A型肉毒杆菌毒素（保妥适）与出汗剂量疗效及与其他肉毒杆菌毒素制剂的比较。

Botulinum toxin A (Botox) and sweating-dose efficacy and comparison to other BoNT preparations.

作者信息

Schlereth Tanja, Mouka Irini, Eisenbarth Gabi, Winterholler Martin, Birklein Frank

机构信息

Department of Neurology, University of Mainz, Germany.

出版信息

Auton Neurosci. 2005 Feb 7;117(2):120-6. doi: 10.1016/j.autneu.2004.11.005.

DOI:10.1016/j.autneu.2004.11.005

PMID:15664565

Abstract

BACKGROUND

Botulinum toxin type A (BoNT/A) is 20-50 times more effective than Botulinum toxin type B (BoNT/B) concerning the treatment of muscular hypercontractions [Sloop, R.R., Cole, B.A., Escutin, R.O., 1997. Human response to botulinum toxin injection: type B compared with type A. Neurology 49, 189-194]. Botulinum toxins block motor nerves as well as autonomic fibres [Rand, M.J., Whaler, B.C., 1965. Impairment of sympathetic transmission by botulinum toxin. Nature 206, 588-591].

OBJECTIVE

Purpose of this study was to analyse the dose dependent reduction of sweating using the BoNT/A preparation Botox and to compare the results with our earlier results analysing Dysport [Braune, C., Erbguth, F., Birklein, F., 2001. Dose thresholds and duration of the local anhidrotic effect of botulinum toxin injections: measured by sudometry. Br. J. Dermatol. 144, 111-117] and Neurobloc (BoNT/B) [Birklein, F., Eisenbarth, G., Erbguth, F., Winterholler, M., 2003. Botulinum toxin type B blocks sudomotor function effectively: a 6 month follow up. J. Invest. Dermatol. 121, 1312-1316].

METHODS

Different doses of Botox were injected subcutaneously (n=27 healthy subjects). Planimetrical analyses of the area of anhidrosis and quantitative sudomotor-axon-reflex testing (QSART) were done after 3 weeks, 3 and 6 months.

RESULTS

A threshold dose of 1.25 MU Botox led to anhidrotic skin spots after 3 weeks. The duration of anhidrosis was prolonged for 3 months when 17.5 MU and for 6 months when 50 MU were injected. Anhidrotic area size decreased with time (p=0.001), indicating partial recovery at the edges. After 3 weeks, QSART had significantly decreased to 29% of baseline. With doses of 70 MU or more it decreased to zero. After 3 months, QSART had returned to 68% of baseline and after 6 months to 87%.

CONCLUSIONS

Botox dose-dependently suppressed sweating. Comparison to Dysport and Neurobloc revealed a strikingly similar efficacy after 3 weeks and 3 months for all preparations. BoNT/A in general induced a more sustained anhidrosis than BoNT/B.

摘要

背景

在治疗肌肉过度收缩方面，A型肉毒毒素（BoNT/A）的效果比B型肉毒毒素（BoNT/B）强20至50倍[Sloop, R.R., Cole, B.A., Escutin, R.O., 1997. 人类对肉毒毒素注射的反应：B型与A型的比较。《神经病学》49, 189 - 194]。肉毒毒素可阻断运动神经以及自主神经纤维[Rand, M.J., Whaler, B.C., 1965. 肉毒毒素对交感神经传递的损害。《自然》206, 588 - 591]。

目的

本研究的目的是分析使用A型肉毒毒素制剂保妥适（Botox）时出汗量的剂量依赖性减少情况，并将结果与我们早期分析Dysport[Braune, C., Erbguth, F., Birklein, F., 2001. 肉毒毒素注射的局部止汗效果的剂量阈值和持续时间：通过汗液测量法测量。《英国皮肤病学杂志》144, 111 - 117]和Neurobloc（B型肉毒毒素）[Birklein, F., Eisenbarth, G., Erbguth, F., Winterholler, M., 2003. B型肉毒毒素有效阻断汗腺运动功能：6个月随访。《皮肤病学研究杂志》121, 1312 - 1316]的结果进行比较。

方法

对27名健康受试者皮下注射不同剂量的保妥适。在3周、3个月和6个月后，对无汗区域进行平面测量分析，并进行定量汗腺运动轴突反射测试（QSART）。

结果

1.25 MU保妥适的阈值剂量在3周后导致出现无汗皮肤斑。注射17.5 MU时无汗持续时间延长3个月，注射50 MU时延长6个月。无汗区域大小随时间减小（p = 0.001），表明边缘部位有部分恢复。3周后，QSART显著降至基线的29%。剂量达到70 MU或更高时降至零。3个月后，QSART恢复到基线的68%，6个月后恢复到87%。