Botolinum neurotoxin: its history and use in dermatology
DOI:
https://doi.org/10.6016/ZdravVestn.3241Keywords:
Clostridium botulinum, botulism, dermatology, aesthetic medicine, history of medicineAbstract
Botulinum neurotoxin is a highly toxic protein produced by the anaerobic Gram-positive bacterium Clostridium botulinum. The discovery of botulinum neurotoxin began with unexplained sausage poisonings, hence its name. The Latin word for sausage is botulus. The knowledge of neurotoxin has grown through centuries of research, and clinical trials are still underway to support new indications with the increasingly widespread use of this toxin in medicine. Botulinum neurotoxin is a protein molecule that, in its active form, becomes a proteolytic enzyme exclusively specific for SNARE complex fusion proteins in presynaptic nerve endings. In the process of chemodenervation, it temporarily inhibits the action of the target tissue, causing, for example, temporary flaccid muscle paralysis on skeletal and smooth muscle. Botulinum neurotoxin is used in neurology to treat bladder overactivity and in dermatology, where botulinum neurotoxin is still widely associated with aesthetics alone. Recent findings reveal that botulinum neurotoxin reduces pain and itching and also affects some non-neuronal cells, such as epidermal keratinocytes, dermal fibroblasts, inflammatory cells, sebaceous cells, vascular endothelial cells, and mesenchymal stem cells in subcutaneous fat. The findings are promising for expanding the range of indications in dermatology too. The following article presents the history of botulinum neurotoxin development, its structure, mechanism of action, as along with current and promising indications for use in dermatology.
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