Department of Pharmacology, University of Zagreb School of Medicine, Šalata 11, 10000 Zagreb, Croatia.
Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary.
Toxins (Basel). 2019 Aug 5;11(8):459. doi: 10.3390/toxins11080459.
Already a well-established treatment for different autonomic and movement disorders, the use of botulinum toxin type A (BoNT/A) in pain conditions is now continuously expanding. Currently, the only approved use of BoNT/A in relation to pain is the treatment of chronic migraines. However, controlled clinical studies show promising results in neuropathic and other chronic pain disorders. In comparison with other conventional and non-conventional analgesic drugs, the greatest advantages of BoNT/A use are its sustained effect after a single application and its safety. Its efficacy in certain therapy-resistant pain conditions is of special importance. Novel results in recent years has led to a better understanding of its actions, although further experimental and clinical research is warranted. Here, we summarize the effects contributing to these advantageous properties of BoNT/A in pain therapy, specific actions along the nociceptive pathway, consequences of its central activities, the molecular mechanisms of actions in neurons, and general pharmacokinetic parameters.
已经成为治疗不同自主和运动障碍的成熟疗法，肉毒毒素 A 型（BoNT/A）在疼痛病症中的应用正在不断扩展。目前，BoNT/A 在疼痛方面唯一被批准的用途是治疗慢性偏头痛。然而，对照临床试验显示在治疗神经病理性和其他慢性疼痛病症方面有良好的效果。与其他传统和非传统镇痛药物相比，BoNT/A 的最大优势在于单次应用后的持续效果及其安全性。在某些对抗疗法有抵抗的疼痛病症中，BoNT/A 的疗效具有特殊的重要性。近年来新的研究结果使我们对其作用机制有了更好的理解，尽管还需要进一步的实验和临床研究。在这里，我们总结了促成 BoNT/A 在疼痛治疗中具有这些有利特性的作用机制，包括沿伤害感受途径的特定作用、其中枢活动的后果、神经元中作用的分子机制以及一般药代动力学参数。
