Intragastric Injection of Botulinum Toxin A for the Treatment of Obesity
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Botulinum toxin A (BTX-A) is a powerful and long-acting inhibitor of muscular contractions in both striated and smooth muscles. Hypothetically, BTX-A should inhibit the acetylcholine-mediated peristalsis, which is mainly responsible for gastric motility, and thereby induce slowed gastric emptying, earlier satiety and weight loss. The aim of this study was to observe the effects of endoscopic intragastric injections of BTX-A in obese patients.
After approval by the University Ethics Committee, 10 female patients with class I obesity (body mass index 30–35) were double-blind randomized into 2 groups (BTX-A and 0.9% Saline). In Group 1, 200 U BTX-A were injected endoscopically into the antrum and the distal gastric body. In Group 2, 0.9% saline was injected endoscopically into the antrum and the distal gastric body. Body weight and feeling of satiety were recorded monthly over a period of 6 months.
Both groups (BTX-A and 0.9% Saline) showed no significant weight reduction (P > 0.05). One patient in Group 1 and two patients in Group 2 reported a feeling of early satiety. No adverse effects related to BTX-A or complications resulting from the endoscopic procedure were observed.
Intragastric injection of BTX-A for the treatment of obesity does not seem to reduce body weight.
- Kopelman, PG (2000) Obesity as a medical problem. Nature 404: pp. 635-643
- International Association for the Study of Obesity (IASO). Newsletter 4/1997.
- Wolf, AM (1998) What is the economic case for treating obesity?. Obes Res 6: pp. 2-7
- Allison, DB, Fontaine, KR, Manson, JE (1999) Annual deaths attributable to obesity in the United States. JAMA 282: pp. 1530-1538 CrossRef
- Colquitt J, Clegg A, Sidhu M et al. Surgery for morbid obesity. Cochrane Database Syst Rev 2003; CD003641.
- Cullen, JJ, Kelly, KA (1993) Motility disorders of the gastrointestinal tract: Gastric motor physiology and pathophysiology. Surg Clin North Am 73: pp. 1145-1160
- Schiavo, G, Rossetto, O, Benfenati, F (1994) Tetanus and botulinum neurotoxins are zinc proteases specific for components of the neuroexocytosis apparatus. Ann N Y Acad Sci 710: pp. 65-75 CrossRef
- Hallett, M (1999) One man’s poison – clinical applications of botulinum toxin. N Engl J Med 341: pp. 118-120 CrossRef
- Pasricha, PJ, Ravich, WJ, Hendix, RT (1994) Treatment of achalasia with intrasphincteric injection of botulinum toxin: a pilot trial. Ann Intern Med 121: pp. 590-591
- Maria, G, Cassetta, E, Gui, D (1998) A comparison of botulinum toxin and saline for the treatment of chronic anal fissure. N Engl J Med 338: pp. 217-220 CrossRef
- Gui, D, Rossi, S, Runfola, M (2003) Review article: botulinum toxin in the therapy of gastrointestinal motility disorders. Aliment Pharmacol Ther 18: pp. 1-16 CrossRef
- Gui, D, Gaetano, A, Spada, PL (2000) Botulinum toxin injected in gastric wall reduces body weight and food intake in rats. Aliment Pharmacol Ther 14: pp. 829-834 CrossRef
- Bentsianov, B, Zalvan, C, Blitzer, A (2004) Noncosmetic uses of botulinum toxin. Clin Dermatol 22: pp. 82-88 CrossRef
- Tokunaga, T, Nishimura, R, Akagi, M (1984) Muscarinic cholinergic receptors in human gastric mucosa. Jpn J Surg 14: pp. 122-126 CrossRef
- Bigalke, H, Habermann, E (1980) Blockade by tetanus and botulinum A toxin of postganglionic cholinergic nerve endings in the myenteric plexus. Naunym Schmiedebergs Arch Pharmacol 312: pp. 255-263 CrossRef
- James, AN, Ryan, JP, Parkman, HP (2003) Inhibitory effects of botulinum toxin on pyloric and antral smooth muscle. Am J Physiol Gastrointest Liver Physiol 285: pp. 291-297
- Rollnik, JD, Meier, PN, Manns, MP (2003) Antral injections of botulinum a toxin for the treatment of obesity. Ann Intern Med 138: pp. 359-360
- Gui, D, Mingrone, G, Valenza, V (2006) Effect of botulinum toxin antral injection on gastric emptying and weight reduction in obese patients: a pilot study. Aliment Pharmacol Ther 23: pp. 675-680 CrossRef
- Gracis, JM, Simpson, DM (2000) Botulinum toxin therapy. The Neurol 6: pp. 98-100 CrossRef
- Cardoso, A, Savassi-Rocha, P, Vaz Coelho, LG (2006) Botulinum A toxin injected into the gastric wall for the treatment of class III obesity: a pilot study. Obes Surg 16: pp. 335-343 CrossRef
- Borodic, G, Ferrante, R, Pearce, L (1994) Histologic assessment of dose-related diffusion and muscle fiber response after therapeutic botulinum A toxin injections. Mov Disord 9: pp. 31-39 CrossRef
- Garcia, A, Fulton, J (1996) Cosmetic denervation of the muscles of facial expression with botulinum toxin: A dose-response study. Dermatol Surg 22: pp. 39-43 CrossRef
- Garcia-Compean, D, Mendoza-Fuerte, E, Martinez, JA (2005) Endoscopic injection of botulinum toxin in gastric antrum for the treatment of obesity. Gastroenterol Clin Biol 29: pp. 789-791 CrossRef
- Intragastric Injection of Botulinum Toxin A for the Treatment of Obesity
Volume 17, Issue 6 , pp 732-736
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- botulinum toxin A
- intragastric injection
- weight loss
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- 1. Department of General and Transplant Surgery, University Hospital, Medical University Innsbruck, Innsbruck, Austria
- 4. Department of General and Transplant Surgery, Medical University Innsbruck, Anichstrasse 35, A – 6020, Innsbruck, Austria
- 2. Department of Anesthesia and Intensive Care Medicine, University Hospital, Medical University Innsbruck, Innsbruck, Austria
- 3. Department of Surgery and Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, USA