Botulinum Toxin: Pharmacology and Therapeutic Roles in Pain States

Patil, Shilpadevi; Willett, Olga; Thompkins, Terin; Hermann, Róbert; Ramanathan, Sathish; Cornett, Elyse M.; Fox, Charles J.; Kaye, Alan D.

doi:10.1007/s11916-016-0545-0

Cited by 58 publications

(39 citation statements)

References 32 publications

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“…Meanwhile, it had the similar function mode to the other three kinds of toxins whose effect duration was ~3 months. Consistent with previous studies, our present study also confirmed the strongest effect of toxins 1 week postinjection and the gradual recovery of muscle function to base level after injection for 12 weeks 19,31. This was in line with clinical data that effective duration of BoNT/A would range from ~3 to 6 months.…”

Section: Discussionsupporting

confidence: 93%

Comparison of neurotoxic potency between a novel chinbotulinumtoxinA with onabotulinumtoxinA, incobotulinumtoxinA and lanbotulinumtoxinA in rats

Feng¹,

Liu²,

Pan³

et al. 2017

DDDT

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Four botulinumtoxin type A (BoNT/A) products, onabotulinumtoxinA (A/Ona), incobotulinumtoxinA (A/Inco), lanbotulinumtoxinA (A/Lan) and chinbotulinumtoxinA (A/Chin), are applied in the present study, among which A/Chin is newly produced. We aimed to compare the neurotoxic potency of these toxins by the gauge of muscle strength reduction. Furthermore, potential molecular and cellular mechanisms were also explored. According to our data, muscle strengths in the four toxin groups were all significantly decreased after injection for 1 week. A/Chin achieved the most obvious reduction in muscle strength as compared to the other three products at the dose of 0.5 U. However, there was no difference between the four toxins when increased to 2 U. As the toxins wore off, muscle strength recovered to basal level 12 weeks postinjection. We further measured the expression levels of key factors involved in neuromuscular junction stabilization and muscle genesis. Our results showed that nicotinic acetylcholine receptor, myogenic regulatory factors and muscle-specific receptor tyrosine kinase were all significantly upregulated upon BoNT/A treatment. Consistent with the result of muscle strength, A/Chin had the most obvious induction of gene expression. Moreover, we also found local inflammation response following BoNT/A injection. Owing to lack of complexing proteins, both A/Inco and A/Chin stimulated relatively lighter inflammation compared to that of A/Ona and A/Lan groups. In conclusion, our study provided evidence for the efficacy of the novel A/Chin and its similar functional mode to that of A/Ona, A/Inco and A/Lan. In addition, A/Chin has superiority in inducing muscle paralysis and inflammation stimulation, which may indicate faster onset and longer duration of this novel A/Chin.

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Section: Discussionsupporting

confidence: 93%

Comparison of neurotoxic potency between a novel chinbotulinumtoxinA with onabotulinumtoxinA, incobotulinumtoxinA and lanbotulinumtoxinA in rats

Feng¹,

Liu²,

Pan³

et al. 2017

DDDT

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“…Even if more than 10,000 lethal doses of unmodified toxin tested, it was evoked a striking response-protection against subsequent challenge against C. botulinum infection (Mohanty et al, 2001). Moreover, botulinum toxin derivatives (Botox®, Botox Cosmetic®, Dysport® and Xeomin®) are approved as commercial therapeutic and cosmetic preparations by the United States Food and Drug Administration (Guaita and Hogl, 2016;Patil et al, 2016;Sundaram et al, 2016).…”

Section: Resultsmentioning

confidence: 99%

Structural constraints-based evaluation of immunogenic avirulent toxins from Clostridium botulinum C2 and C3 toxins as subunit vaccines

Prisilla

Prathiviraj

Sasikala

et al. 2016

Infection, Genetics and Evolution

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“…In spasticity, Botulinum Toxin is used to reduce muscle hyperactivity by blockade of the pre-synaptic terminal to prevent acetylcholine release [6]. In pain management, Botulinum Toxin has been shown to inhibit nociceptive neurotransmitters such as substance P, glutamate and Calcitonin Gene-Related Peptide (CRGP) [7]. However evidence has shown that following treatment with Botulinum Toxin for neuropathic pain, there were no changes in total concentrations of substance P or CGRP in biopsy samples.…”

Section: Discussionmentioning

confidence: 99%

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2017

JNSK

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Purpose: Spasticity and pain are common complications of stroke. Pain following stroke is multi factorial and can be due to musculoskeletal problems, painful spasticity or central post stroke pain. Botulinum Toxin A is the first line pharmacotherapy in spasticity management and increasing evidence has shown benefits in neuropathic pain.Results: This case report demonstrates the benefit of Botulinum Toxin A in the management of central post-stroke pain with elbow flexor spasticity. The clinical characteristics of the pain were neuropathic and the severity was greater than expected given the degree of spasticity. The pain responded to Botulinum Toxin treatment within a few days, independently of the improvement in spasticity and the effect was continued over six cycles of treatment. Conclusion:Management of central post stroke pain is challenging due systemic side effects of oral medications. Botulinum Toxin A has increasingly being shown to benefits in neuropathic pain either through blockade of nociceptive substances or acting on central transmission of pain. Although the treatment in our case was given for spasticity management, the patient had unexpected and significant improvement in pain prior to improvement in range of movement. Given the increasing evidence in use of Botulinum Toxin A in neuropathic pain, we feel this may be a possible future treatment option for central post-stroke pain

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Botulinum Toxin: Pharmacology and Therapeutic Roles in Pain States

Cited by 58 publications

References 32 publications

Comparison of neurotoxic potency between a novel chinbotulinumtoxinA with onabotulinumtoxinA, incobotulinumtoxinA and lanbotulinumtoxinA in rats

Comparison of neurotoxic potency between a novel chinbotulinumtoxinA with onabotulinumtoxinA, incobotulinumtoxinA and lanbotulinumtoxinA in rats

Structural constraints-based evaluation of immunogenic avirulent toxins from Clostridium botulinum C2 and C3 toxins as subunit vaccines

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