Clinical uses of botulinum neurotoxins: Current indications, limitations and future developments

Sheng Chen

Research output: Journal article publicationReview articleAcademic researchpeer-review

118 Citations (Scopus)


Botulinum neurotoxins (BoNTs) cause flaccid paralysis by interfering with vesicle fusion and neurotransmitter release in the neuronal cells. BoNTs are the most widely used therapeutic proteins. BoNT/A was approved by the U.S. FDA to treat strabismus, blepharospam, and hemificial spasm as early as 1989 and then for treatment of cervical dystonia, glabellar facial lines, axillary hyperhidrosis, chronic migraine and for cosmetic use. Due to its high efficacy, longevity of action and satisfactory safety profile, it has been used empirically in a variety of ophthalmological, gastrointestinal, urological, orthopedic, dermatological, secretory, and painful disorders. Currently available BoNT therapies are limited to neuronal indications with the requirement of periodic injections resulting in immune-resistance for some indications. Recent understanding of the structure-function relationship of BoNTs prompted the engineering of novel BoNTs to extend therapeutic interventions in non-neuronal systems and to overcome the immune-resistance issue. Much research still needs to be done to improve and extend the medical uses of BoNTs.
Original languageEnglish
Pages (from-to)913-939
Number of pages27
Issue number10
Publication statusPublished - 1 Oct 2012


  • Botulinum neurotoxin
  • Clinical indications
  • Future developments
  • Novel applications

ASJC Scopus subject areas

  • Toxicology
  • Health, Toxicology and Mutagenesis


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