Effect of Botulinum Toxin A on Bladder Pain-Molecular Evidence and Animal Studies

Botulinum toxin A (BTX-A) is a powerful neurotoxin with long-lasting activity that blocks muscle contractions. In addition to effects on neuromuscular junctions, BTX-A also plays a role in sensory feedback loops, suggesting the potentiality for pain relief. Although the only approved indications for...

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Bibliographic Details
Published in:Toxins 2020-02, Vol.12 (2), p.98
Main Authors: Yeh, Ting-Chun, Chen, Po-Cheng, Su, Yann-Rong, Kuo, Hann-Chorng
Format: Article
Language:English
Subjects:
Analgesics - pharmacology
Analgesics - therapeutic use
Animals
Anti-Inflammatory Agents - pharmacology
Anti-Inflammatory Agents - therapeutic use
bladder pain
botulinum toxin a
Botulinum Toxins, Type A - pharmacology
Botulinum Toxins, Type A - therapeutic use
interstitial cystitis
molecular mechanism
Neuromuscular Agents - pharmacology
Neuromuscular Agents - therapeutic use
Pelvic Pain - drug therapy
Pelvic Pain - physiopathology
Review
Urinary Bladder Diseases - drug therapy
Urinary Bladder Diseases - physiopathology
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Summary:Botulinum toxin A (BTX-A) is a powerful neurotoxin with long-lasting activity that blocks muscle contractions. In addition to effects on neuromuscular junctions, BTX-A also plays a role in sensory feedback loops, suggesting the potentiality for pain relief. Although the only approved indications for BTX-A in the bladder are neurogenic detrusor overactivity and refractory overactive bladder, BTX-A injections to treat bladder pain refractory to conventional therapies are also recommended. The mechanism of BTX-A activity in bladder pain is complex, with several hypotheses proposed in recent studies. Here we comprehensively reviewed properties of BTX-A in peripheral afferent and efferent nerves, the inhibition of nociceptive neurotransmitter release, the reduction of stretch-related visceral pain, and its anti-inflammatory effects on the bladder urothelium. Studies have also revealed possible effects of BTX-A in the human brain. However, further basic and clinical studies are warranted to provide solid evidence-based support in using BTX-A to treat bladder pain.
ISSN:2072-6651
2072-6651
DOI:10.3390/toxins12020098