title: Clinical uses of botulinum neurotoxins: current indications, limitations and future developments.
abstract: Botulinum neurotoxins (BoNTs) cause flaccid paralysis by interfering with vesicle fusion and neurotransmitter release in the neuronal cells. BoNTs are the most widely used therapeutic proteins. BoNT/A was approved by the U.S. FDA to treat strabismus, blepharospam, and hemificial spasm as early as 1989 and then for treatment of cervical dystonia, glabellar facial lines, axillary hyperhidrosis, chronic migraine and for cosmetic use. Due to its high efficacy, longevity of action and satisfactory safety profile, it has been used empirically in a variety of ophthalmological, gastrointestinal, urological, orthopedic, dermatological, secretory, and painful disorders. Currently available BoNT therapies are limited to neuronal indications with the requirement of periodic injections resulting in immune-resistance for some indications. Recent understanding of the structure-function relationship of BoNTs prompted the engineering of novel BoNTs to extend therapeutic interventions in non-neuronal systems and to overcome the immune-resistance issue. Much research still needs to be done to improve and extend the medical uses of BoNTs.
authors.affiliation: Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. sheng.chen@polyu.edu.hk
authors.forename: Sheng
authors.initials: S
authors.lastname: Chen
mesh_terms: D000818:Animals; D001905:Botulinum Toxins / Q000627:therapeutic use*; D005145:Face; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy; D009498:Neurotoxins / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012867:Skin / Q000187:drug effects / Q000378:metabolism; D013035:Spasm / Q000188:drug therapy; D013285:Strabismus / Q000188:drug therapy; D014103:Torticollis / Q000188:drug therapy
chemical_list: D009498:Neurotoxins; D001905:Botulinum Toxins