Document Detail


Botulinum toxin type A reduces histamine-induced itch and vasomotor responses in human skin.
MedLine Citation:
PMID:  19624547     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clinical evidence has revealed the antipruritic effect of botulinum toxin type A (BoNT/A). BoNT/A is believed to be effective against itch as it inhibits the release of acetylcholine as well as some other substances that may be involved in itch. OBJECTIVES: To investigate the effect of subcutaneous administration of BoNT/A on experimentally histamine-induced itch in human skin. METHODS: In this double-blind, placebo-controlled study, 14 healthy men (mean +/- SD age 26.3 +/- 2.6 years) received BoNT/A (Botox; Allergan, Irvine, CA, U.S.A.; 5 U) and isotonic saline on the volar surface of either forearm. Histamine prick tests were performed four times at the treatment sites (before treatment, and days 1, 3 and 7 after treatment). The itch intensity (as rated on a 0-10 visual analogue scale), itch area, neurogenic inflammation (visible flare area), blood flow (laser Doppler) and cutaneous temperature (thermographic images) were measured over the course of the trials. RESULTS: BoNT/A reduced the histamine-induced itch intensity (F(1,39) = 30.2, P < 0.001) and itch area (F(1,39) = 8.8, P = 0.011) compared with saline at all time points after treatment. The duration of itch was also shorter for BoNT/A-treated areas (F(1,39) = 19.4, P < 0.001), with a peak effect at day 7. The flare area was smaller in the BoNT/A-treated arm compared with the saline-treated arm at all time points after treatment (F(1,39) = 15.4, P = 0.002). Findings from blood flow (F(1,26) = 177.3, P < 0.001) and temperature measurements (F(1,26) = 27.6, P < 0.001) clearly showed the suppressive effect of BoNT/A on vasomotor reactions, with the maximal effect on days 3 and 7. CONCLUSIONS: BoNT/A reduced the itch intensity, blood flow and neurogenic inflammation in response to the histamine prick test in human skin. The findings could be applicable in the treatment of some pruritic conditions that can be difficult to treat with conventional treatments.
Authors:
P Gazerani; N S Pedersen; A M Drewes; L Arendt-Nielsen
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-05-11
Journal Detail:
Title:  The British journal of dermatology     Volume:  161     ISSN:  1365-2133     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-28     Completed Date:  2010-03-11     Revised Date:  2010-08-05    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  737-45     Citation Subset:  IM    
Affiliation:
Center for Sensory-Motor Interaction, Department of Health Sciences and Technology, Aalborg University, DK-9220 Aalborg, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antipruritics / administration & dosage*
Botulinum Toxin Type A / administration & dosage*
Dermatitis / drug therapy
Double-Blind Method
Histamine
Humans
Laser-Doppler Flowmetry
Male
Prospective Studies
Pruritus / chemically induced,  drug therapy*
Skin / blood supply,  drug effects*
Skin Tests
Thermography
Vasoconstriction / drug effects*
Chemical
Reg. No./Substance:
0/Antipruritics; 0/Botulinum Toxin Type A; 51-45-6/Histamine
Comments/Corrections
Comment In:
Br J Dermatol. 2010 Aug;163(2):424-6   [PMID:  20346021 ]

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