Variability of the immunologic and clinical response in dystonic patients immunoresistant to botulinum toxin injections
Identifieur interne : 004E72 ( Main/Exploration ); précédent : 004E71; suivant : 004E73Variability of the immunologic and clinical response in dystonic patients immunoresistant to botulinum toxin injections
Auteurs : Charulata Sankhla [États-Unis] ; Jankovic [États-Unis] ; Drake Duane [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 1998-01.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Animals, Antibodies, Antibody, Antibody Specificity, Botulinum Toxins (immunology), Botulinum Toxins (therapeutic use), Botulinum Toxins, Type A (immunology), Botulinum Toxins, Type A (therapeutic use), Botulinum toxin, Chemotherapy, Clostridium botulinum, Drug Resistance (immunology), Dystonia, Dystonia (drug therapy), Dystonia (immunology), Female, Human, Humans, Immune resistance, Immunologic Memory, Immunoresistance, Longitudinal Studies, Male, Mice, Middle Aged, Neuromuscular Agents (immunology), Neuromuscular Agents (therapeutic use), Toxin, Treatment, Treatment Outcome.
- MESH :
- chemical , immunology : Botulinum Toxins, Botulinum Toxins, Type A, Neuromuscular Agents.
- chemical , therapeutic use : Botulinum Toxins, Botulinum Toxins, Type A, Neuromuscular Agents.
- drug therapy : Dystonia.
- immunology : Drug Resistance, Dystonia.
- Aged, Aged, 80 and over, Animals, Antibody Specificity, Female, Humans, Immunologic Memory, Longitudinal Studies, Male, Mice, Middle Aged, Treatment Outcome.
Abstract
Immunoresistance (Ab+) to botulinum toxin type A (BTX‐A) has been a serous concern since the introduction of BTX‐A in the treatment of dystonia and other disorders associated with abnormal muscle contractions. We studied seven patients who developed Ab+ and later reverted to antibodynegative (Ab‐) status. These seven patients, six women (mean age, 56 years; range, 41–80 years), with an average duration of dystonia for all patients of 197 months (range, 84–360 months), received a total mean cumulative dose of 1659 units (U) (range,810‐1975 U), with an average dose of 207 U per visit. All of these patients became unresponsive to BTX‐A treatment and became Ab+ as determined by mouse bioassay. Their response to BTX‐A after they revertedd to Ab‐ was analyzed. The average latency between the initial BTX‐A treatment and development of Ab+ was 27 months (range, 15–43 months). The average duration between the detection of Ab+ status and subsequent reversal to Ab‐ status was 30 months (range, 10–78 months). Six of these Ab‐ patients were reinjected with BTX‐A, and all six benefited from repeat injections comparable with their earlier response. Three patients lost their clinical response to subsequent injections and were found to be again Ab+. Two of the five patients who became immunoresistant to BTX‐A received botulinum toxin type F (BTX‐F) injections and one patient received a single session of BTX‐B with improvement in their symptoms. In conclusion, this unique group of patients who were Ab+ and became Ab‐ responded favorably to repeat BTX‐A injections, but some lost the benefit with subsequent injections. These observations suggest that the anamnestic immunologic response to BTX‐A can wane, but can be reactivated by repeat BTX‐A treatments. The presence of antibodies did not interfere with the response to BTX‐F or BTX‐B injections, thus confirming the antigenic specificity of various BTX serotypes.
Url:
DOI: 10.1002/mds.870130128
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Istex, to step Corpus: 001656
- to stream Istex, to step Curation: 001656
- to stream Istex, to step Checkpoint: 003607
- to stream PubMed, to step Corpus: 004502
- to stream PubMed, to step Curation: 004502
- to stream PubMed, to step Checkpoint: 004302
- to stream Ncbi, to step Merge: 004E83
- to stream Ncbi, to step Curation: 004E83
- to stream Ncbi, to step Checkpoint: 004E83
- to stream Main, to step Merge: 007D84
- to stream PascalFrancis, to step Corpus: 003082
- to stream PascalFrancis, to step Curation: 003742
- to stream PascalFrancis, to step Checkpoint: 002E97
- to stream Main, to step Merge: 008021
- to stream Main, to step Curation: 004E72
Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Variability of the immunologic and clinical response in dystonic patients immunoresistant to botulinum toxin injections</title><author><name sortKey="Sankhla, Charulata" sort="Sankhla, Charulata" uniqKey="Sankhla C" first="Charulata" last="Sankhla">Charulata Sankhla</name></author><author><name sortKey="Jankovic" sort="Jankovic" uniqKey="Jankovic" last="Jankovic">Jankovic</name></author><author><name sortKey="Duane, Drake" sort="Duane, Drake" uniqKey="Duane D" first="Drake" last="Duane">Drake Duane</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:2A510840FC7DD47D04551A97370FB4EE5703473E</idno><date when="1998" year="1998">1998</date><idno type="doi">10.1002/mds.870130128</idno><idno type="url">https://api.istex.fr/document/2A510840FC7DD47D04551A97370FB4EE5703473E/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001656</idno><idno type="wicri:Area/Istex/Curation">001656</idno><idno type="wicri:Area/Istex/Checkpoint">003607</idno><idno type="wicri:doubleKey">0885-3185:1998:Sankhla C:variability:of:the</idno><idno type="wicri:source">PubMed</idno><idno type="RBID">pubmed:9452341</idno><idno type="wicri:Area/PubMed/Corpus">004502</idno><idno type="wicri:Area/PubMed/Curation">004502</idno><idno type="wicri:Area/PubMed/Checkpoint">004302</idno><idno type="wicri:Area/Ncbi/Merge">004E83</idno><idno type="wicri:Area/Ncbi/Curation">004E83</idno><idno type="wicri:Area/Ncbi/Checkpoint">004E83</idno><idno type="wicri:doubleKey">0885-3185:1998:Sankhla C:variability:of:the</idno><idno type="wicri:Area/Main/Merge">007D84</idno><idno type="wicri:source">INIST</idno><idno type="RBID">Pascal:98-0080315</idno><idno type="wicri:Area/PascalFrancis/Corpus">003082</idno><idno type="wicri:Area/PascalFrancis/Curation">003742</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">002E97</idno><idno type="wicri:doubleKey">0885-3185:1998:Sankhla C:variability:of:the</idno><idno type="wicri:Area/Main/Merge">008021</idno><idno type="wicri:Area/Main/Curation">004E72</idno><idno type="wicri:Area/Main/Exploration">004E72</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Variability of the immunologic and clinical response in dystonic patients immunoresistant to botulinum toxin injections</title><author><name sortKey="Sankhla, Charulata" sort="Sankhla, Charulata" uniqKey="Sankhla C" first="Charulata" last="Sankhla">Charulata Sankhla</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Jankovic" sort="Jankovic" uniqKey="Jankovic" last="Jankovic">Jankovic</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Duane, Drake" sort="Duane, Drake" uniqKey="Duane D" first="Drake" last="Duane">Drake Duane</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Arizona Dystonia Institute/Arizona State University, Scottsdale, Arizona</wicri:regionArea><placeName><region type="state">Arizona</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="1998-01">1998-01</date><biblScope unit="vol">13</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="150">150</biblScope><biblScope unit="page" to="154">154</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">2A510840FC7DD47D04551A97370FB4EE5703473E</idno><idno type="DOI">10.1002/mds.870130128</idno><idno type="ArticleID">MDS870130128</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Animals</term><term>Antibodies</term><term>Antibody</term><term>Antibody Specificity</term><term>Botulinum Toxins (immunology)</term><term>Botulinum Toxins (therapeutic use)</term><term>Botulinum Toxins, Type A (immunology)</term><term>Botulinum Toxins, Type A (therapeutic use)</term><term>Botulinum toxin</term><term>Chemotherapy</term><term>Clostridium botulinum</term><term>Drug Resistance (immunology)</term><term>Dystonia</term><term>Dystonia (drug therapy)</term><term>Dystonia (immunology)</term><term>Female</term><term>Human</term><term>Humans</term><term>Immune resistance</term><term>Immunologic Memory</term><term>Immunoresistance</term><term>Longitudinal Studies</term><term>Male</term><term>Mice</term><term>Middle Aged</term><term>Neuromuscular Agents (immunology)</term><term>Neuromuscular Agents (therapeutic use)</term><term>Toxin</term><term>Treatment</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>Botulinum Toxins</term><term>Botulinum Toxins, Type A</term><term>Neuromuscular Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Botulinum Toxins</term><term>Botulinum Toxins, Type A</term><term>Neuromuscular Agents</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Dystonia</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>Drug Resistance</term><term>Dystonia</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Animals</term><term>Antibody Specificity</term><term>Female</term><term>Humans</term><term>Immunologic Memory</term><term>Longitudinal Studies</term><term>Male</term><term>Mice</term><term>Middle Aged</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Anticorps</term><term>Chimiothérapie</term><term>Clostridium botulinum</term><term>Dystonie</term><term>Homme</term><term>Immunorésistance</term><term>Toxine</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Immunoresistance (Ab+) to botulinum toxin type A (BTX‐A) has been a serous concern since the introduction of BTX‐A in the treatment of dystonia and other disorders associated with abnormal muscle contractions. We studied seven patients who developed Ab+ and later reverted to antibodynegative (Ab‐) status. These seven patients, six women (mean age, 56 years; range, 41–80 years), with an average duration of dystonia for all patients of 197 months (range, 84–360 months), received a total mean cumulative dose of 1659 units (U) (range,810‐1975 U), with an average dose of 207 U per visit. All of these patients became unresponsive to BTX‐A treatment and became Ab+ as determined by mouse bioassay. Their response to BTX‐A after they revertedd to Ab‐ was analyzed. The average latency between the initial BTX‐A treatment and development of Ab+ was 27 months (range, 15–43 months). The average duration between the detection of Ab+ status and subsequent reversal to Ab‐ status was 30 months (range, 10–78 months). Six of these Ab‐ patients were reinjected with BTX‐A, and all six benefited from repeat injections comparable with their earlier response. Three patients lost their clinical response to subsequent injections and were found to be again Ab+. Two of the five patients who became immunoresistant to BTX‐A received botulinum toxin type F (BTX‐F) injections and one patient received a single session of BTX‐B with improvement in their symptoms. In conclusion, this unique group of patients who were Ab+ and became Ab‐ responded favorably to repeat BTX‐A injections, but some lost the benefit with subsequent injections. These observations suggest that the anamnestic immunologic response to BTX‐A can wane, but can be reactivated by repeat BTX‐A treatments. The presence of antibodies did not interfere with the response to BTX‐F or BTX‐B injections, thus confirming the antigenic specificity of various BTX serotypes.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Arizona</li><li>Texas</li></region></list><tree><country name="États-Unis"><region name="Texas"><name sortKey="Sankhla, Charulata" sort="Sankhla, Charulata" uniqKey="Sankhla C" first="Charulata" last="Sankhla">Charulata Sankhla</name></region><name sortKey="Duane, Drake" sort="Duane, Drake" uniqKey="Duane D" first="Drake" last="Duane">Drake Duane</name><name sortKey="Jankovic" sort="Jankovic" uniqKey="Jankovic" last="Jankovic">Jankovic</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/MovDisordV3/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 004E72 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 004E72 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Santé
|area= MovDisordV3
|flux= Main
|étape= Exploration
|type= RBID
|clé= ISTEX:2A510840FC7DD47D04551A97370FB4EE5703473E
|texte= Variability of the immunologic and clinical response in dystonic patients immunoresistant to botulinum toxin injections
}}
| This area was generated with Dilib version V0.6.23. |  |