Depletion of neutralising antibodies resensitises a secondary non-responder to botulinum A neurotoxin
| Autor: | H Bigalke, Markus Naumann, J Ahmadpour, B Mansouri Taleghani, Karlheinz Reiners, K.V. Toyka |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
medicine.medical_treatment Neurotoxins Short Report medicine.disease_cause medicine Humans Neurotoxin Botulism Cervical dystonia Botulinum Toxins Type A Immunoadsorption Torticollis Dystonia Chemotherapy Binding Sites Plasma Exchange biology Toxin business.industry medicine.disease Psychiatry and Mental health Immunoglobulin G Immunology biology.protein Female Surgery Neurology (clinical) Antibody business |
| Zdroj: | Journal of Neurology, Neurosurgery & Psychiatry. 65:924-927 |
| ISSN: | 0022-3050 |
| DOI: | 10.1136/jnnp.65.6.924 |
| Popis: | The objective was to evaluate whether removal of neutralising antibodies potentially resensitises a secondary nonresponder to botulinum neurotoxin A (BoNT/A). Neutralising antibodies directed against BoNT/A are produced during long term treatment with BoNT/Ahemagglutinin complex in up to 10% of patients with cervical dystonia. These patients become secondary nonresponders. Other serotypes of BoNT are not yet generally available and may also bear the risk of inducing antibody formation. Plasma exchange (PE) (one treatment cycle) and immunoadsorption on a protein A column (IA-PA; three treatment cycles) was employed over 15 months to remove neutralising antibodies from a severely disabled secondary nonresponder with cervical dystonia. After plasma exchange or IA-PA, BoNT/A was reinjected. Antibodies were measured with a sensitive functional toxin neutralising test. Repeated use of plasma exchange and IA-PA depleted neutralising antibodies to below the detection limit and subsequently allowed successful BoNT/A injection into dystonic muscles. No serious side eVects were found related to the depletion of IgG. In conclusion PE or IA-PA performed before BoNT/A readministration may provide an alternative strategy in treating selected secondary non-responders who are severely disabled. (J Neurol Neurosurg Psychiatry 1998;65:924‐927) |
| Databáze: | OpenAIRE |
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