Jankovic J
Department of Neurology, Baylor College of Medicine, Houston, TX 77030.
Curr Opin Neurol. 1994 Aug;7(4):358-66. doi: 10.1097/00019052-199408000-00014.
The most potent biologic toxin, botulinum toxin (BTX), has become a powerful therapeutic tool in the treatment of a variety of neurologic, ophthalmic, and other disorders manifested by abnormal, excessive, or inappropriate muscle contractions. This review focuses on the use of BTX in the treatment of dystonia and other movement disorders. The therapeutic application of BTX, however, extends beyond movement disorders; chemodenervation with BTX has been found to ameliorate spasticity, rigidity, spastic bladder, achalasia, and even some cosmetic conditions. In addition to describing its therapeutic effects, this article also reviews recent advances in the understanding of the molecular and cellular mechanisms of BTX. Few therapeutic agents have been better understood in terms of their mechanism of action or have had greater impact on patients' functioning than BTX. BTX-A has been used in nearly all clinical trials. Blocking anti-BTX-A antibodies have been detected in about 5% of patients chronically treated with this type of BTX. Patients who develop immunoresistance to BTX-A may benefit from other serotypes of BTX, such as BTX-B and -F, currently undergoing clinical trials.
最具毒性的生物毒素——肉毒杆菌毒素（BTX），已成为治疗各种由异常、过度或不适当肌肉收缩所表现出的神经、眼科及其他病症的有力治疗工具。本综述聚焦于BTX在治疗肌张力障碍及其他运动障碍方面的应用。然而，BTX的治疗应用并不局限于运动障碍；已发现用BTX进行化学去神经支配可改善痉挛、僵硬、痉挛性膀胱、贲门失弛缓症，甚至一些美容问题。除了描述其治疗效果外，本文还综述了对BTX分子和细胞机制认识的最新进展。就作用机制而言，很少有治疗药物比BTX得到更深入的了解，对患者功能的影响也没有比BTX更大的。BTX-A几乎已用于所有临床试验。在约5%长期接受此类BTX治疗的患者中检测到了抗BTX-A阻断抗体。对BTX-A产生免疫抗性的患者可能会受益于其他血清型的BTX，如目前正在进行临床试验的BTX-B和-F。
