Botulinum Toxin and Neuronal Regeneration after Traumatic Injury of Central and Peripheral Nervous System

Toxins (Basel). 2020 Jul 2;12(7):434. doi: 10.3390/toxins12070434.

Abstract

Botulinum neurotoxins (BoNTs) are toxins produced by the bacteria Clostridiumbotulinum, the causing agent for botulism, in different serotypes, seven of which (A-G) are well characterized, while others, such as H or FA, are still debated. BoNTs exert their action by blocking SNARE (soluble N-ethylmale-imide-sensitive factor-attachment protein receptors) complex formation and vesicle release from the neuronal terminal through the specific cleavage of SNARE proteins. The action of BoNTs at the neuromuscular junction has been extensively investigated and knowledge gained in this field has set the foundation for the use of these toxins in a variety of human pathologies characterized by excessive muscle contractions. In parallel, BoNTs became a cosmetic drug due to its power to ward off facial wrinkles following the activity of the mimic muscles. Successively, BoNTs became therapeutic agents that have proven to be successful in the treatment of different neurological disorders, with new indications emerging or being approved each year. In particular, BoNT/A became the treatment of excellence not only for muscle hyperactivity conditions, such as dystonia and spasticity, but also to reduce pain in a series of painful states, such as neuropathic pain, lumbar and myofascial pain, and to treat various dysfunctions of the urinary bladder. This review summarizes recent experimental findings on the potential efficacy of BoNTs in favoring nerve regeneration after traumatic injury in the peripheral nervous system, such as the injury of peripheral nerves, like sciatic nerve, and in the central nervous system, such as spinal cord injury.

Keywords: botulinum neurotoxin; central nervous system; nerve regeneration; peripheral nerve injury; peripheral nervous system; spinal cord injury.

Publication types

  • Review

MeSH terms

  • Animals
  • Botulinum Toxins / adverse effects
  • Botulinum Toxins / therapeutic use*
  • Brain Injuries / drug therapy*
  • Brain Injuries / pathology
  • Brain Injuries / physiopathology
  • Central Nervous System Agents / adverse effects
  • Central Nervous System Agents / therapeutic use*
  • Humans
  • Nerve Regeneration / drug effects*
  • Peripheral Nerve Injuries / drug therapy*
  • Peripheral Nerve Injuries / pathology
  • Peripheral Nerve Injuries / physiopathology
  • Peripheral Nervous System Agents / adverse effects
  • Peripheral Nervous System Agents / therapeutic use*
  • Recovery of Function
  • Spinal Cord Injuries / drug therapy*
  • Spinal Cord Injuries / pathology
  • Spinal Cord Injuries / physiopathology
  • Spinal Cord Regeneration / drug effects

Substances

  • Central Nervous System Agents
  • Peripheral Nervous System Agents
  • Botulinum Toxins