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Botulinum Toxin: Application, Safety, and Limitations

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Botulinum Neurotoxins

Part of the book series: Current Topics in Microbiology and Immunology ((CT MICROBIOLOGY,volume 364))

Abstract

Botulinum neurotoxin type A (BoNT/A), despite its high toxicity, is approved for therapy of many neurological (e.g., dystonia, spasticity) and non-neurological (e.g., achalasia, hyperhidrosis) disorders. Its mode of action is well understood. This has led to more and more indications (e.g., pain, gastrointestinal and urologic disorders), in which the toxin can reduce disturbing symptoms. In general the application is safe (pharmacological index 20–100, depending on indication). Few unwanted reactions may occur. In worst cases BoNT treated patients may develop neutralizing antibodies. These patients are excluded from further treatment. A more recently approved second serotype (BoNT/B) could be effective in those secondary non-responders, however, due to less potency in humans higher doses have to be applied leading to an only transient successful treatment. Other serotypes as BoNT/A and B, e.g., BoNT/C should be approved as medicines.

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Abbreviations

Abo:

AbobotulinumtoxinA

BoNT:

Botulinum neurotoxin

Inco:

IncobotulinumtoxinA

LERS:

Lambert-Eaton-Rooke-Syndrome

MG:

Myasthenia gravis

NNT:

Number needed to treat

Ona:

OnabotulinumtoxinA

Rima:

RimabotulinumtoxinB

SNAP-25:

Synaptosomal associated protein

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Authors and Affiliations

  1. Institute of Toxicology, Medical School of Hannover, 30625, Hannover, Germany

    Hans Bigalke

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  1. Hans Bigalke
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Correspondence to Hans Bigalke .

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Editors and Affiliations

  1. , Institut für Toxikologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, Hannover, 30625, Germany

    Andreas Rummel

  2. , Institut für Physiologische Chemie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, Hannover, 30625, Germany

    Thomas Binz

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Bigalke, H. (2012). Botulinum Toxin: Application, Safety, and Limitations. In: Rummel, A., Binz, T. (eds) Botulinum Neurotoxins. Current Topics in Microbiology and Immunology, vol 364. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-33570-9_14

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