deoxycholic acid
Sources réglementaires consultées
Indications approuvées
- Convexité ou plénitude modérée à sévère liée à la graisse sous-mentonnière chez l’adulte lorsqu’elle a un retentissement psychologique important.
Contre-indications
Absolues
- Hypersensibilité à l’acide désoxycholique ou aux excipients.
- Infection aux sites d’injection prévus.
Mises en garde cliniques
- Mise en garde majeure · Une technique incorrecte peut léser le nerf marginal mandibulaire, les vaisseaux, les glandes, les ganglions ou le muscle et provoquer une asymétrie faciale, une ulcération, une nécrose ou une cicatrice. Administrer uniquement dans la graisse sous-cutanée préplatysmale sous-mentonnière. — CIMA/AEMPS, ficha técnica 81627
- Mise en garde majeure · Il peut provoquer une dysphagie, un hématome, une infection ou une alopécie au site d’injection. Utiliser avec prudence en cas de dysphagie préexistante, trouble de la coagulation ou traitement anticoagulant ou antiagrégant. — CIMA/AEMPS, ficha técnica 81627
Effets indésirables
Communs (≥1%)
Douleur, œdème ou gonflement au site d’injection · Anesthésie, paresthésie ou induration au site d’injection · Nodule, hématome, érythème ou prurit au site d’injection · Céphalée · Dysphagie ou nausées
Grossesse et allaitement
Il n’existe pas d’études adéquates chez la femme enceinte. Aucun effet fœtal n’a été observé chez l’animal jusqu’à cinq fois la dose humaine maximale. Les données cliniques sur l’allaitement sont insuffisantes.
Bibliographie récente (PubMed)
Cardiometabolic disease (CMD), characterized with metabolic disorder triggered cardiovascular events, is a leading cause of death and disability. Metabolic disorders trigger chronic low-grade inflammation, and actually, a new concept of metaflammation has been proposed to define the state of metabolism connected with immunological adaptations. Amongst the continuously increased list of systemic metabolites in regulation of immune system, bile acids (BAs) represent a distinct class of metabolites implicated in the whole process of CMD development because of its multifaceted roles in shaping systemic immunometabolism. BAs can directly modulate the immune system by either boosting or inhibiting inflammatory responses via diverse mechanisms. Moreover, BAs are key determinants in maintaining the dynamic communication between the host and microbiota. Importantly, BAs via targeting Farnesoid X receptor (FXR) and diverse other nuclear receptors play key roles in regulating metabolic homeostasis of lipids, glucose, and amino acids. Moreover, BAs axis per se is susceptible to inflammatory and metabolic intervention, and thereby BAs axis may constitute a reciprocal regulatory loop in metaflammation. We thus propose that BAs axis represents a core coordinator in integrating systemic immunometabolism implicated in the process of CMD. We provide an updated summary and an intensive discussion about how BAs shape both the innate and adaptive immune system, and how BAs axis function as a core coordinator in integrating metabolic disorder to chronic inflammation in conditions of CMD.
Chronic liver disease (CLD) is one of the leading causes of disability-adjusted life years in many countries. A recent understanding of nuclear bile acid receptor pathways has increased focus on the impact of crosstalk between the gut, bile acids, and liver on liver pathology. While conventionally used in cholestatic disorders and to dissolve gallstones, the discovery of bile acids' influence on the gut microbiome and human metabolism offers a unique potential for their utility in early and advanced liver diseases because of diverse etiologies. Based on these findings, preclinical studies using bile acid-based molecules have shown encouraging results at addressing liver inflammation and fibrosis. Emerging data also suggest that bile acid profiles change distinctively across various causes of liver disease. We summarize the current knowledge and evidence related to bile acids in health and disease and discuss culminated and ongoing therapeutic trials of bile acid derivatives in CLD. In the near future, further evidence in this area might help clinicians better detect and manage liver diseases.
Bile acids (BAs) as cholesterol-derived molecules play an essential role in some physiological processes such as nutrient absorption, glucose homeostasis and regulation of energy expenditure. They are synthesized in the liver as primary BAs such as cholic acid (CA), chenodeoxycholic acid (CDCA) and conjugated forms. A variety of secondary BAs such as deoxycholic acid (DCA) and lithocholic acid (LCA) and their derivatives is synthesized in the intestine through the involvement of various microorganisms. In addition to essential physiological functions, BAs and their metabolites are also involved in the differentiation and functions of innate and adaptive immune cells such as macrophages (Macs), dendritic cells (DCs), myeloid derived suppressive cells (MDSCs), regulatory T cells (Treg), Breg cells, T helper (Th)17 cells, CD4 Th1 and Th2 cells, CD8 cells, B cells and NKT cells. Dysregulation of the BAs and their metabolites also affects development of some diseases such as inflammatory bowel diseases. We here summarize recent advances in how BAs and their metabolites maintain gut and systemic homeostasis, including the metabolism of the BAs and their derivatives, the role of BAs and their metabolites in the differentiation and function of immune cells, and the effects of BAs and their metabolites on immune-associated disorders.