Temporal characteristics of botulinum neurotoxin therapy

Abstract

Botulinum neurotoxin is a pharmaceutical treatment used for an increasing number of neurological and non-neurological indications, symptoms and diseases. Despite the wealth of clinical reports that involve the timing of the therapeutic effects of this toxin, few studies have attempted to integrate these data into unified models. Secondary reactions have also been examined including the development of adverse events, resistance to repeated applications, and nerve terminal sprouting. Our primary intent for conducting this review was to gather relevant pharmacodynamic data from suitable biomedical literature regarding botulinum neurotoxins via the use of automated data-mining techniques. We envision that mathematical models will ultimately be of value to those who are healthcare decision makers and providers, as well as clinical and basic researchers. Furthermore, we hypothesize that the combination of this computer-intensive approach with mathematical modeling will predict the percentage of patients who will favorably or adversely respond to this treatment and thus will eventually assist in developing the increasingly important area of personalized medicine.

Keywords::

• antigenicity
• decay
• diffusion
• duration
• immunogenicity
• onset
• persistence
• spread
• waning

Acknowledgements

The authors would like to thank the anonymous reviewers for their constructive critiques and insights that significantly contributed to this manuscript. Some of the references cited in this paper were obtained electronically from the National Library of Medicine, the Uniform Services University of the Health Sciences and the Sheridan Libraries at Johns Hopkins University.

Financial & competing interests disclosure

This work was supported by the Defense Threat Reduction Agency Joint Science and Technology Office-Chemical Biological Defense [project 3.10043–07-RD-B] to Frank J Lebeda; and by the National Cancer Institute, National Institutes of Health, under contract No. HHSN261200800001E. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the US Army. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.