The extremely potent substance botulinum neurotoxin (BoNT) has attracted much interest in diverse fields. Originally identified as cause for the rare but deadly disease botulism, military and terrorist intended to misuse this sophisticated molecule as biological weapon. This caused its classification as select agent category A by the Centers for Diseases Control and Prevention and the listing in the Biological and Toxin Weapons Convention. Later, the civilian use of BoNT as long acting peripheral muscle relaxant has turned this molecule into an indispensable pharmaceutical world wide with annual revenues >$1.5 billion. Also basic scientists value the botulinum neurotoxin as molecular tool for dissecting mechanisms of exocytosis. This book will cover the most recent molecular details of botulinum neurotoxin, its mechanism of action as well as its detection and application.
The new, therapeutically-focused Botulinum Toxin presents comprehensive, cross-disciplinary guidance on current practices, covering more than 100 non-cosmetic conditions that occur in neurology, physical medicine and rehabilitation, pain medicine, ophthalmology, gastroenterology, urology, orthopedics, and surgery. International contributors review the current understanding of the biology and cellular mechanisms along with relevant research so you can easily apply them to the pathophysiology of the numerous disorders that botulinum toxin is used to treat—such as botulinum toxin applications for the treatment of cranial-cervical dystonias, motor disorders in cerebral palsy, bruxism and temporomandibular disorders, headache, overactive bladder, chronic pelvic pain syndromes, arthritis joint pain, and wound healing. With discussions of the latest in approved treatment practices as well as new and emerging uses, you’ll get in-depth management guidance on the application of the toxin. Provides clinical applications of botulinum toxin for over 100 disorders for immediate access and easy reference during practice and treatment. Covers a broad array of hot topics, including botulinum toxin applications for the treatment of cranial-cervical dystonias, motor disorders in cerebral palsy, bruxism and temporomandibular disorders, headache, overactive bladder, chronic pelvic pain syndromes, arthritis joint pain, and wound healing. Focuses on approved uses with expert advice on thoroughly tested applications but also discusses new and emerging applications to expose you to additional treatment options. Presents the most comprehensive and up-to-date material available so you get all the information you need from this one resource. Offers the cross-disciplinary guidance of the best world-class expertise through an authoritative, international group of authors who demonstrate the applications of botulinum toxin across various specialties.
The extremely potent substance botulinum neurotoxin (BoNT) has attracted much interest in diverse fields. Originally identified as cause for the rare but deadly disease botulism, military and terrorist intended to misuse this sophisticated molecule as biological weapon. This caused its classification as select agent category A by the Centers for Diseases Control and Prevention and the listing in the Biological and Toxin Weapons Convention. Later, the civilian use of BoNT as long acting peripheral muscle relaxant has turned this molecule into an indispensable pharmaceutical world wide with annual revenues >$1.5 billion. Also basic scientists value the botulinum neurotoxin as molecular tool for dissecting mechanisms of exocytosis. This book will cover the most recent molecular details of botulinum neurotoxin, its mechanism of action as well as its detection and application.
In a rapidly progressing field, Botulinum Toxin Therapy provides both clinicians and basic researchers with the latest science on the structure and function of botulinum toxins and the use of these toxins to treat a wide variety of diseases. Part 1 of the book reviews the basic science of botulinum toxins including advances in our understanding of the molecular structure and mechanism of action of botulinum toxins. This section also discusses the manufacturing and formulation of botulinum toxins for clinical use and the development of novel therapeutic toxins for the future. Part 2 reviews the use of botulinum toxins in clinical practice. It discusses the clinical pharmacology of botulinum toxin drugs and their use in a wide variety of clinical conditions including headache, spasticity, pain, disorders of the genitourinary and gastrointestinal tract, strabismus, and medical aesthetics.
Tetanus has been known from the very beginning of medical literature since it was first described by Hyppocrates of Cos in the fifth century B.C. For 24 centuries it was considered a neuro logical disease until the breakthrough of CARLE and RATIONE (1884) who demonstrated its infectious etiology. Following the establishment of purified cultures of Clostridium tetani(KITASATO 1889), FABER (1890), and TIZZONI and CATIANI (1890) demon strated that the disease is actually an intoxication caused by a proteic neurotoxin. This toxin was shown by BRUSHCHETIINI (1892) to move retroaxonally and to act at the spinal cord level. Soon thereafter VAN ERMENGEN (1897) demonstrated that botu lism is also due to intoxication with a protein toxin produced by bacteria of the genus Clostridium. These bacteria and their spores and ubiquitous, and the majority of them do not produce neurotoxins. The selective advantage of producing such potent toxin is still a matter of speculation (see Popoff, this volume). The next major advance was the discovery that tetanus neurotoxin 1 can be converted by formaldehyde treatment to a nonpathogenic but still fully immunogenic form, and that this can be used successfully as a vaccine to prevent tetanus (RAMON and DESCOMBEY 1925). Similar vaccines (toxoids) can be prepared with botulism neurotoxins (see MiDDLEBROOK and BROWN, this volume). The prevention oftetanus by vaccination (see Galatzka and Gasse, this volume) is one of the great successes of basic research coupled with an efficient public medicine service.
Three days in Madison have thoroughly modified my view on clostridial neurotoxins. While still realizing the numerous activating, modifying and protective inputs, I cannot judge the meaningfulness of the meeting impartially. Neither may the reader expect a complete summary of all presentations. Collected in this volume, they speak for themselves without requiring an arbiter. Instead I shall write down my very personal opinions as a researcher who has studied clostridial neurotoxins for nearly 25 years. Comparable conferences have been rare during this time. A comprehensive symposium 4 on C. botulinum neurotoxins has been organized at Ft. Detrick. International conferences on tetanus have been held regularly under the auspices of the Wodd Health Organization. One or maximally two days of these meetings have been devoted to tetanus toxin and its actions whereas the sponsor and the majority of the participants have been interested mainly in epidemiology, prevention and treatment of tetanus as a disease (see refs. 5,6). Some aspects of clostridial neurotoxins have been addressed in the context of bacterial toxins, in particular in the biennial European workshops. 1-3,7,8 The Madison meeting differed from the previous ones in three aspects. First, it covered both tetanus and botulinum neurotoxins. The fusion was justified because of their huge similarities in primary structure, in their mode of action and in their cellular targets. Second, the meeting was not limited to toxins but drew some lines on which modern neurobiology might proceed.
The Essential Guide for Clinicians Who Prescribe and Inject BoNTs This is a detailed and practical guide to botulinum neurotoxin therapy (BoNT) and the wide range of applications for neurological and pain disorders. A unique reference source for new injectors and experienced clinicians alike, this indispensable manual provides information on dose, dilution, and indications for all four FDA-approved toxins in one handy text. Following a brief review of relevant pharmacology, the book provides product information and comparative distinctions between the four FDA-approved toxins (BotoxÆ, MyoblocÆ, XeominÆ, and DysportÆ), along with indications and doses for FDA-approved conditions, guidance techniques, and common and emerging clinical applications. The heart of the book is an injection manual, organized anatomically and by condition and covering all applications for medical treatment. For each condition or site, information is provided on typical muscle pattern or muscle groups involved, dosing guidelines and dilution for the applicable toxins, number of injection sites, and potential risks and benefits. Targeting techniques are organized in table format for quick retrieval. Anatomic illustrations and cross-sections are provided to orient injectors and help identify optimal insertion points. An appendix with useful clinical rating scales is also included. Key Features: Presents state-of-the-art information about current indications for all four FDA-approved botulinum neurotoxins Compares and contrasts the four toxins along with common and emerging clinical applications Provides dosing guidelines for various indications and injection sites for each muscle Includes anatomic drawings and cross-sections to illustrate muscle relationships and insertion points Serves as a practical, portable, how-to guide for new and experienced clinicians
Currently, there are tremendous advances being made in understanding the basic science of both the structure and function of botulinum neurotoxins. This knowledge is opening up opportunities in regard to both therapeutic uses and treatment and protection options for civil and bio-defense applications. This volume fully evaluates the status of neurotoxin research and exploitation. The book is a multi-authored collection of chapters written by the leading authorities responsible for the current scientific and clinical research that is advancing the understanding and exploitation of the neurotoxins and is both up to date and authoritative.
This book concisely summarizes the use of Botulinum neurotoxin in facial rejuvenation. It details relevant aspects of the physiology, pharmacology, safety profile and anatomy of the toxin. Chapters breakdown critical aspects related to the clinical assessment and aesthetic administration of this neurotoxin along with insightful information on its regulation. Botulinum Toxin in Clinical Practice provides a practically focused introductory text to the cosmetic applications of this neurotoxin in aesthetic dermatology, making it an ideal resource for the trainee practitioner seeking a concise summary of the topic.
This book collects 25 scientific articles from laboratories around the world, all of which use botulinum neurotoxins as the main protagonists of their studies. The use of botulinum neurotoxin in medicine, following its ability to inhibit the effects of various disorders of different etiology on the human organism, constitutes the main topic of each article presented here. This book, which is aimed at both students and medical professionals, attempts to summarize current knowledge about the use of botulinum toxin as a therapeutic agent in many diseases, ranging from spasticity to tremor, form motor dysfunction after stroke to neuropathic pain, from hyperactive muscle to migraine, and so on. Thanks to its simplified writing, accessible to an audience who may not be familiar with the mysteries of science, readers will get new insights into this biological toxin and its multiple applications, not simply relegated to its historical use to correct of face wrinkles. Both review and research articles are presented, not only concerning animal studies, but also clinical reports. This book will provide an up-to-date picture of the state-of-the-art of the possible development of novel applications of botulinum neurotoxins for future therapeutic purposes.
