Mechanisms of Botulinum Toxin Type A Action on Pain

• Main Authors: Ivica Matak, Kata Bölcskei, Lidija Bach-Rojecky, Zsuzsanna Helyes
• Format: Article
• Language: English
• Published: MDPI AG 2019-08-01
• Series: Toxins
• Subjects: botulinum toxin type A; pain therapy; migraine; neuropathic pain; mechanism of action
• Online Access: https://www.mdpi.com/2072-6651/11/8/459

Already a well-established treatment for different autonomic and movement disorders, the use of botulinum toxin type A (BoNT/A) in pain conditions is now continuously expanding. Currently, the only approved use of BoNT/A in relation to pain is the treatment of chronic migraines. However, controlled clinical studies show promising results in neuropathic and other chronic pain disorders. In comparison with other conventional and non-conventional analgesic drugs, the greatest advantages of BoNT/A use are its sustained effect after a single application and its safety. Its efficacy in certain therapy-resistant pain conditions is of special importance. Novel results in recent years has led to a better understanding of its actions, although further experimental and clinical research is warranted. Here, we summarize the effects contributing to these advantageous properties of BoNT/A in pain therapy, specific actions along the nociceptive pathway, consequences of its central activities, the molecular mechanisms of actions in neurons, and general pharmacokinetic parameters.