Clinical application of Clostridium botulinum type A neurotoxin purified by a simple procedure for patients with urinary incontinence caused by refractory destrusor overactivity
Clinical application of Clostridium botulinum type A neurotoxin purified by a simple procedure for patients with urinary incontinence caused by refractory destrusor overactivity
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DOI：
10.1111/j.1574-695x.2007.00301.x
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发表时间：
2007-10-01
影响因子：
--
通讯作者：
Oguma, Keiji
中科院分区：
文献类型：
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作者：
Lee, Jae-Chul;Yokoyama, Teruhiko;Oguma, Keiji
用乳糖凝胶柱纯化肉毒梭菌A型神经毒素。该程序以前曾报道过B型神经毒素。血凝素阳性毒素（19 S和16 S）在酸性条件下与柱结合，通过将柱的pH值改变为碱性条件，使神经毒素单独与这些血凝素阳性毒素解离。通过补充0.1%白蛋白或0.05%白蛋白加1%海藻糖，该纯化毒素制剂的毒性在-30 ℃下保持至少1年。该制剂用于治疗18例难治性特发性和神经源性逼尿肌过度活动引起的尿失禁患者;其中16例患者表现出极好的改善。在大多数情况下，注射后1周内开始改善，持续3-12个月。12 S毒素分解成NTX和NTNH。最近，我们发现19 S毒素是16 S毒素的二聚体，血凝素由四个亚组分组成，命名为AA-1，AA-2，AA-3a和HA-3b。
Type A neurotoxin of Clostridium botulinum was purified by a simple procedure using a lactose gel column. This procedure was previously reported for type B neurotoxin. Hemagglutinin-positive toxins (19S and 16S) were bound to the column under acid conditions, and the neurotoxin alone was dissociated from these hemagglutinin-positive toxins by changing the pH of the column to an alkaline condition. The toxicity of this purified toxin preparation was retained for at least 1 year at -30 degrees C by supplementing it with either 0.1% albumin or 0.05% albumin plus 1% trehalose. This preparation was used to treat 18 patients with urinary incontinence caused by refractory idiopathic and neurogenic detrusor overactivity; 16 of the patients showed excellent improvement. Improvements started within 1 week after injection in most cases and lasted 3-12 months. 12S toxin dissociates into an NTX and an NTNH. Recently, we discovered that 19S toxin is a dimer of 16S toxin, and that haemagglutinin consists of four subcomponents designated AA-1, AA-2, AA-3a and HA-3b.