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

Hodan Ibrahim, Jacquie Maignel, Fraser Hornby, Donna Daly, Matthew Beard

Toxins 2022 Jan 12

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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.

Citation

Hodan Ibrahim, Jacquie Maignel, Fraser Hornby, Donna Daly, Matthew Beard. BoNT/A in the Urinary Bladder-More to the Story than Silencing of Cholinergic Nerves. Toxins. 2022 Jan 12;14(1)