Bushara K O, Park D M, Jones J C, Schutta H S
Department of Neurology, University of Wisconsin Hospital and Clinics, Madison 53792-5132, USA.
Clin Exp Dermatol. 1996 Jul;21(4):276-8. doi: 10.1111/j.1365-2230.1996.tb00093.x.
The inhibitory action of botulinum toxin is not limited to the neuromuscular junction. The toxin also blocks the autonomic cholinergic fibres, including the sympathetic fibres to sweat glands. We have previously demonstrated that the toxin produces localized anhidrosis. To determine the dosage, pattern and duration of the anhidrotic effect of botulinum toxin and to test the efficacy of axillary injections, we further studied seven healthy volunteers. Two individuals had subcutaneous injections of botulinum toxin (20 mouse units, Dysport-Porton Products) in the dorsum of the hand. Five healthy volunteers had 15-50U of botulinum toxin A (Botox) injected in one axilla. A circular area of complete anhidrosis on the dorsum of the hand was evident on day 2 and persisted for 11 months. By day 3, two of the axillae (injected with 50 U each) were totally dry and in one (injected with 30 U) the sweating was substantially reduced. The effect persisted for 6-8 months before wearing off. No effect was appreciated in two axillae (injected with 15 and 20 U). No significant side-effects were encountered. Subcutaneous injections of botulinum toxin causes chemodenervation of the sweat glands. In normal individuals axillary sweating can be abolished by 50 U of botulinum toxin A (Botox). The results offer a possible novel treatment for severe cases of axillary hyperhidrosis.
肉毒杆菌毒素的抑制作用并不局限于神经肌肉接头。该毒素还会阻断自主胆碱能纤维，包括通向汗腺的交感神经纤维。我们之前已经证明，这种毒素会导致局部无汗。为了确定肉毒杆菌毒素无汗作用的剂量、模式和持续时间，并测试腋窝注射的效果，我们进一步研究了7名健康志愿者。两名受试者在手背部进行了肉毒杆菌毒素（20鼠单位，Dysport - 波顿产品）的皮下注射。五名健康志愿者在一侧腋窝注射了15 - 50单位的A型肉毒杆菌毒素（保妥适）。手背部在第2天出现了一个完全无汗的圆形区域，并持续了11个月。到第3天，两个腋窝（各注射50单位）完全干燥，一个腋窝（注射30单位）出汗明显减少。这种效果持续了6 - 8个月才消失。两个腋窝（分别注射15单位和20单位）没有观察到效果。未出现明显的副作用。皮下注射肉毒杆菌毒素会导致汗腺化学去神经支配。在正常个体中，50单位的A型肉毒杆菌毒素（保妥适）可消除腋窝出汗。这些结果为严重腋窝多汗症提供了一种可能的新治疗方法。
