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Clinical application of Clostridium botulinum type A neurotoxin purified by a simple procedure for patients with urinary incontinence caused by refractory destrusor overactivity.

Lee JC, Yokoyama T, Hwang HJ, Arimitsu H, Yamamoto Y, Kawasaki M, Takigawa T, Takeshi K, Nishikawa A, Kumon H, Oguma K

Department of Bacteriology, Okayama University Medical School, Okayama, Japan.

Type A neurotoxin of Clostridium botulinum was purified by a simple procedure using a lactose gel column. This procedure was previously reported for type B neurotoxin. Hemagglutinin-positive toxins (19S and 16S) were bound to the column under acid conditions, and the neurotoxin alone was dissociated from these hemagglutinin-positive toxins by changing the pH of the column to an alkaline condition. The toxicity of this purified toxin preparation was retained for at least 1 year at -30 degrees C by supplementing it with either 0.1% albumin or 0.05% albumin plus 1% trehalose. This preparation was used to treat 18 patients with urinary incontinence caused by refractory idiopathic and neurogenic detrusor overactivity; 16 of the patients showed excellent improvement. Improvements started within 1 week after injection in most cases and lasted 3-12 months. 12S toxin dissociates into an NTX and an NTNH. Recently, we discovered that 19S toxin is a dimer of 16S toxin, and that haemagglutinin consists of four subcomponents designated AA-1, AA-2, AA-3a and HA-3b.

Published 14 September 2007 in FEMS Immunol Med Microbiol, 51(1): 201-11.
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