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Botulinum Neurotoxins and Cancer—A Review of the Literature

1
Head, Section for Parkinson’s Disease and Movement Disorders, Cleveland Clinic Abu Dhabi, Abu Dhabi 112412, UAE
2
Department of Neurology, Yale University School of Medicine, New Haven, CT 06519, USA
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(1), 32; https://doi.org/10.3390/toxins12010032
Received: 10 December 2019 / Revised: 31 December 2019 / Accepted: 1 January 2020 / Published: 5 January 2020
(This article belongs to the Special Issue Toxins and Cancer Therapy)
Botulinum neurotoxins (BoNT) possess an analgesic effect through several mechanisms including an inhibition of acetylcholine release from the neuromuscular junction as well as an inhibition of specific pain transmitters and mediators. Animal studies have shown that a peripheral injection of BoNTs impairs the release of major pain transmitters such as substance P, calcitonin gene related peptide (CGRP) and glutamate from peripheral nerve endings as well as peripheral and central neurons (dorsal root ganglia and spinal cord). These effects lead to pain relief via the reduction of peripheral and central sensitization both of which reflect important mechanisms of pain chronicity. This review provides updated information about the effect of botulinum toxin injection on local pain caused by cancer, painful muscle spasms from a remote cancer, and pain at the site of cancer surgery and radiation. The data from the literature suggests that the local injection of BoNTs improves muscle spasms caused by cancerous mass lesions and alleviates the post-operative neuropathic pain at the site of surgery and radiation. It also helps repair the parotid damage (fistula, sialocele) caused by facial surgery and radiation and improves post-parotidectomy gustatory hyperhidrosis. The limited literature that suggests adding botulinum toxins to cell culture slows/halts the growth of certain cancer cells is also reviewed and discussed. View Full-Text
Keywords: botulinum toxin; botulinum neurotoxin; cancer; cancer cells; neuropathic pain; post-surgical pain; parotid gland; submaxillary gland; gustatory hyperhidrosis; sialocele; parotid fistula botulinum toxin; botulinum neurotoxin; cancer; cancer cells; neuropathic pain; post-surgical pain; parotid gland; submaxillary gland; gustatory hyperhidrosis; sialocele; parotid fistula
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Mittal, S.O.; Jabbari, B. Botulinum Neurotoxins and Cancer—A Review of the Literature. Toxins 2020, 12, 32.

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