BoNT/A in the Urinary Bladder-More to the Story than Silencing of Cholinergic Nerves

Botulinum neurotoxin (BoNT/A) is an FDA and NICE approved second-line treatment for overactive bladder (OAB) in patients either not responsive or intolerant to anti-cholinergic drugs. BoNT/A acts to weaken muscle contraction by blocking release of the neurotransmitter acetyl choline (ACh) at neuromu...

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Bibliographic Details
Published inToxins Vol. 14; no. 1; p. 53
Main Authors Ibrahim, Hodan, Maignel, Jacquie, Hornby, Fraser, Daly, Donna, Beard, Matthew
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 12.01.2022
MDPI
Subjects
Acetylcholine
Animals
Anticholinergics
Biological activity
Bladder
botulinum neurotoxin
Botulinum toxin
Botulinum Toxins, Type A - pharmacology
Choline
Cholinergic nerves
Cholinergic Neurons - drug effects
Cholinergic Neurons - physiology
Humans
Mice
Muscle contraction
Muscle Contraction - drug effects
Muscle Contraction - physiology
Muscles
Muscular function
Nerves
Neuromuscular junctions
neurotoxin
Neurotoxins
Neurotransmitters
Nocturia
Pain
Paralysis
Proteins
Rabbits
Rats
Review
Smooth muscle
SNAP-25
SNAP-25 protein
Spinal cord injuries
Toxins
Urinary bladder
Urinary Bladder - drug effects
Urinary Bladder - physiology
Urinary Bladder, Overactive - drug therapy
Urinary Bladder, Overactive - physiopathology
Urine
urology
Urothelium
bladder
urology
neurotoxin
botulinum neurotoxin
urothelium
SNAP-25
SV2
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Summary:Botulinum neurotoxin (BoNT/A) is an FDA and NICE approved second-line treatment for overactive bladder (OAB) in patients either not responsive or intolerant to anti-cholinergic drugs. BoNT/A acts to weaken muscle contraction by blocking release of the neurotransmitter acetyl choline (ACh) at neuromuscular junctions. However, this biological activity does not easily explain all the observed effects in clinical and non-clinical studies. There are also conflicting reports of expression of the BoNT/A protein receptor, SV2, and intracellular target protein, SNAP-25, in the urothelium and bladder. This review presents the current evidence of BoNT/A's effect on bladder sensation, potential mechanisms by which it might exert these effects and discusses recent advances in understanding the action of BoNT in bladder tissue.
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SourceType-Scholarly Journals-1
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ISSN:2072-6651
2072-6651
DOI:10.3390/toxins14010053