Impact of intradetrusor botulinum toxin A injections on serum and urinary concentrations of nerve growth factor and brain‐derived neurotrophic factor in patients with multiple sclerosis and neurogenic detrusor overactivity

Abstract

Aims: To evaluate the practical relevance of changes in serum and urinary neurotrophins levels in patients with multiple sclerosis (MS) and neurogenic lower urinary tract dysfunction (NLUTD) after intradetrusor injections of botulinum toxin A (BoNTA). Methods: The study included 36 patients with MS and NLUTD and 20 controls. The patients with NLUTD received intradetrusor injection of BoNTA (200 U). The nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) levels were measured in serum and urine at baseline and then at 1, 3, and 6 months by enzyme-linked immunosorbent assay. Urinary NGF and BDNF were normalized to creatinine (NGF/Cr, BDNF/Cr). Patients' assessment included urodynamic examination and Neurogenic Bladder Symptom Score (NBSS). Results: After BoNTA injections, no significant changes were observed in the serum NGF and BDNF or the urinary BDNF/Cr. The urinary NGF/Cr was significantly higher in MS patients (1.23 ± 0.34) at baseline compared with controls (0.084 ± 0.02; p = .021). The urinary NGF/Cr decreased to 0.51 ± 0.12 (p = .001) and 0.53 ± 0.32 (p = .005) at 1 and 3 months, increasing to 1.12 ± 0.49 (p = .003) at 6 months. The urinary NGF/Cr level at baseline demonstrated a low diagnostic accuracy in predicting a better response to the BoNTA treatment (area under the curve = 0.661; p = .047) and no correlation with the urodynamic parameters. Conclusions: The urinary NGF/Cr at baseline or its reduction at the first month following treatment does not serve as a predictor for the response to the BoNTA injections or for urodynamic changes.

Effects of botulinum toxin type A in the prevention and treatment of facial hypertrophic scars: A meta‐analysis

“… 47 It also acts by reducing fibroblast and collagen metabolism, lowering the differentiation of transforming growth factors and promoting the secretion of recombinant cells, thereby achieving the goal of scar prevention. 48 …”

“…Additionally, BTX‐A effectively suppresses the proliferation of fibroblasts in hypertrophic scars and the secretion of collagen, accelerating the apoptosis of fibroblasts in hypertrophic scars 47 . It also acts by reducing fibroblast and collagen metabolism, lowering the differentiation of transforming growth factors and promoting the secretion of recombinant cells, thereby achieving the goal of scar prevention 48 …”

Blood levels of brain-derived neurotrophic factor (BDNF) in people with multiple sclerosis (MS): A systematic review and meta-analysis

“…As summarized in Table 1, thirteen studies published from 2003 to 2021 provided original data on BDNF levels in MS patients and HC (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). Ten studies compared BDNF levels in the serum of multiple sclerosis (MS) patients (n = 515) to those in healthy controls (HC) (n = 437) (22, 23, 25-30, 32, 33), while three studies provided additional information on plasma BDNF levels in MS patients (n = 174) and HCs (n = 146) (21,24,31).…”

“…Using the ' nd.outliers' command in R software, eight studies (21,(26)(27)(28)(29)(30)(31)33) were identi ed as outliers; accordingly, we repeated the meta-analysis of ve remained studies and obtained the following results: SMD − 0.6619 (95% CI [-0.9391; -0.3848], p-value < 0.0001, Fig. 2B), which indicates statistically signi cant lower BDNF levels in MS participants compared to controls.…”