TAILIEUCHUNG - Botulinum Toxin in Aesthetic Medicine_1

Seven distinct antigenic botulinum toxins (BNT-A, -B, -C, -D, -E, -F, and -G) produced by different strains of Clostridium botulinum have been described. The human nervous system is susceptible to five toxin serotypes (BNT-A, -B, -E, -F, -G) and unaffected by 2 (BNT-C, -D). Although all toxins have different molecular targets, their action leads to the blockade of the cholinergic nerves. However, only the A and B toxins are available as drugs. In aesthetic medicine, the BNT predominately used has been of type A so far, even though some trials have been published utilizing type B BNT (Baumann et al. 2003) | Chapter 1 Overview of Botulinum Toxin Berthold Rzany Hendrik Zielke 1 Contents Introduction Introduction . 1 Different Subtypes of Botulinum Toxin . 1 Mode of Action. 1 Antidote. 3 Different Products . 3 Units of Botulinum Toxin . 3 Off-Label Use. 4 Botulinum toxin BNT is a fascinating drug which specifically targets the release of acetylcholine. BNT is produced by the anaerobic bacterium Clostridium botulinum. In order to be used as a drug the toxin has to be isolated purified and stabilized Huang et al. 2000 Table . New Drugs. 4 Evidence Behind the Use of BNT-A . . 4 Efficacy Optimal Dosage . 5 Botox . 5 Dysport . 6 Effectiveness Dosages and Repeated Treatments . 6 Botox . 7 Dysport . 7 Safety . 7 Short-term Safety Eyelid Ptosis . 7 Botox . 7 Dysport . 7 Long-term Safety Eyelid Ptosis . 8 Botox . 8 Dysport . 8 Marketing and Evidence . 8 References . 9 Different Subtypes of Botulinum Toxin Seven distinct antigenic botulinum toxins BNT-A -B -C -D -E -F and -G produced by different strains of Clostridium botulinum have been described. The human nervous system is susceptible to five toxin serotypes BNT-A -B -E -F -G and unaffected by 2 BNT-C -D . Although all toxins have different molecular targets their action leads to the blockade of the cholinergic nerves. However only the A and B toxins are available as drugs. In aesthetic medicine the BNT predominately used has been of type A so far even though some trials have been published utilizing type B BNT Baumann et al. 2003 . Mode of Action BNT blocks the action of acetylcholine. Acetylcholine is a common neural transmitter and Table . Pharmacological aspects of therapeutic botulinum toxin preparations modified from Dressier 2006 Botox Vistabel Dysport Xeomin Myobloc NeuroBloc Manufacturer Allergan Inc Irvine CA USA Ipsen Ltd. Slough Berks UK Merz Pharmaceuticals Frankfurt M .

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