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Clinical Applications and Diversity of Botulinum Toxins

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A special issue of Toxins (ISSN 2072-6651). This special issue belongs to the section "Bacterial Toxins".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 8027

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Special Issue Editor

Dr. Christine Rasetti-Escargueil

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Guest Editor

Institut Pasteur, Unité des Bactéries Anaérobies et Toxines, 25 Avenue du Docteur Roux, 75015 Paris, France
Interests: botulism; botulinum neurotoxins; antitoxins

Special Issue Information

Dear Colleagues,

Botulinum neurotoxins (BoNTs) are produced by Gram-positive, anaerobic and spore-forming bacteria belonging to the genus Clostridium (Clostridium botulinum, C. butyricum, C. baratii and C. argentinense spp), with high immunological and genetic diversity. BoNTs are divided into nine toxinotypes (A, B, C, D, E, F, G, H or F/A, X) based on serological methods using specific antisera or, more recently, using genome sequencing for BoNT/X. To add further complexity, each toxinotype is subdivided into subtypes based on amino acid variations, leading to the identification of 41 subtypes so far. BoNTs are classified as the most harmful biological weapons due to their extreme potency. At the same time, BoNTs are widely used in therapy for an increasing number of applications. Enhancing our understanding of the activity of the BoNT variants, as well as the development of BoNT-based engineered proteins, opens the door to novel applications. Moreover, there is a pressing need to optimize the current detection methods challenged by BoNT diversity. This review will focus on BoNTs’ variability and the opportunities or challenges posed for future clinical applications.

Dr. Christine Rasetti-Escargueil
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Toxins is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

botulinum neurotoxins (BoNTs)
subtypes
BoNT variants
detection
antitoxins

Published Papers (5 papers)

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Research

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11 pages, 1576 KiB

Open AccessArticle

Pain Control during the Treatment of Primary Palmar Hyperhidrosis with Botulinum Toxin A by a Topical Application of Liposomal Lidocaine: Clinical Effectiveness

by Andrea Marani, Helena Gioacchini, Matteo Paolinelli, Ivan Bobyr, Emanuela Martina, Giulia Radi, Federico Diotalallevi and Anna Campanati

Toxins 2024, 16(1), 28; https://doi.org/10.3390/toxins16010028 - 06 Jan 2024

Viewed by 1567

Abstract

Primary palmar hyperhidrosis (PPH) constitutes a debilitating condition that profoundly impacts the social, functional, and occupational aspects of individuals. The intradermal administration of botulinum toxin type A (BoNT-A) stands as an established therapeutic approach for PPH, albeit one frequently accompanied by considerable pain, posing challenges for patient tolerance. Our study aimed to assess the efficacy of combining cryoanalgesia spray (CA) with topical anesthesia utilizing a cream containing liposomal lidocaine at a concentration of 40 mg/g, with the objective of mitigating the pain associated with intradermal BoNT-A injection for PPH treatment. Nineteen participants, aged ≥18 years and afflicted with severe PPH, were enrolled in a double-blind randomized vehicle-controlled trial. Patient-perceived pain during the procedure was quantified using the Numeric Rating Scale (NRS). Statistical analysis was applied to the collected data. The combination of CA and the topical application of liposomal lidocaine during BoNT-A treatment for PPH resulted in diminished pain compared to CA alone and the combination of CA with the application of a basic cream. Topical anesthesia through the application of a liposomal lidocaine-containing cream emerged as a facile, secure, and efficacious approach for alleviating the pain associated with intradermal BoNT-A injection in PPH treatment. Furthermore, it demonstrated compatibility with CA, thereby offering a comprehensive strategy for pain management during BoNT-A administration. Full article

(This article belongs to the Special Issue Clinical Applications and Diversity of Botulinum Toxins)

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14 pages, 2132 KiB

Open AccessArticle

Efficacy of Botulinum Toxin Type A for Prevention of Post-Mastectomy Scar in Transmen: A Prospective, Randomized Study

by Waranaree Winayanuwattikun, Vasanop Vachiramon, Teerapong Rattananukrom, Pasita Palakornkitti and Ngamcherd Sitpahul

Toxins 2023, 15(11), 636; https://doi.org/10.3390/toxins15110636 - 31 Oct 2023

Viewed by 1654

Abstract

Background: Subcutaneous mastectomies in transmen have been gaining popularity. However, post-operative scars are an inevitable consequence. Recently, Botulinum neurotoxin A (BoNT-A) has shown positive effects in scar prevention. The objective of this study is to investigate the effectiveness of BoNT-A in scar prevention. Methods: Fifteen patients who had undergone subcutaneous mastectomy were included. At 14 days post-surgery, either incoBoNT-A or a placebo was injected into the scar on each side. The primary outcome assessment measured the scar’s severity using the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS). The secondary outcome assessment evaluated the scar’s color using a standard measurement device. Outcome assessments were conducted until 6 months post-surgery. Results: There were significantly lower VSS scores in the BoNT-A group compared to the placebo at the end of the study (7.43 ± 0.26 vs. 8.82 ± 0.26, p < 0.001). The objective assessment revealed a statistically significant decrease in redness values in the BoNT-A group compared to the placebo at 3 and 6 months. Conclusion: BoNT-A has demonstrated effectiveness in scar prevention by reducing the severity of postoperative scar formation and improving overall scar appearance. Full article

(This article belongs to the Special Issue Clinical Applications and Diversity of Botulinum Toxins)

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12 pages, 13432 KiB

Open AccessArticle

Ideal Injection Points for Botulinum Neurotoxin for Pectoralis Minor Syndrome: A Cadaveric Study

by Ji-Hyun Lee, Hyung-Jin Lee, Kyu-Ho Yi, Kang-Woo Lee, Young-Chun Gil and Hee-Jin Kim

Toxins 2023, 15(10), 603; https://doi.org/10.3390/toxins15100603 - 07 Oct 2023

Viewed by 1891

Abstract

Pectoralis Minor Syndrome (PMS) causes significant discomfort due to the compression of the neurovascular bundle within the retropectoralis minor space. Botulinum neurotoxin (BoNT) injections have emerged as a potential treatment method; however, their effectiveness depends on accurately locating the injection site. In this study, we aimed to identify optimal BoNT injection sites for PMS treatment. We used twenty-nine embalmed and eight non-embalmed human cadavers to determine the origin and intramuscular arborization of the pectoralis minor muscle (Pm) via manual dissection and Sihler’s nerve staining techniques. Our findings showed the Pm’s origin near an oblique line through the suprasternal notch, with most neural arborization within the proximal three-fourths of the Pm. Blind dye injections validated these results, effectively targeting the primary neural arborized area of the Pm at the oblique line’s intersection with the second and third ribs. We propose BoNT injections at the arborized region within the Pm’s proximal three-fourths, or the C region, for PMS treatment. These findings guide clinicians towards safer, more effective BoNT injections. Full article

(This article belongs to the Special Issue Clinical Applications and Diversity of Botulinum Toxins)

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Review

Jump to: Research

13 pages, 1046 KiB

Open AccessReview

Recent Developments in Engineering Non-Paralytic Botulinum Molecules for Therapeutic Applications

by Aisha Zhantleuova, Charlotte Leese, Anna P. Andreou, Altynay Karimova, Guy Carpenter and Bazbek Davletov

Toxins 2024, 16(4), 175; https://doi.org/10.3390/toxins16040175 - 03 Apr 2024

Viewed by 699

Abstract

This review discusses the expanding application of botulinum neurotoxin in treating neurological conditions. The article specifically explores novel approaches to using non-paralytic botulinum molecules. These new molecules, such as BiTox or el-iBoNT, offer an alternative for patients who face limitations in using paralytic forms of botulinum neurotoxin due to concerns about muscle function loss. We highlight the research findings that confirm not only the effectiveness of these molecules but also their reduced paralytic effect. We also discuss a potential cause for the diminished paralytic action of these molecules, specifically changes in the spatial parameters of the new botulinum molecules. In summary, this article reviews the current research that enhances our understanding of the application of new botulinum neurotoxins in the context of common conditions and suggests new avenues for developing more efficient molecules. Full article

(This article belongs to the Special Issue Clinical Applications and Diversity of Botulinum Toxins)

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19 pages, 498 KiB

Open AccessReview

Navigating the Complexities Involving the Identification of Botulinum Neurotoxins (BoNTs) and the Taxonomy of BoNT-Producing Clostridia

by Theresa J. Smith, Kristin M. Schill and Charles H. D. Williamson

Toxins 2023, 15(9), 545; https://doi.org/10.3390/toxins15090545 - 03 Sep 2023

Cited by 1 | Viewed by 1496

Abstract

Botulinum neurotoxins are a varied group of protein toxins that share similar structures and modes of activity. They include at least seven serotypes and over forty subtypes that are produced by seven different clostridial species. These bacterial species are not limited strictly to BoNT-producers as neuro-toxigenic and non-neuro-toxigenic members have been identified within each species. The nomenclature surrounding these toxins and associated bacteria has been evolving as new isolations and discoveries have arisen, resulting in challenges in diagnostic reporting, epidemiology and food safety studies, and in the application of therapeutic products. An understanding of the intricacies regarding the nomenclature of BoNTs and BoNT-producing clostridia is crucial for communication that allows for accurate reporting of information that is pertinent to each situation. Full article

(This article belongs to the Special Issue Clinical Applications and Diversity of Botulinum Toxins)

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