Beyond botulinum neurotoxin A for chemodenervation of the bladder.
Beyond botulinum neurotoxin A for chemodenervation of the bladder.
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DOI：
10.1097/mou.0000000000000843
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发表时间：
2021-03-01
影响因子：
2.5
通讯作者：
Dong M
中科院分区：
文献类型：
--
作者：
Thaker H;Zhang S;Diamond DA;Dong M
A 型肉毒杆菌神经毒素 (BoNT/A) 或 Botox 是治疗膀胱过度活动症 (OAB) 和神经源性膀胱 (NGB) 伴或不伴尿失禁的常用选择。本综述旨在讨论 BoNT 在成人和儿童膀胱疾病中的临床结果，并介绍除 BoNT/A 之外的新型工程神经毒素的潜在益处。大量证据支持使用肉毒杆菌治疗 OAB（减少尿急、尿频和尿失禁发作）和 NGB（减少尿失禁并改善膀胱容量和逼尿肌压力）。 Botox 现已获得美国食品药品监督管理局 (FDA) 批准用于治疗儿童神经源性逼尿肌过度活动。然而，尿潴留、随时间推移反应减弱以及治疗失败是肉毒杆菌的普遍问题。修饰天然 BoNT 或形成嵌合毒素是 BoNT/A 的替代方案，可能具有更高的功效和更低的副作用。一个例子是 BoNT/Bmy-ww。这种新型工程毒素与更常见表达的突触结合蛋白受体结合，具有潜在更有效的麻痹作用和更低的全身扩散能力。新型工程神经毒素可能是 OAB 和 NGB 治疗的下一个前沿领域。
Botulinum neurotoxin A (BoNT/A), or Botox, is a popular option for overactive bladder (OAB) and neurogenic bladder (NGB) with or without incontinence. This review aims to discuss the clinical outcomes of BoNT in adult and pediatric bladder conditions, and introduces the potential benefit of novel, engineered neurotoxins beyond BoNT/A. A large volume of evidence supports the use of Botox for OAB (to reduce urgency, frequency and incontinence episodes), and for NGB (to decrease incontinence and improve bladder capacity and detrusor pressures). Botox is now also Food & Drug Administration (FDA)-approved for pediatric neurogenic detrusor overactivity. However, urinary retention, diminished response over time and treatment failures are prevalent issues with Botox. Modifying natural BoNTs or forming chimeric toxins are alternatives to BoNT/A that may have higher efficacy and lower side-effect profile. One example is BoNT/Bmy-ww. This novel engineered toxin binds to a more commonly expressed synaptotagmin receptor, with potentially more potent paralytic effect and less capacity for systemic diffusion. Novel engineered neurotoxins may be the next frontier in OAB and NGB therapy.
影响因子：
1.8
作者：
Mühlstädt S;Mischner S;Kranz J;Anheuser P;Mohammed N;Steffens JA;Fornara P
通讯作者：
Fornara P