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Abstracts Toxins 2011 / Toxicon 68 (2013) 60–12364
Medicine Award, Academy of Pain Medicine; the Annual Award forExcellence in Research, American Society of Anesthesiology; the GordhAward, Swedish Society of Medicine; and the Bonica Award, InternationalAssociation for the Study of Pain. His research, published inmore than 700papers, focuses on the encoding process for nociceptive information andthe development of pain management therapies.
http://dx.doi.org/10.1016/j.toxicon.2012.07.027
Effect of botulinum toxin on pain transduction andtransmission
L. Arendt-NielsenCenter for Sensory-Motor Interaction, Department of Health Science andTechnology, School of Medicine, Aalborg University, Aalborg, Denmark
Patients treated with botulinum toxin type A (BoNT/A)for, e.g., spasticity or dystonia often experience reduction ofpain. Whether the analgesic effect results from the relief of,e.g., muscle spasms or results from an active effect on thenociceptive nerves/receptors is not entirely clear.
In a series of studies we have shown that intra-cuta-neous administration of BoNT/A inhibits the capsaicin-evoked pain intensity, hyperalgesia and neurogenic vaso-dilatation (flare, temperature, blood flow) in human skin.The action was detected after one week and lasted for fourweeks. In follow-up studies the analgesic action of BoNT/Aon capsaicin-evoked pain, hyperalgesia and neurogenicinflammation were already present after one day andincreased in action over the following week. A selectiveeffect on C-nociceptive afferents was found, explainingwhymany previous studies had failed to show any effect (theyassessed A-delta-fibres).
As itch (pruritus) is also mediated by C-fibres, wetherefore were interested in studying the effect of BoNT/Aon itch. We therefore designed a study to evaluate ifsubcutaneous administration of BoNT/A reduced hista-mine-induced itch and the associated neurogenic inflam-mation (flare, temperature, blood flow). The anti-pruriticaction of BoNT/A on histamine evoked itch and neurogenicinflammation was present already after one day andincreased in action over the following week. A series ofhuman experimental studies have proved that BoNT/Aexerts a significant long-lasting effect on the peripheralsensory apparatus related to the generation and trans-mission of C-fibre-related pain and itch. These findingsopen a whole new series of clinical applications.
Lars Arendt-Nielsen, Ph.D., Dr. Med. Sci., [email protected], Center forSensory-Motor Interaction, Aalborg University, Denmark. Professor LarsArendt-Nielsen, Dr. Med. Sci., Ph.D., is founder and director of the Inter-national Center for Sensory-Motor Interaction (100 employees, 70 Ph. D.students enrolled), Aalborg University, Denmark. His research focus is on1) translational pain research, 2) experimental methods for the assess-ment of pain from skin, muscles and viscera in healthy volunteers and painpatients, 3) development of human bio-markers for screening of newanalgesic compounds in humans (volunteers and patients), and 4) proof-of-concept studies on new analgesic and anti-inflammatory compounds.Dr. Arendt-Nielsen is Director of Research and Development for C4Pain,a highly advanced, research-based clinical trial unit that provides testfacilities for screening analgesic and anti-inflammatory compounds inearly and late development. Dr. Arendt-Nielsen has delivered more than250 keynote lectures at international meetings and published morethan 750 papers on experimental and clinical pain research in inter-national peer-reviewed journals. He is a Council Member of the Inter-national Association for the Study of Pain (IASP), Co-President of the
IASP Global Year Against Musculoskeletal Pain 2010, serves on theIASP Publication and Taxonomy Committees, and heads the IASP GrantCommittee.
http://dx.doi.org/10.1016/j.toxicon.2012.07.028
Botulinum toxin in headache disorders
S. SilbersteinThomas Jefferson University, Philadelphia, PA, USA
Headache disorders, including migraine and chronicmigraine (headaches >15 days/month and a link tomigraine), are common debilitating conditions thatprofoundly impact quality of life. There are seven botulinumtoxin (BoNT) serotypes (A, B, C, D, E, F and G). Botulinumtoxin type A (BoNT/A) has been the most widely studiedserotype for therapeutic purposes. Several randomized,double-blinded, placebo-controlled studies support theefficacy of BoNT for the treatment of chronicmigraine.Morerecently, the PREEMPT clinical program confirmed onabo-tulinumtoxinA as an effective, safe and well-toleratedheadache prophylactic treatment for adults with chronicmigraine. The PATS program suggested that onabotuli-numtoxinA is a safe treatment that is efficacious for theprevention of high-frequency episodic migraine. Furtherresearch isneeded tounderstandthemechanismof actionofBoNT inheadache, furtherestablish its safetyandefficacy forthese indications, and fully develop its therapeutic potential.
Stephen Silberstein, M.D., [email protected], Thomas Jef-ferson University, USA. Stephen D. Silberstein, M.D., is Professor ofNeurology and Director of the Jefferson Headache Center at ThomasJefferson University. He is a Fellow of the American College of Physiciansand Past President and a Fellow of the American Headache Society.Dr. Silberstein received his medical degree from the University of Penn-sylvania and completed a neurology residency at the Hospital of theUniversity of Pennsylvania. Dr. Silberstein is senior editor of the 8thedition ofWolff's Headache and Other Head Pain. He has written more than300 publications, and he lectures extensively on neurotoxins and on thepathogenesis, neurobiology, diagnosis and treatment of headache.
http://dx.doi.org/10.1016/j.toxicon.2012.07.029
Botulinum toxin in rare pain disorders
B. VollerNational Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
Therapeutic botulinum neurotoxin (BoNT) is the treat-ment of choice in focal dystonia and in focal spasticity afterstroke. Reduction of pain has been observed in manystudies. Investigations have shown that the analgesic effectis not only due to the effect of muscle relaxation but also tothe blocking of the release of inflammatory mediators, suchas substance P and glutamate.
Because of its muscle relaxing and possible analgesiceffects, BoNT has also gained much interest as a possibletreatment for other pain syndromes. Up to now, convincingevidence has been found for the use of BoNT serotype A inthe treatment of chronic migraine. Other rare painsyndromes such as neuropathic pain, complex regional
