Botulinum toxin A in the overactive bladder: current status and future directions

Dmochowski, Roger R.; Sand, Peter K.

doi:10.1111/j.1464-410x.2007.06575.x

Cited by 71 publications

(58 citation statements)

References 59 publications

(148 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the present study an average of only about 30% (mean of all patients) of detrusor muscle was covered with 13 contrast agent. Nevertheless, a sufficient effect of the BoNT/A treatment could be observed, which is well comparable with the success rates reported in former studies [6,7]. Therefore, it might not be necessary to cover the whole detrusor with BoNT/A, to achieve good clinical results.…”

Section: Discussionsupporting

confidence: 75%

See 1 more Smart Citation

A morphological evaluation of botulinum neurotoxin A injections into the detrusor muscle using magnetic resonance imaging

et al. 2009

View full text Add to dashboard Cite

OBJECTIVES: Although botulinum neurotoxin type A (BoNT/A) intradetrusor injections are a recommended therapy for neurogenic detrusor overactivity (NDO), refractory to antimuscarinic drugs, a standardisation of injection technique is missing. Furthermore, some basic questions are still unanswered, as where the toxin solution exactly spreads after injection. Therefore, we investigated the distribution of the toxin solution after injection into the bladder wall, using magnet resonance imaging (MRI). METHODS: Six patients with NDO were recruited. Three of six patients received 300 U of BoNT/A + contrast agent distributed over 30 injection sites (group 1). The other three patients received 300 U of BoNT/A + contrast agent distributed over 10 injection sites (group 2). Immediately after injection, MRI of the pelvis was performed. The volume of the detrusor and the total volume of contrast medium inside and outside the bladder wall were calculated. RESULTS: In all patients, a small volume (mean 17.6%) was found at the lateral aspects of the bladder dome in the extraperitoneal fat tissue, whereas 82.4% of the injected volume reached the target area (detrusor). In both groups there was a similar distribution of the contrast medium in the target area. A mean of 33.3 and 25.3% of the total detrusor volume was covered in group 1 and 2, respectively. Six weeks after injection, five of six patients were continent and showed no detrusor overactivity in the urodynamic follow-up. No systemic side effects were observed. CONCLUSIONS: Our results provide morphological arguments that the currently used injection techniques are appropriate and safe.A morphological evaluation of botulinum neurotoxin A injections into the detrusor muscle using magnetic resonance Abstract ObjectivesAlthough botulinum neurotoxin type A (BoNT/A) intradetrusor injections are a recommended therapy for neurogenic detrusor overactivity (NDO), refractory to antimuscaric drugs, a standardisation of injection technique is missing. Furthermore, some basic questions are still unanswered, as where the toxin solution exactly spreads after injection. Therefore, we investigated the distribution of the toxin solution after injection into the bladder wall, using magnet resonance imaging (MRI). MethodsSix patients with NDO were recruited. 3 of 6 patients received 300 units of BoNT/A + contrast agent distributed over 30 injection sites (Group 1). The other 3 patients received 300 units of BoNT-A + contrast agent distributed over 10 injection sites (Group 2).Immediately after injection, MRI of the pelvis was performed. The volume of the detrusor and the total volume of contrast medium inside and outside the bladder wall were calculated. ResultsIn all patients, a small volume (mean 17.6%) was found at the lateral aspects of the bladder dome in the extraperitoneal fat tissue, whereas 82.4% of the injected volume reached the target area (detrusor).In both groups there was a similar distribution of the contrast medium in the target area.A mean of 33.3% and 25.3% of th...

show abstract

Section: Discussionsupporting

confidence: 75%

“…BoNT/A injections have been successfully used to treat NDO worldwide and further indications and therapy options are currently explored [5][6][7][8]. The toxin is injected into the detrusor muscle via a cystoscopic approach, either flexible or rigid.…”

Section: Introductionmentioning

confidence: 99%

A morphological evaluation of botulinum neurotoxin A injections into the detrusor muscle using magnetic resonance imaging

et al. 2009

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…Therapeutic preparations of BoNT/A and B serotypes are Food and Drug Administration (FDA) approved for treating glabellar lines, strabismus, cervical dystonia, blepharospasm, cranial nerve VII disorders, and primary axillary hyperhidrosis. Dozens of ''off-label'' BoNT clinical applications have also been documented [14][15][16][17].The mouse bioassay, or lethality test, has been the standard for testing BoNT-containing samples for the past 30 years [18][19][20]. Government agencies use this method for testing food and serum samples for the presence of BoNT, whereas the pharmaceutical industry uses it for quality control and to quantify ''for human use'' BoNT preparations.…”

mentioning

confidence: 99%

Detection of six serotypes of botulinum neurotoxin using fluorogenic reporters

Ruge

Dunning

Piazza

et al. 2011

Analytical Biochemistry

View full text Add to dashboard Cite

a b s t r a c tMethods that do not require animal sacrifice to detect botulinum neurotoxins (BoNTs) are critical for BoNT antagonist discovery and the advancement of quantitative assays for biodefense and pharmaceutical applications. Here we describe the development and optimization of fluorogenic reporters that detect the proteolytic activity of BoNT/A, B, D, E, F, and G serotypes in real time with femtomolar to picomolar sensitivity. Notably, the reporters can detect femtomolar concentrations of BoNT/A in 4 h and BoNT/E in 20 h, sensitivity that equals that of animal-based methods. The reporters can be used to determine the specific activity of BoNT preparations with intra-and inter-assay coefficients of variation of approximately 10%. Finally, we find that the greater sensitivity of our reporters compared with those used in other commercially available assays makes the former attractive candidates for high-throughput screening of BoNT antagonists.Ó 2011 Elsevier Inc. All rights reserved.Botulinum neurotoxins (BoNTs), 1 produced by the bacteria of the genus Clostridium, are the most lethal substances known. The zinc-dependent endopeptidases act by entering neurons and cleaving soluble N-ethylmaleimide-sensitive factor attachment protein receptors (SNAREs) and, thus, compromise the protein machinery responsible for neurotransmitter release [1][2][3][4][5][6][7][8]. Failure to promptly treat a victim of BoNT poisoning can result in flaccid paralysis, respiratory failure, or death [9]. The combination of extreme potency and a lack of medical treatments other than antitoxin administration and intensive care has made BoNT a biodefense priority requiring the discovery and development of assays to quantify toxins and to identify antagonists to counteract intoxication [10][11][12][13]. Despite their lethality, BoNTs are widely used for cosmetic and pharmaceutical applications due in part to their exquisite specificity for the neuromuscular junction. BoNTs provide relief of muscle tension and pain by inhibiting neurons that cause excessive muscle contractions. Therapeutic preparations of BoNT/A and B serotypes are Food and Drug Administration (FDA) approved for treating glabellar lines, strabismus, cervical dystonia, blepharospasm, cranial nerve VII disorders, and primary axillary hyperhidrosis. Dozens of ''off-label'' BoNT clinical applications have also been documented [14][15][16][17].The mouse bioassay, or lethality test, has been the standard for testing BoNT-containing samples for the past 30 years [18][19][20]. Government agencies use this method for testing food and serum samples for the presence of BoNT, whereas the pharmaceutical industry uses it for quality control and to quantify ''for human use'' BoNT preparations. The test is carried out by injecting mice intraperitoneally with approximately 0.5 ml of sample per mouse and recording the number of deaths over a 1-to 7-day period. The assay is very sensitive, with a detection limit of 5-10 pg for BoNT/A [21,22]. Results for the mouse bioassay are reported in...

show abstract

“…Es una neurotoxina producida por Clostridium botulinum que provoca la relajación del músculo liso de la vejiga por la inhibición de la liberación de acetilcolina en la unión presináptica (53). Se han utilizado dosis entre 5 y 12 U/kg (52,53).…”

Section: Tratamiento Farmacológico Anticolinérgicosunclassified

Evaluación y tratamiento del niño con síntomas del tracto urinario inferior (LUTS)

Guerrero-Tinoco

Cano-Martínez

Vanegas-Ruiz

2018

iatreia

View full text Add to dashboard Cite

RESUMENLa disfunción miccional es un trastorno del llenado o vaciado de la vejiga en niños sin alteraciones neurológicas o anatómicas. Los síntomas del tracto urinario inferior (LUTS, por la sigla en inglés de Lower urinary tract symptoms) son un motivo frecuente de consulta con el pediatra, el nefrólogo o el urólogo pediatra, e incluso con el neurólogo y el psicólogo infantil. Se le considera una enfermedad relativamente benigna lo que en ocasiones genera desinterés entre médicos y familiares y lleva a consultas tardías e interpretación inadecuada de los síntomas. Manifestaciones como urgencia, incontinencia, enuresis, goteo posmiccional, infecciones urinarias, vulvovaginitis recurrente y constipación, en un niño sin enfermedad neurológica, deben hacer pensar al médico en disfunción miccional para enfocar oportunamente el diagnóstico, restablecer la calidad de vida del paciente, evitar las infecciones urinarias y el daño renal subsecuente e irreversible secundario a un diagnóstico tardío. Las recomendaciones actuales hacen énfasis en un enfoque menos invasivo, tratamiento conservador, manejo de la constipación y reentrenamiento vesical. Este artículo discute la evaluación, el diagnóstico y el tratamiento correctos de niños con LUTS.

show abstract

Botulinum toxin A in the overactive bladder: current status and future directions

Cited by 71 publications

References 59 publications

A morphological evaluation of botulinum neurotoxin A injections into the detrusor muscle using magnetic resonance imaging

A morphological evaluation of botulinum neurotoxin A injections into the detrusor muscle using magnetic resonance imaging

Detection of six serotypes of botulinum neurotoxin using fluorogenic reporters

Evaluación y tratamiento del niño con síntomas del tracto urinario inferior (LUTS)

Contact Info

Product

Resources

About