Abstract
The use of botulinum toxin type A (BoNT-A) in pain conditions is continuously growing largely because of its long-lasting effect after local application and safety profile. These unique features distinguish BoNT-A from other conventional and adjuvant analgesic drugs. Furthermore, BoNT-A diminishes only the pathological pain, without affecting the normal pain threshold. Preclinical data from several complex pain models suggested the central site of its action on pain after retrograde axonal transport from the peripheral site of application. Further investigations of the mechanism of BoNT-A antinociceptive action are ongoing as well as experiments on new recombinant BoNTs with higher selectivity for nociceptive neurons.
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References
Crofford LJ (2015). Chronic Pain: Where the Body Meets the Brain. Trans Am Clin Climatol Assoc. 126:167–83.
Loeser JD, Treede RD. The Kyoto protocol of IASP basic pain terminology. Pain. 2008;137(3):473–7. https://doi.org/10.1016/j.pain.2008.04.025.
Kosek E, Cohen M, Baron R, Gebhart GF, Mico JA, Rice AS, Rief W, Sluka AK. Do we need a third mechanistic descriptor for chronic pain states? Pain. 2016;157(7):1382–6. https://doi.org/10.1097/j.pain.0000000000000507.
Granan LP. We do not need a third mechanistic descriptor for chronic pain states! Not yet. Pain. 2017;158(1):179. https://doi.org/10.1097/j.pain.0000000000000735.
Heinricher MM, Tavares I, Leith JL, Lumb BM. Descending control of nociception: specificity, recruitment and plasticity. Brain Res Rev. 2008;60(1):214–25. https://doi.org/10.1016/j.brainresrev.2008.12.009.
Beecher HK. The measurement of pain: prototype for the quantitative study of subjective responses. Pharmacol Rev. 1957;9(1):59–209.
Rothman SS. Lessons from the living cell: the culture of science and the limits of reductionism. New York: McGraw-Hill; 2002. ISBN 0-07-137820-0.
Chapman CR, Casey KL, Dubner R, Foley KM, Gracely RH, Reading AE. Pain measurement: an overview. Pain. 1985;22:1–31. https://doi.org/10.1016/0304-3959(85)90145-9.
Gregory N, Harris AL, Robinson CR, Dougherty PM, Fuchs PN, Sluka KA. An overview of animal models of pain: disease models and outcome measures. J Pain. 2013;14(11):1255–69. https://doi.org/10.1016/j.jpain.2013.06.008.
Kurejova M, Nattenmüller U, Hildebrandt U, Selvaraj D, Stösser S, Kuner R. An improved behavioural assay demonstrates that ultrasound vocalizations constitute a reliable indicator of chronic cancer pain and neuropathic pain. Mol Pain. 2010;6:18. https://doi.org/10.1186/1744-8069-6-18.
Langford DJ, Bailey AL, Chanda ML, Clarke SE, Drummond TE, Echols S, Glick S, Ingrao J, Klassen-Ross T, Lacroix-Fralish ML, Matsumiya L, Sorge RE, Sotocinal SG, Tabaka JM, Wong D, van den Maagdenberg AM, Ferrari MD, Craig KD, Mogil JS. Coding of facial expressions of pain in the laboratory mouse. Nat Methods. 2010;7(6):447–9. https://doi.org/10.1038/nmeth.1455.
Akintola T, Raver C, Studlack P, Uddin O, Masri R, Keller A. The grimace scale reliably assesses chronic pain in a rodent model of trigeminal neuropathic pain. Neurobiol Pain. 2017;2:13–7. https://doi.org/10.1016/j.ynpai.2017.10.001.
Haefeli M, Elfering A. Pain assessment. Eur Spine J. 2006;15(Suppl 1):S17–24. https://doi.org/10.1007/s00586-005-1044-x.
Martucci KT, Mackey SC. Neuroimaging of pain: human evidence and clinical relevance of central nervous system processes and modulation. Anesthesiology. 2018;128(6):1241–54. https://doi.org/10.1097/ALN.0000000000002137.
Zhang S, Masuyer G, Zhang J, Shen Y, Lundin D, Henriksson L, Miyashita SI, MartÃnez-Carranza M, Dong M, Stenmark P. Identification and characterization of a novel botulinum neurotoxin. Nat Commun. 2017;8:14130. https://doi.org/10.1038/ncomms14130.
Pier CL, Chen C, Tepp WH, Lin G, Janda KD, Barbieri JT, Pellett S, Johnson EA. Botulinum neurotoxin subtype A2 enters neuronal cells faster than subtype A1. FEBS Lett. 2011;585(1):199–206. https://doi.org/10.1016/j.febslet.2010.11.045.
Blasi J, Chapman ER, Link E, Binz T, Yamasaki S, De Camilli P, Südhof TC, Niemann H, Jahn R. Botulinum neurotoxin A selectively cleaves the synaptic protein SNAP-25. Nature. 1993;365(6442):160–3. https://doi.org/10.1038/365160a0.
Schiavo G, Santuci A, Dasgupta BR, Mehta PP, Jontes J, Benfenati F, Wilson M, Montecucco C. Botulinum neurotoxins serotypes A and E cleave SNAP-25 at distinct COOH-terminal peptide bonds. FEBS Lett. 1993;335(1):99–103a. https://doi.org/10.1016/0014-5793(93)80448-4.
Shen XM, Selcen D, Brengman J, Engel AG. Mutant SNAP25B causes myasthenia, cortical hyperexcitability, ataxia, and intellectual disability. Neurology. 2014;83(24):2247–55. https://doi.org/10.1212/WNL.0000000000001079.
Feng Y, Crosbie J, Wigg K, Pathare T, Ickowicz A, Schachar R, Tannock R, Roberts W, Malone M, Swanson J, Kennedy JL, Barr C. The SNAP25 gene as a susceptibility gene contributing to attention-deficit hyperactivity disorder. Mol Psychiatry. 2005;10:998–1005. https://doi.org/10.1038/sj.mp.4001722.
Dolly JO, Black J, Williams RS, Melling J. Acceptors for botulinum neurotoxin reside on motor nerve terminals and mediate its internalization. Nature. 1984;307(5950):457–60. https://doi.org/10.1038/307457a0.
Montecucco C. How do tetanus and botulinum toxins bind to neuronal membranes? Trends Biochem Sci. 1986;11:314–7.
Rummel A. Double receptor anchorage of botulinum neurotoxins accounts for their exquisite neurospecificity. Curr Top Microbiol Immunol. 2013;364:61–90. https://doi.org/10.1007/978-3-642-33570-9_4.
Antonucci F, Rossi C, Gianfranceschi L, Rossetto O, Caleo M. Long-distance retrograde effects of botulinum neurotoxin A. J Neurosci. 2008;2;28(14):3689–96. https://doi.org/10.1523/JNEUROSCI.0375-08.2008.
Matak I, Bach-Rojecky L, Filipović B, Lacković Z. Behavioral and immunohistochemical evidence for central antinociceptive activity of botulinum toxin A. Neuroscience. 2011;186:201–7. https://doi.org/10.1016/j.neuroscience.2011.04.026.
Caleo M, Spinelli M, Colosimo F, Matak I, Rossetto O, Lackovic Z, Restani L. Transsynaptic action of botulinum neurotoxin type A at central cholinergic boutons. J Neurosci. 2018;38(48):10329–37. https://doi.org/10.1523/JNEUROSCI.0294-18.2018.
Kitamura M, Igimi S, Furukawa K, Furukawa K. Different response of the knockout mice lacking b-series gangliosides against botulinum and tetanus toxins. Biochim Biophys Acta. 2005;1741(1–2):1–3. https://doi.org/10.1016/j.bbadis.2005.04.005.
Montecucco C, Rasotto MB. On botulinum neurotoxin variability. mBio. 2015;6(1):e02131–14. https://doi.org/10.1128/mBio.02131-14.
Matak I, Lacković Z. Botulinum toxin A, brain and pain. Prog Neurobiol. 2014;119–120:39–59. https://doi.org/10.1016/j.pneurobio.2014.06.001.
Bach-Rojecky L, Lacković Z. Central origin of the antinociceptive action of botulinum toxin type A. Pharmacol Biochem Behav. 2009;94(2):234–8. https://doi.org/10.1016/j.pbb.2009.08.012pain.
Bach-Rojecky L, Salković-Petrisić M, Lacković Z. Botulinum toxin type A reduces pain supersensitivity in experimental diabetic neuropathy: bilateral effect after unilateral injection. Eur J Pharmacol. 2010;633(1–3):10–4. https://doi.org/10.1016/j.ejphar.2010.01.020.
Favre-Guilmard C, Auguet M, Chabrier PE. Different antinociceptive effects of botulinum toxin type A in inflammatory and peripheral polyneuropathic rat models. Eur J Pharmacol. 2009;617(1–3):48–53. https://doi.org/10.1016/j.ejphar.2009.06.047.
Matak I, Riederer P, Lacković Z. Botulinum toxin’s axonal transport from periphery to the spinal cord. Neurochem Int. 2012;61(2):236–9. https://doi.org/10.1016/j.neuint.2012.05.001.
Matak I, Rossetto O, Lacković Z. Botulinum toxin type A selectivity for certain types of pain is associated with capsaicin-sensitive neurons. Pain. 2014;155(8):1516–26. https://doi.org/10.1016/j.pain.2014.04.027.
Filipović B, Matak I, Bach-Rojecky L, Lacković Z. Central action of peripherally applied botulinum toxin type A on pain and dural protein extravasation in rat model of trigeminal neuropathy. PLoS One. 2012;7(1):e29803. https://doi.org/10.1371/journal.pone.0029803.
Wu C, Xie N, Lian Y, Xu H, Chen C, Zheng Y, Chen Y, Zhang H. Central antinociceptive activity of peripherally applied botulinum toxin type A in lab rat model of trigeminal neuralgia. Springerplus. 2016;5:431. https://doi.org/10.1186/s40064-016-2071-2.
Lacković Z, Filipović B, Matak I, Helyes Z. Activity of botulinum toxin type A in cranial dura: implications for treatment of migraine and other headaches. Br J Pharmacol. 2016;173(2):279–91. https://doi.org/10.1111/bph.13366.
Drinovac Vlah V, Filipović B, Bach-Rojecky L, Lacković Z. Role of central versus peripheral opioid system in antinociceptive and anti-inflammatory effect of botulinum toxin type A in trigeminal region. Eur J Pain. 2018;22(3):583–91. https://doi.org/10.1002/ejp.1146.
Drinovac V, Bach-Rojecky L, Lacković Z. Association of antinociceptive action of botulinum toxin type A with GABA-A receptor. J Neural Transm (Vienna). 2014;121(6):665–9. https://doi.org/10.1007/s00702-013-1150-6.
Drinovac V, Bach-Rojecky L, Matak I, Lacković Z. Involvement of μ-opioid receptors in antinociceptive action of botulinum toxin type A. Neuropharmacology. 2013;270:331–7. https://doi.org/10.1016/j.neuropharm.2013.02.011.
Mika J, Rojewska E, Makuch W, Korostynski M, Luvisetto S, Marinelli S, Pavone F, Przewlocka B. The effect of botulinum neurotoxin A on sciatic nerve injury-induced neuroimmunological changes in rat dorsal root ganglia and spinal cord. Neuroscience. 2011;175:358–66. https://doi.org/10.1016/j.neuroscience.2010.11.040.
Vacca V, Marinelli S, Luvisetto S, Pavone F. Botulinum toxin A increases analgesic effects of morphine, counters development of morphine tolerance and modulates glia activation and μ opioid receptor expression in neuropathic mice. Brain Behav Immun. 2013;32:40–50. https://doi.org/10.1016/j.bbi.2013.01.088.
Finocchiaro A, Marinelli S, De Angelis F, Vacca V, Luvisetto S, Pavone F. Botulinum toxin B affects neuropathic pain but not functional recovery after peripheral nerve injury in a mouse model. Toxins. 2018;10(3):128. https://doi.org/10.3390/toxins10030128.
Marinelli S, Vacca V, Ricordy R, Uggenti C, Tata AM, Luvisetto S, Pavone F. The analgesic effect on neuropathic pain of retrogradely transported botulinum neurotoxin A involves Schwann cells and astrocytes. PLoS One. 2012;7(10):e47977. https://doi.org/10.1371/journal.pone.0047977.
da Silva LB, Poulsen JN, Arendt-Nielsen L, Gazerani P. Botulinum neurotoxin type A modulates vesicular release of glutamate from satellite glial cells. J Cell Mol Med. 2015;19(8):1900–9. https://doi.org/10.1111/jcmm.12562.
Villa G, Ceruti S, Zanardelli M, Magni G, Jasmin L, Ohara PT, Abbracchio MP. Temporomandibular joint inflammation activates glial and immune cells in both the trigeminal ganglia and in the spinal trigeminal nucleus. Mol Pain. 2010;6:89. https://doi.org/10.1186/1744-8069-6-89.
Shi X, Gao C, Wang L, Chu X, Shi Q, Yang H, Li T. Botulinum toxin type A ameliorates adjuvant-arthritis pain by inhibiting microglial activation-mediated neuroinflammation and intracellular molecular signaling. Toxicon. 2019;178:33–40. https://doi.org/10.1016/j.toxicon.2019.12.153.
Lew MF, Chinnapongse R, Zhang Y, Corliss M. RimabotulinumtoxinB effects on pain associated with cervical dystonia: results of placebo and comparator-controlled studies. Int J Neurosci. 2010;120(4):298–300. https://doi.org/10.3109/00207451003668408.
Fadeyi MO, Adams QM. Use of botulinum toxin type B for migraine and tension headaches. Am J Health Syst Pharm. 2002;59(19):1860–2. https://doi.org/10.1093/ajhp/59.19.1860.
Grogan PM, Alvarez MV, Jones L. Headache direction and aura predict migraine responsiveness to rimabotulinumtoxinB. Headache. 2013;53(1):126–36. https://doi.org/10.1111/j.1526-4610.2012.02288.x.
Huang PP, Khan I, Suhail MS, Malkmus S, Yaksh TL. Spinal botulinum neurotoxin B: effects on afferent transmitter release and nociceptive processing. PLoS One. 2011;6(4):e19126. https://doi.org/10.1371/journal.pone.0019126.
Marino MJ, Terashima T, Steinauer JJ, Eddinger KA, Yaksh TL, Xu Q. Botulinum toxin B in the sensory afferent: transmitter release, spinal activation, and pain behavior. Pain. 2014;155(4):674–84. https://doi.org/10.1016/j.pain.2013.12.009.
Park HJ, Marino MJ, Rondon ES, Xu Q, Yaksh TL. The effects of intraplantar and intrathecal botulinum toxin type B on tactile allodynia in mono and polyneuropathy in the mouse. Anesth Analg. 2015;121(1):229–38. https://doi.org/10.1213/ANE.0000000000000777.
Ramachandran R, Lam C, Yaksh TL. Botulinum toxin in migraine: role of transport in trigemino-somatic and trigemino-vascular afferents. Neurobiol Dis. 2015;79:111–22. https://doi.org/10.1016/j.nbd.2015.04.011.
Meng J, Ovsepian SV, Wang J, Pickering M, Sasse A, Aoki KR, Lawrence GW, Dolly JO. Activation of TRPV1 mediates calcitonin gene-related peptide release, which excites trigeminal sensory neurons and is attenuated by a retargeted botulinum toxin with anti-nociceptive potential. J Neurosci. 2009;29(15):4981–92. https://doi.org/10.1523/JNEUROSCI.5490-08.2009.
Meng J, Wang J, Lawrence G, Dolly JO. Synaptobrevin I mediates exocytosis of CGRP from sensory neurons and inhibition by botulinum toxins reflects their anti-nociceptive potential. J Cell Sci. 2007;120(Pt 16):2864–74. https://doi.org/10.1242/jcs.012211.
Meng J, Dolly JO, Wang J. Selective cleavage of SNAREs in sensory neurons unveils protein complexes mediating peptide exocytosis triggered by different stimuli. Mol Neurobiol. 2014;50(2):574–88. https://doi.org/10.1007/s12035-014-8665-1.
Foster KA. A new wrinkle on pain relief: re-engineering clostridial neurotoxins for analgesics. Drug Discov Today. 2005;10(8):563–9. https://doi.org/10.1016/S1359-6446(05)03389-1.
Duggan MJ, Quinn CP, Chaddock JA, Purkiss JR, Alexander FC, Doward S, Fooks SJ, Friis LM, Hall YH, Kirby ER, Leeds N, Moulsdale HJ, Dickenson A, Green GM, Rahman W, Suzuki R, Shone CC, Foster K. Inhibition of release of neurotransmitters from rat dorsal root ganglia by a novel conjugate of a Clostridium botulinum toxin A endopeptidase fragment and Erythrina cristagalli lectin. J Biol Chem. 2002;277(38):34846–52. https://doi.org/10.1074/jbc.M202902200.
Maiarù M, Leese C, Certo M, Echeverria-Altuna I, Mangione AS, Arsenault J, Davletov B, Hunt SP. Selective neuronal silencing using synthetic botulinum molecules alleviates chronic pain in mice. Sci Transl Med. 2018;10(450):eaar7384. https://doi.org/10.1126/scitranslmed.aar7384.
Mangione AS, Obara I, Maiarú M, Geranton SM, Tassorelli C, Ferrari E, Leese C, Davletov B, Hunt SP. Nonparalytic botulinum molecules for the control of pain. Pain. 2016;157(5):1045–55. https://doi.org/10.1097/j.pain.0000000000000478.
Vazquez-Cintron E, Tenezaca L, Angeles C, Syngkon A, Liublinska V, Ichtchenko K, Band P. Pre-clinical study of a novel recombinant botulinum neurotoxin derivative engineered for improved safety. Sci Rep. 2016;6:30429. https://doi.org/10.1038/srep30429.
Wang J, Zurawski TH, Meng J, Lawrence G, Olango WM, Finn DP, Wheeler L, Dolly JO. A dileucine in the protease of botulinum toxin A underlies its long-lived neuroparalysis: transfer of longevity to a novel potential therapeutic. J Biol Chem. 2011;286(8):6375–85. https://doi.org/10.1074/jbc.M110.181784.
Wang J, Casals-Diaz L, Zurawski T, Meng J, Moriarty O, Nealon J, Edupuganti OP, Dolly O. A novel therapeutic with two SNAP-25 inactivating proteases shows long-lasting anti-hyperalgesic activity in a rat model of neuropathic pain. Neuropharmacology. 2017;118:223–32. https://doi.org/10.1016/j.neuropharm.2017.03.026.
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Lacković, Z., Matak, I., Bach-Rojecky, L. (2020). Basic Science of Pain and Botulinum Toxin. In: Jabbari, B. (eds) Botulinum Toxin Treatment in Surgery, Dentistry, and Veterinary Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-50691-9_5
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