The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Smirnov V.V.

Institute of Immunology;
Sechenov First Moscow State Medical University (Sechenov University)

Turenko V.N.

Institute of Immunology;
Sechenov First Moscow State Medical University (Sechenov University)

Bagaev D.E.

Institute of Immunology;
Sechenov First Moscow State Medical University (Sechenov University)

Temnova V.V.

Institute of Immunology

Khodzhava M.V.

Institute of Immunology

Immunogenicity of botulinum toxin products: the emergence of resistance and ways to overcome it

Authors:

Smirnov V.V., Turenko V.N., Bagaev D.E., Temnova V.V., Khodzhava M.V.

More about the authors

Journal: Plastic Surgery and Aesthetic Medicine. 2025;(1): 125‑134

Read: 2457 times


To cite this article:

Smirnov VV, Turenko VN, Bagaev DE, Temnova VV, Khodzhava MV. Immunogenicity of botulinum toxin products: the emergence of resistance and ways to overcome it. Plastic Surgery and Aesthetic Medicine. 2025;(1):125‑134. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia2025011125

Recommended articles:
Evaluation of the immu­nogenecity of a complex of reco­mbinant Brucella proteins in vitro. Mole­cular Gene­tics, Microbiology and Viro­logy. 2024;(4):30-36

References:

  1. Scott AB. Botulinum Toxin Injection into Extraocular Muscles as an Alternative to Strabismus Surgery. Ophthalmology. 1980;87(10):1044-1049. https://doi.org/10.1016/S0161-6420(80)35127-0
  2. Palazón-García R, Benavente-Valdepeñas AM. Botulinum toxin: From poison to possible treatment for spasticity in spinal cord injury. International Journal of Molecular Sciences. 2021;22(9):4886. https://doi.org/10.3390/ijms22094886
  3. Friedman O, Singolda R, Mehrabi JN, Artzi O, Boggio RF, Bento AM. Current use of botulinum neurotoxin in esthetic practice — Clinical guide and review. Journal of Cosmetic Dermatology. 2021;20(6):1648-1654. https://doi.org/10.1111/jocd.14152
  4. Choudhury S, Baker MR, Chatterjee S, Kumar H. Botulinum toxin: an update on pharmacology and newer products in development. Toxins. 2021; 13(1):58.  https://doi.org/10.3390/toxins13010058
  5. Rohrich RJ, Janis JE, Fagien S, Stuzin JM. The cosmetic use of botulinum toxin. Plastic and Reconstructive Surgery. 2003;112(Suppl):177S-188S. https://doi.org/10.1097/01.PRS.0000082208.37239.5B
  6. Marques RE, Duarte GS, Rodrigues FB, Castelão M, Ferreira J, Sampaio C, Moore AP, Costa J. Botulinum toxin type B for cervical dystonia. The Cochrane Database of Systematic Reviews. 2016(5):CD004315. https://doi.org/10.1002/14651858.CD004315.pub3
  7. Eleopra R, Tugnoli V, Quatrale R, Rossetto O, Montecucco C. Different types of botulinum toxin in humans. Movement Disorders. 2004;19(S8): S53-S59.  https://doi.org/10.1002/mds.20010
  8. Srinoulprasert Y, Wanitphakdeedecha R. Antibody‐induced botulinum toxin treatment failure: A review and novel management approach. Journal of Cosmetic Dermatology. 2020;19(10):2491-2496. https://doi.org/10.1111/jocd.13637
  9. Sethu S, Govindappa K, Alhaidari M, Pirmohamed M, Park K, Sathish J. Immunogenicity to Biologics: Mechanisms, Prediction and Reduction. Archivum Immunologiae Et Therapiae Experimentalis. 2012;60(5):331-344.  https://doi.org/10.1007/s00005-012-0189-7
  10. Nechansky A, Kircheis R. Immunogenicity of therapeutics: a matter of efficacy and safety. Expert Opinion on Drug Discovery. 2010;5(11):1067-1079. https://doi.org/10.1517/17460441.2010.514326
  11. Bryson CJ, Jones TD, Baker MP. Prediction of immunogenicity of therapeutic proteins. BioDrugs. 2010;24(1):1-8.  https://doi.org/10.2165/11318560-000000000-00000
  12. Batista FD, Harwood NE. The who, how and where of antigen presentation to B cells. Nature Reviews Immunology. 2008;9(1):15-27.  https://doi.org/10.1038/nri2454
  13. Harnett MM. B cells spread and gather. Science. 2006;312(5774):709-710.  https://doi.org/10.1126/science.1127652
  14. Vaisman-Mentesh A, Gutierrez-Gonzalez M, DeKosky BJ, Wine Y. The molecular mechanisms that underlie the immune biology of anti-drug antibody formation following treatment with monoclonal antibodies. Frontiers in Immunology. 2020;11:01951. https://doi.org/10.3389/fimmu.2020.01951
  15. Schellekens H. Factors influencing the immunogenicity of therapeutic proteins. Nephrology Dialysis Transplantation. 2005;20(Suppl 6):vi3-vi9.  https://doi.org/10.1093/ndt/gfh1092
  16. Rho NK, Gil YC. Botulinum neurotoxin type A in the treatment of facial seborrhea and acne: Evidence and a proposed mechanism. Toxins. 2021; 13(11):817.  https://doi.org/10.3390/toxins13110817
  17. Freeman MD, Margulies IG, Sanati-Mehrizy P, Burish N, Taub PJ. Nonaesthetic applications for botulinum toxin in plastic surgery. Plastic and Reconstructive Surgery. 2020;146(1):157-170.  https://doi.org/10.1097/PRS.0000000000006908
  18. Mittal SO, Lenka A, Jankovic J. Botulinum toxin for the treatment of tremor. Parkinsonism and Related Disorders. 2019;63:31-41.  https://doi.org/10.1016/j.parkreldis.2019.01.023
  19. Wang YF. OnabotulinumtoxinA injection in the treatment of chronic migraine. Progress in Brain Research. 2020;255:171-206.  https://doi.org/10.1016/bs.pbr.2020.05.013
  20. Schulze J, Neumann I, Magid M, Finzi E, Sinke C, Wollmer MA, Krüger THC. Botulinum toxin for the management of depression: An updated review of the evidence and meta-analysis. Journal of Psychiatric Research. 2021;135:332-340.  https://doi.org/10.1016/j.jpsychires.2021.01.016
  21. Dan Spinu A, Gabriel Bratu O, Cristina Diaconu C, Maria Alexandra Stanescu A, Bungau S, Fratila O, Bohiltea R, Liviu Dorel Mischianu D. Botulinum toxin in low urinary tract disorders over 30 years of practice (Review). Experimental and Therapeutic Medicine. 2020;20(1):117-120.  https://doi.org/10.3892/etm.2020.8664
  22. Viticchi G, Falsetti L, Salvemini S, Bartolini M, Paolucci S, Buratti L, Silvestrini M. Efficacy of Onabotulinum Toxin A on Obsessive-Compulsive Traits in a Population of Chronic Migraine Patients. Brain Sciences. 2022; 12(11):1563. https://doi.org/10.3390/brainsci12111563
  23. Samizadeh S, De Boulle K. Botulinum neurotoxin formulations: overcoming the confusion. Clinical Cosmetic and Investigational Dermatology. 2018; 11:273-287.  https://doi.org/10.2147/CCID.S156851
  24. Dressler D, Pan L, Su J, Teng F, Jin L. Lantox — The Chinese Botulinum Toxin Drug — Complete English Bibliography and comprehensive formalised Literature review. Toxins. 2021;13(6):370.  https://doi.org/10.3390/toxins13060370
  25. Khatkova SE, Orlova OR, Pokhabov DV, Diaghileva VP, Novikov SA, Pogoreltseva OA, Shevchenko VS, Nikolaev EA. Safety and efficacy of Relatox in the treatment of patients with cervical dystonia (results of a multicenter simple blind comparative randomized study). S.S. Korsakov Journal of Neurology and Psychiatry. 2022;122(11):80-85. (In Russ.). https://doi.org/10.17116/jnevro202212211180
  26. Artemenko AR, Abramov VG. Botulinum toxin type A (Relatox) in the treatment of chronic migraine in adults: results of phase IIIb, randomized, one-blind, multicenter, active-controlled, parallel-group trial. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(5):89-99. (In Russ.). https://doi.org/10.17116/jnevro202312305189
  27. Novik TS, Koveshnikova EI, Kurochkina KG, Chukina SI. Investigation of general toxic effects of Relatox in comparison with Dysport. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(12):75-78. (In Russ.). https://doi.org/10.17116/jnevro202412412175
  28. Khatkova SE, Pogoreltseva OA, Orlova OR, Konovalova ZN, Yakovleva PN, Zakharov DV, Korenko AN, Krasavina DA, Kostenko EV, Abramov VG, Dudin VA, Novikov SA. Safety and efficacy of Relatox in comparison with Dysport in the treatment of focal spasticity of the upper limb in patients after stroke and traumatic brain injury (results of a prospective simple blind randomized comparative study in parallel groups). S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(12):79-85. (In Russ.). https://doi.org/10.17116/jnevro202412412179
  29. Dressler D, Bigalke H. Immunological aspects of botulinum toxin therapy. Expert Review of Neurotherapeutics. 2016;17(5):487-494.  https://doi.org/10.1080/14737175.2017.1262258
  30. Frevert N, Dressler N. Complexing proteins in botulinum toxin type A drugs: a help or a hindrance? Biologics. 2010;4:325-332.  https://doi.org/10.2147/btt.s14902
  31. Bellows S, Jankovic J. Immunogenicity Associated with Botulinum Toxin Treatment. Toxins. 2019;11(9):491.  https://doi.org/10.3390/toxins11090491
  32. Do KH, Chun MH, Paik NJ, Park YG, Lee SU, Kim MW, Kim DK. Safety and efficacy of letibotulinumtoxinA(BOTULAX) in treatment of post stroke upper limb spasticity: a randomized, double blind, multi-center, phase III clinical trial. Clinical Rehabilitation. 2017;31(9):1179-1188. https://doi.org/10.1177/0269215516689331
  33. Raytseva SS. Polimodal injection approach to managing patients with structural changes in the face within an integral therapeutic strategy. Metamorfozy. 2018;22:70-90. (In. Russ.).
  34. Patent RF na izobretenie № RU 2292910 C2/10.02.07. Zainullin RR, Melnikov NV, Zagidullin NV, Alsynbaev MM, Khaziev AF, Nigamov FN. Sposob polucheniya miorelaksantnogo lekarstvennogo sredstva dlya lecheniya myshechnykh distonij. (In Russ.). Accessed November 18, 2024. https://patents.google.com/patent/RU2292910C2/ru
  35. Frevert J, Ahn KY, Park MY, Sunga O. Comparison of botulinum neurotoxin type A formulations in Asia. Clinical Cosmetic and Investigational Dermatology. 2018;11:327-331.  https://doi.org/10.2147/CCID.S160723
  36. Khaziev AF. Neuroproteins. Arguments and Facts. In”ektsionnye metody v kosmetologii. 2019;2:48-53. (In Russ.).
  37. Dressler D, Bigalke H, Frevert J. The immunology of botulinum toxin therapy: A brief summary. Toxicology. 2022;481:153341. https://doi.org/10.1016/J.TOX.2022.153341
  38. Tian R, Widel M, Imanian B. The Light Chain Domain and Especially the C-Terminus of Receptor-Binding Domain of the Botulinum Neurotoxin (BoNT) Are the Hotspots for Amino Acid Variability and Toxin Type Diversity. Genes. 2022;13(10):1915. https://doi.org/10.3390/genes13101915
  39. Avtomonov VYu, Razumovskaya EA. Botulinum toxins in cosmetology: clarifications. Russian Journal of Clinical Dermatology and Venereology. 2021; 20(4):135-144. (In Russ.). https://doi.org/10.17116/klinderma202120041135
  40. Mathevon L, Declemy A, Laffont I, Perennou D. Immunogenicity induced by botulinum toxin injections for limb spasticity: A systematic review. Annals of Physical and Rehabilitation Medicine. 2019;62(4):241-251.  https://doi.org/10.1016/j.rehab.2019.03.004
  41. Rosen O, Ozeri E, Barnea A, David AB, Zichel R. Development of an Innovative in Vitro Potency Assay for Anti-Botulinum Antitoxins. Toxins. 2016; 8(10):276.  https://doi.org/10.3390/toxins8100276
  42. Dressler D, Johnson EA. Botulinum toxin therapy: past, present and future developments. Journal of Neural Transmission. 2022;129(5-6):829-833.  https://doi.org/10.1007/s00702-022-02494-5
  43. Park JY, Corduff N, Frevert J, Wanitphakdeedecha R, Chao YYY. Immunogenicity Associated with Aesthetic Botulinumtoxin A: A Survey of Asia-Pacific Physicians’ Experiences and Recommendations. Plastic and Reconstructive Surgery Global Open. 2022;10(4):e4217. https://doi.org/10.1097/GOX.0000000000004217
  44. Srinoulprasert Y, Kantaviro W, Nokdhes YN, Patthamalai P, Dowdon L, Chawengkiattikul R, Wanitphakdeedecha R. Development of inhibition ELISA to detect antibody-induced failure of botulinum toxin a therapy in cosmetic indications. Journal of Immunological Methods. 2019;473:112635. https://doi.org/10.1016/j.jim.2019.112635
  45. Korolkova TN, Matytsin VO, Ivanov AM, Dovbeshko TG. Role of antibody production in the formation of resistance to botulotoxin a drugs. Rossijskij zhurnal kozhnykh i venericheskikh boleznej. 2013;(16)6:43-47. (In Russ.). https://doi.org/10.17816/dv36859
  46. Simpson L. The life history of a botulinum toxin molecule. Toxicon. 2013; 68:40-59.  https://doi.org/10.1016/j.toxicon.2013.02.014
  47. Wee SY, Park ES. Immunogenicity of botulinum toxin. Archives of Plastic Surgery. 2022;49(1):12-18.  https://doi.org/10.5999/aps.2021.00766
  48. Sedova ES, Pervoykina KA, Shcherbinin DN, Shmarov MM. Genetic constructs performing adjuvant functions in adenoviral vector-based vaccines. Immunologiya. 2022;43(1):5-17. (In Russ.). https://doi.org/10.33029/0206-4952-2021-42-6-5-17
  49. Khaitov RM. Immunomodulators: myths and reality. Immunologiya. 2020; 41(2):101-106. (In Russ.). https://doi.org/10.33029/0206-4952-2020-41-2-101-106
  50. Kukreja R, Chang TW, Cai S, Lindo P, Riding S, Zhou Y, Ravichandran E, Singh BR. Immunological characterization of the subunits of type A botulinum neurotoxin and different components of its associated proteins. Toxicon. 2009;53(6):616-624.  https://doi.org/10.1016/j.toxicon.2009.01.017
  51. Orlova OR, Timerbaeva SL, Khat’kova SE, Kostenko EV, Krasavina DA, Zakharov DV. Conversion ratio between different botulinum neuroprotein product in neurological practice. S.S. Korsakov Journal of Neurology and Psychiatry. 2017;117(9):132-141. (In Russ.). https://doi.org/10.17116/jnevro201711791132-141
  52. Avelar R. Botulinum toxin accessory proteins: Are they just an accessory? Dermatologic Surgery. 2024;50(9S):S38-S41.  https://doi.org/10.1097/DSS.0000000000004284
  53. Park JY, Sunga O, Wanitphakdeedecha R, Frevert J. Neurotoxin impurities: A review of Threats to efficacy. Plastic and Reconstructive Surgery Global Open. 2020;8(1):e2627. https://doi.org/10.1097/GOX.0000000000002627
  54. Frevert J. Content of botulinum neurotoxin in Botox/Vistabel, Dysport/Azzalure, and Xeomin/Bocouture. Drugs in R&D. 2010;10(2):67-73.  https://doi.org/10.2165/11584780-000000000-00000
  55. Nestor MS, Arnold D, Fischer D. The mechanisms of action and use of botulinum neurotoxin type A in aesthetics: Key Clinical Postulates II. Journal of Cosmetic Dermatology. 2020;19(11):2785-2804. https://doi.org/10.1111/jocd.13702
  56. Field M, Splevins A, Picaut P, Van der Schans M, Langenberg J, Noort D, Foster K. AbobotulinumtoxinA (Dysport), OnabotulinumtoxinA (Botox), and IncobotulinumtoxinA (Xeomin) Neurotoxin Content and Potential Implications for Duration of Response in Patients. Toxins. 2018;10(12):535.  https://doi.org/10.3390/toxins10120535
  57. Kutschenko A, Bigalke H, Wegner F, Wohlfarth K. The role of human serum albumin and neurotoxin associated proteins in the formulation of BoNT/A products. Toxicon. 2019;168:158-163.  https://doi.org/10.1016/j.toxicon.2019.07.005
  58. Han Y, Jin BS, Lee SB, Sohn Y, Joung JW, Lee JH. Effects of sugar additives on protein stability of recombinant human serum albumin during lyophilization and storage. Archives of Pharmacal Research. 2007;30(9): 1124-1131. https://doi.org/10.1007/BF02980247
  59. Anhorn MG, Mahler HC, Langer K. Freeze drying of human serum albumin (HSA) nanoparticles with different excipients. International Journal of Pharmaceutics. 2008;363(1-2):162-169.  https://doi.org/10.1016/j.ijpharm.2008.07.004
  60. Hou M, Wang X, Yue O, Zheng M, Zhang H, Liu X. Development of a multifunctional injectable temperature-sensitive gelatin-based adhesive double-network hydrogel. Biomaterials Advances. 2021;134:112556. https://doi.org/10.1016/j.msec.2021.112556
  61. Zhao X, Li X, Zhao Y, Cheng Y, Yang Y, Fang Z, Xie Y, Liu Y, Chen Y, Ouyang Y, Yuan W. Immune activities of polycationic vectors for gene delivery. Frontiers in Pharmacology. 2017;8:510.  https://doi.org/10.3389/fphar.2017.00510
  62. Dong Z. Progress of gelatin-based microspheres (GMSs) as delivery vehicles of drug and cell. Materials Science and Engineering. C, Materials for Biological Applications. 2021;122:111949. https://doi.org/10.1016/j.msec.2021.111949
  63. Su K, Wang C. Recent advances in the use of gelatin in biomedical research. Biotechnology Letters. 2015;37(11):2139-2145. https://doi.org/10.1007/s10529-015-1907-0
  64. Dashtipour K, Pedouim F. Botulinum toxin: preparations for clinical use, immunogenicity, side effects, and safety profile. Seminars in Neurology. 2016;36(01):029-033.  https://doi.org/10.1055/s-0035-1571213
  65. Hefter H, Schomaecker I, Schomaecker M, Rosenthal D, Samadzadeh S. The Use of High Initial Doses of Botulinum Toxin Therapy for Cervical Dystonia Is a Risk Factor for Neutralizing Antibody Formation — A Monocentric Cross-Sectional Pilot Study. Medicina. 2022; 58(1):88.  https://doi.org/10.3390/medicina58010088
  66. Carr WW, Jain N, Sublett JW. Immunogenicity of botulinum toxin formulations: potential therapeutic implications. Advances in Therapy. 2021;38(10): 5046-5064. https://doi.org/10.1007/s12325-021-01882-9
  67. Frevert J, Dressler D. Clinical relevance of immunoresistance to botulinum therapy. In: Botulinum Toxin Therapy Manual for Dystonia and Spasticity. InTech; 2016. https://doi.org/10.5772/64566
  68. Rahman E, Carruthers JDA. Immunogenicity of Botulinum Toxin A: Insights. Dermatologic Surgery. 2024;50(9S):S117-S126. https://doi.org/10.1097/DSS.0000000000004293
  69. Hamed Azzam S, Mukari A, Hamed M, Kridin K. Influence of COVID-19 mRNA vaccination on the efficacy and safety of Botulinum toxin type A injections. Journal of Cosmetic Dermatology. 2022;21(9):3663-3666. https://doi.org/10.1111/jocd.15251
  70. Dressler D, Saberi FA. Safety of botulinum toxin short interval therapy using incobotulinumtoxin A. Journal of Neural Transmission. 2017;124(4): 437-440.  https://doi.org/10.1007/s00702-016-1628-0
  71. Dessy LA, Fallico N, Mazzocchi M, Scuderi N. Botulinum toxin for glabellar lines. American Journal of Clinical Dermatology. 2011:12(6):377-388.  https://doi.org/10.2165/11592100-000000000-00000
  72. Foster K, Beard M. Comments on immunogenicity associated with botulinum toxin treatment. Toxins. 2020;12(2):71.  https://doi.org/10.3390/toxins12020071
  73. Rahman E, Alhitmi HK, Mosahebi A. Immunogenicity to botulinum toxin type A: A systematic review with meta-analysis across therapeutic indications. Oxford University Press. 2022;42(1):106-120.  https://doi.org/10.1093/asj/sjab058
  74. Fabbri M, Leodori G, Fernandes RM, Bhidayasiri R, Marti MJ, Colosimo C, Ferreira JJ. Neutralizing Antibody and Botulinum Toxin therapy: A Systematic review and meta-analysis. Neurotoxicity Research. 2015;29(1):105-117.  https://doi.org/10.1007/s12640-015-9565-5
  75. Hefter H, Rosenthal D, Moll M. High botulinum Toxin‐Neutralizing antibody prevalence under Long‐Term cervical Dystonia treatment. Movement Disorders Clinical Practice. 2016;3(5):500-506.  https://doi.org/10.1002/mdc3.12322
  76. Naumann M, Boo LM, Ackerman AH, Gallagher CJ. Immunogenicity of botulinum toxins. Journal of Neural Transmission. 2012;120(2):275-290.  https://doi.org/10.1007/s00702-012-0893-9
  77. Hefter H, Rosenthal D, Bigalke H, Moll M. Clinical relevance of neutralizing antibodies in botulinum toxin long-term treated still-responding patients with cervical dystonia. Therapeutic Advances in Neurological Disorders. 2019;12:175628641989207. https://doi.org/10.1177/1756286419892078
  78. Stephan F, Habre M, Tomb R. Clinical resistance to three types of botulinum toxin type A in aesthetic medicine. Journal of Cosmetic Dermatology. 2014;13(4):346-348.  https://doi.org/10.1111/jocd.12108
  79. Dover JS, Monheit G, Greener M, Pickett A. Botulinum toxin in aesthetic Medicine: myths and realities. Dermatologic Surgery. 2017;44(2):249-260.  https://doi.org/10.1097/DSS.0000000000001277
  80. Rho NK, Han KH, Kim HS. An Update on the Cosmetic Use of Botulinum Toxin: The Pattern of Practice among Korean Dermatologists. Toxins. 2022;14(5):329.  https://doi.org/10.3390/toxins14050329
  81. Ho WWS, Albrecht P, Calderon PE, Corduff N, Loh D, Martin MU, Park JY, Suseno LS, Tseng FW, Vachiramon V, Wanitphakdeedecha R, Won CH, Yu JNT, Dingley M. Emerging trends in Botulinum Neurotoxin A Resistance: An international multidisciplinary review and consensus. Plastic and Reconstructive Surgery Global Open. 2022;10(6):E4407. https://doi.org/10.1097/GOX.0000000000004407
  82. Kwolek M, Block JE. Maximizing botulinum toxin injections for cosmetic and therapeutic applications with a single use, disposable, exact dose injection assist device. Clinical Cosmetic and Investigational Dermatology. 2019; 12:35-46.  https://doi.org/10.2147/CCID.S189595
  83. Ali S, Al Bukhari F, Al Nuaimi K, Elenany H, Fakih-Gomez N, Ghannam S, Haidar R, Isse N, Labib N, Mosahebi A, Ravichandran S, Turkmani MG, Youssef C. Consensus statement on the use of botulinum neurotoxin in the Middle East. Clinical Cosmetic and Investigational Dermatology. 2023;16:2899-2909. https://doi.org/10.2147/CCID.S420921
  84. Wanitphakdeedecha R, Kantaviro W, Suphatsathienkul P, Tantrapornpong P, Yan C, Apinumtham C, Srinoulprasert Y. Association between secondary botulinum toxin a treatment failure in cosmetic indication and Anti-Complexing protein antibody production. Dermatology and Therapy. 2020; 10(4):707-720.  https://doi.org/10.6084/m9.figshare.12287270
  85. Dressler D, Saberi FA, Bigalke H. IncobotulinumtoxinA (Xeomin) can produce antibody-induced therapy failure in a patient pretreated with abobotulinumtoxinA (Dysport). Journal of Neural Transmission. 2014;121(7):769-771.  https://doi.org/10.1007/s00702-014-1165-7
  86. Kamm C, Schümann F, Mix E, Benecke R. Secondary antibody-induced treatment failure under therapy with incobotulinumtoxinA (Xeomin) in a patient with segmental dystonia pretreated with abobotulinumtoxinA (Dysport). Journal of the Neurological Sciences. 2015;350(1-2):110-111.  https://doi.org/10.1016/j.jns.2015.01.032
  87. Walter U, Mühlenhoff C, Benecke R, Dressler D, Mix E, Alt J, Wittstock M, Dudesek A, Storch A, Kamm C. Frequency and risk factors of antibody-induced secondary failure of botulinum neurotoxin therapy. Neurology. 2020;94(20):e2109-e2120. https://doi.org/10.1212/WNL.0000000000009444
  88. Park MY, Ahn KY. Scientific review of the aesthetic uses of botulinum toxin type A. Archives of Craniofacial Surgery. 2021;22(1):1-10.  https://doi.org/10.7181/acfs.2021.00003
  89. Atassi MZ. Molecular basis of immunogenicity to botulinum neurotoxins and uses of the defined antigenic regions. Toxicon. 2015;107:50-58.  https://doi.org/10.1016/j.toxicon.2015.06.003

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.