± 20% with positive-control lidocaine (P < .01), compared with 7% ± 13% with negative-control saline. Demyelinating injury was a significant mechanism of injury in the affected nerve fibers compared with uninjured nerve fibers (P < .04), but there was no difference in the axon-to-myelin area ratio between the lidocaine and ATX-101 cohorts. After 2 weeks, Wallerian degeneration was evident with only small regenerating nerve fibers present in the ATX-101-injured groups compared with saline (average fiber width, 2.54 ± 0.26 μm vs 5.03 ± 0.44 μm, P < .001).
Conclusions: ATX-101 can cause extensive nerve injury in rats. The mechanism of action for ATX-101 does not preferentially target myelin more than other common neurotoxic agents. Appropriate knowledge of surgical anatomy and injection technique is necessary for any practitioners administering ATX-101 injections.
Related Projects
- Published on Jul 11, 2023Aesthetic surgery fellowship applications were consolidated under the San Francisco Match in 2018. The impact of these changes on aesthetic program and applicant numbers had not yet been investigated.
- Published on Apr 12, 2023Breast Implant Illness (BII) describes a variety of symptoms reported by patients with breast implants. Biospecimens data revealed minimal statistical differences between BII and non-BII cohorts. Baseline analysis of PROMIS data demonstrated significant...
- Published on Aug 18, 2022There has been an increasing need to acquire rigorous scientific data to answer the concerns of physicians, patients, and the FDA regarding the self-reported illness identified as breast implant illness (BII). There are no diagnostic tests or specific...