IMUNOGENICIDADE ASSOCIADA AO TRATAMENTO COM TOXINA BOTULÍNICA

Kamila Aquino de Souza; Laura Teixeira Rodrigues da Silva; Gabriel Lima de Freitas

doi:10.47820/recima21.v4i1.4227

Autores

Kamila Aquino de Souza https://orcid.org/0009-0009-3118-3827
Laura Teixeira Rodrigues da Silva https://orcid.org/0009-0000-5452-8634
Gabriel Lima de Freitas

DOI:

https://doi.org/10.47820/recima21.v4i1.4227

Palavras-chave:

Toxina Botulínica, Imunogenicidade, Imunorresistência

Resumo

O envelhecimento cutâneo é um fator inevitável e natural de todos os seres humanos. A fim de se alcançar a prevenção aos sinais de envelhecimento e melhora da autoestima, como amenizar rugas e linhas de expressão, os tratamentos estéticos vem aumentando, sendo os tratamentos à base de toxina botulínica os mais buscados no mundo todo, entretanto, pouco se aborda sobre a resistência imunológica e efeitos a longo prazo. Objetivo: Discutir os efeitos do tratamento com toxina botulínica no decorrer dos anos e as causas de resistência e do “efeito vacina”. Método: Trabalho de revisão de literatura, tendo como fonte de pesquisa artigos publicados em periódicos nacionais e internacionais. Discussão: Além do envelhecimento intrínseco, temos que considerar o extrínseco, que está relacionado com fatores externos e ao estilo de vida do indivíduo, diversos fatores influenciam a imunogenicidade das neurotoxinas botulínicas, tais como: fatores relacionados ao produto, ao processo de fabricação, à carga proteica antigênica e à presença de proteínas acessórias, o sistema imunológico tem memória cumulativa e estudos mostram que a formação de anticorpos em pacientes de tratamentos estéticos é rara, sendo que aqueles que desenvolveram anticorpos, receberam doses da formulação acima do indicado, com intervalo menor que um mês entre as injeções ou então sofreram reação cruzada a outros anticorpos decorrentes de múltiplas vacinas antitetânicas, uma vez que a proteína da toxina botulínica tem partes de sua estrutura homólogas à estrutura produzida pelo Clostridium tetani.

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Biografia do Autor

Kamila Aquino de Souza

Graduanda do Curso de Biomedicina - Complexo Educacional Faculdade Metropolitanas Unidas (FMU).

Laura Teixeira Rodrigues da Silva

Graduanda do Curso de Biomedicina - Complexo Educacional Faculdade Metropolitanas Unidas (FMU).

Gabriel Lima de Freitas

Biomédico Pós graduado em Cosmetologia e Estética Avançada.

Referências

Aoki KR. Botulinum toxin: a successful therapeutic protein.[Internet]Curr Med Chem. 2004;11(23):3085-92. [cited 2023 May 12] Available from:https://www.Eurekaselect.com/ article/7848.

Meunier FA, Herreros J, Schiavo G, Poulain B, Molgó J. Molecular mechanism of action of botulinal neurotoxins and the synaptic remodeling they induce in vivo at skeletal neuromuscular junction. [Internet] In: Massaro EJ. Handbook of neurotoxicology. Totowa: Human Press; 2002 Barbosa DBM, Brito A de S. A utilização da toxina botulínica tipo a para alcançar a estética facial. Revista Terra & Cultura: Cadernos de Ensino e Pesquisa [Internet]. 2020 Jul 3;36(70):75–86.[cited 2023 May 12] Available from: http://periodicos.unifil.br/ index.php/Revistateste/ article/view/1354.

Kumar R, Dhaliwal H, Kukreja R, Singh B. The Botulinum Toxin as a Therapeutic Agent: Molecular Structure and Mechanism of Action in Motor and Sensory Systems. Seminars in Neurology. [Internet] 2016 Feb 11;36 (01):010–9. [cited 2023 May 12] Available from: https://www.thiemeconnect.de/products/ejournals/abstract/10.1055/s-0035-1571215.

Jankovic J. Botulinum toxin: State of the art. Movement Disorders. [Internet] 2017 Jun 22; 32(8):1131–8 [cited 2023 May 12] Available from: https://movementdisorders.onlinelibrary. wiley.com/doi/10.1002/mds.27072.

Lacordia MHFA, Januário FS-M, Pereira JCC. Estrabismo após toxina botulínica para fins estéticos. [Internet]. Rev brasoftalmol 2011 May; 70(3): 179–81.[cited 2023 May 12] Available from:https://doi.org/10.1590/S0034-72802011000300009.

Caroline Dos Reis L, Uchôas Luz D, Alves Da Silva A, Flaviana R, Fernandes, Bacelar De Assis I.Desvendando o uso da toxina botulínica na estética e em enfermidades/discovering the use of botulinic toxin in aesthetics and in diseases[Internet]. 2020 [cited 2023 May 12] Available from: https:// encurtador.com.br/TYZ48.

Poli MA, Lebeda FJ. An overview of clostridial neurotoxins.[Interner] In: Massaro EJ. Handbook of neurotoxicology. Totowa: Human Press; 2002. p. 293-30 [cited 2023May 12] Available from: https://link.springer.com/chapter/ 10.1007/978-1-59259-132-9_16.

Bernard Poulain, Michel R. Popoff, Jordi Molgó. How do the Botulinum Neurotoxins block neurotransmitter release: from botulism to the molecular mechanism of action. The Botulinum Journal, 2008, 1 (1), pp.14-87. [cited 2023 May 12] Available from: ⟨10.1504/TBJ.2008.018951⟩. ⟨hal-00303601⟩.

Turton K, Chaddock JA, Acharya KRavi. Botulinum and tetanus neurotoxins: structure, function and therapeutic utility. [Internet] Trends in Biochemical Sciences. 2002 Nov;27(11):552–8. [cited 2023 May 12] Available from: https://www.sciencedirect.com/ science/article/abs/pii/S0968000402021771.

Hicks RP, Hartell MG, Nichols DA, Bhattacharjee AK, van Hamont JE, Skillman DR. The medicinal chemistry of botulinum, ricin and anthrax toxins.[Internet] Curr Med Chem. 2005;12(6):667-90[cited 2023 May 12] Available from: https://pubmed.ncbi.nlm.nih.gov/ 15790305/. p 305-47 [cited 2023 May 12] Available from: https://hal.science/hal-00194091/.

Paiva A, Meunier FA, Molgó J, Aoki KR, Dolly JO. Functional repair of motor endplates after botulinum neurotoxin type A poisoning: biphasic switch of synaptic activity between nerve sprouts and their parent terminals.Proc Natl Acad Sci [Internet] USA. 1999;96(6):3200-5 [cited 2023 May 12] Available from: https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC15919/.

FUJITA, R. L. R.; HURTADO, C. C. N., Aspectos relevantes do uso da toxina botulínica no tratamento estético e seus diversos mecanismos de ação. Rev. Saber Científico Internet] v. 8, n. 1, p.120–133, 2019, Porto Velho. [cited 2023 May 12] Available from: https:// revista.saolucas.edu.br/index.php /resc/article/ view/ 1069/pdf>. Acesso em: 20 de março de 2022.

SPOSITO, M. M. M., Toxina Botulínica do Tipo A: mecanismo de ação. [Internet] Rev. Acta Fisiátr, v.16, n.1, p. 25-37, 2009, São Paulo.[cited 2023 May 12] Available from: https://www.revistas.usp.br/actafisiatrica/ article/view/103037/ 101317 > .

Gart Michael, Gutowski Karol. Overview of Botulinum Toxins for Aesthetic Uses. Clinics in Plastic Surgery [Internet]. 2016 May 04 43(3):459-71.[cited 2023 Apr 11]; Available from: https://pubmed.ncbi.nlm.nih.gov/27363760/.

Archana M S. Toxin yet not toxic: Botulinum toxin in dentistry. The Saudi dental journal [Internet]. 2016 Jan 01 [cited 2023 Apr 4];28:63-9. DOI doi:10.1016/j.sdentj.2015.08.002 .Available:from:https://pubmed.ncbi.nlm.nih.gov/27486290/.

Naumann, M., et al. (2010). Meta-analysis of neutralizing antibody conversion with onabotulinumtoxinA (BOTOX®) across multiple indications. [Internet] Movement disorders: official journal of the Movement Disorder Society, 25(13), 2211–2218. [cited 2023 May 12] Available from: https://doi. org/10.1002/mds.23254.

Atassi MZ, Dolimbek BZ, Jankovic J, Steward LE, Aoki KR. Regions of botulinum neurotoxin A light chain recognized by human anti-toxin antibodies from cervical dystonia patients immunoresistant to toxin treatment. [Internet] Immunobiology. 2011 Jul; 216 (7):782–92. [cited 2023 May 12]. Available from: https://pubmed.ncbi.nlm.nih.gov/21281977/.

Baizabal-Carvallo José,Feld Jordan &Jankovic Joseph. Flu-like symptoms and associated immunological response following therapy with botulinum toxins. Neurotoxicity research [Internet]. 2013 May 16 2013(24):298-306. [cited 2023 Apr 4]; Available from: https://pubmed. ncbi.nlm.nih.gov/23677449/.

Wanitphakdeedecha R, Kantaviro W, Suphatsathienkul P, Tantrapornpong P, Yan C, Apinumtham C, et al. Association Between Secondary Botulinum Toxin A Treatment Failure in Cosmetic Indication and Anti-Complexing Protein Antibody Production. [Internet] Dermatology and Therapy. 2020 May 22;10(4):707–20.[cited 2023 May 12] Available from: https://pubmed.ncbi.nlm.nih.gov/32445175/

Park JY, Sunga O, Wanitphakdeedecha R, Frevert J. Neurotoxin Impurities. [Internet] Plastic and Reconstructive Surgery - Global Open. 2020 Jan ;8(1) :e2627 [cited 2023 May 12] Available from: https://pubmed.ncbi.nlm. nih.gov/32095419/.

Naumann Markus, et al. Immunogenicity of botulinum toxins. Journal of neural transmission [Internet]. 2012 Sep 25 [cited 2023 Apr 4];120(2):275-90. DOI 10.1007/s00702-012-0893-9. Available from: https://pubmed.ncbi.nlm. nih.gov/ 23008029/.

Hanna PA, Jankovic J, Vincent A. Comparison of mouse bioassay and immunoprecipitation assay for botulinum toxin antibodies. [Internet] Journal of Neurology, Neurosurgery & Psychiatry. 1999 May 1;66(5):612–6. [cited 2023 May 12] Available from: https://pubmed. ncbi.nlm.nih.gov/10209172/

Brin MF, Comella CL, Jankovic J, Lai F, Naumann M. Long-term treatment with botulinum toxin type A in cervical dystonia has low immunogenicity by mouse protection assay.[Internet] Movement Disorders. 2008 Jul 30;23 (10):1353–60. [cited 2023 May 12]. Available from: https://movementdisorders .onlinelibrary.wiley.com/ doi/ 10.1002/mds.22157.

Benecke Reiner. Clinical relevance of botulinum toxin immunogenicity. BioDrugs [Internet]. 2012 Apr 01 [cited 2023 Apr 4];26:e1-e9. DOI 10.2165/11599840-000000000-00000. Available from: https://pubmed.ncbi. nlm.nih.gov/22385408/.

Aoki K. Botulinum Toxin: A Successful Therapeutic Protein.[Internet] Current Medicinal Chemistry. 2004 Dec 1;11(23):3085–92. [cited on 2023 May 12] Available from: htps:// www.eurekaselect.com/article/7848.

Eduarda Pautz CAMPOS, Vicente C. Toxina botulínica tipo A: Ações farmacológicas e uso na estética facial: Pharmacological actions and use in facial aesthetics. Revista sáude Multidisciplinar[Internet].2021;9(1).[cited 2023 May 12] Available from: http://revistas.famp. edu.br/revistasaudemulti disciplinar/article/view/167.

Dressler D. Clinical presentation and management of antibody-induced failure of botulinum toxin therapy. [Internet] Movement Disorders. 2004;19(S8):S92–100. [cited 2023 May 12] Available from:https:// pubmed.ncbi.nlm.nih.gov/ 15027060/.

Bellows S, Jankovic J. Immunogenicity Associated with Botulinum Toxin Treatment.[Internet] Toxins. 2019 Aug 26;11(9):491. [cited 2023 May 12] Available from: https:// www.ncbi.nlm.nih .gov/pmc/articles/PMC6784164/.

Flynn TC.. Advances in the use of botulinum neurotoxins in facial esthetics. Journal of cosmetic dermatology [Internet]. 2012 Mar 11 [cited 2023 Apr 4];11:42–50. DOI https://doi.org/10.1111/j.1473-2165.2011.00593.x. Available from https://pubmed.ncbi .nlm.nih.gov/22360334/.

Stengel G, Bee EK. Antibody-induced secondary treatment failure in a patient treated with botulinum toxin type A for glabellar frown lines. Clinical interventions in aging [Internet]. 2011 Nov 09 [cited 2023 Apr 4];6:281–284. DOI https:// doi.org/10.2147/CIA.S18997.Available from: https://pubmed.ncbI.nlm.nih.gov/ 22162643/.

Silva VCM. O rejuvenescimento facial na Biomedicina Estética [Internet]. Universidade Federal de Pernambuco 2022 [cited 2023 May 13]. Available from: https:// repositorio.ufpe. br/handle/123456789/45422.