1126 BOTULINUM TOXIN: BIOLOGICAL WEAPON, BEAUTY AND THE BLADDER

You have accessJournal of UrologyHistory of Urology1 Apr 20101126 BOTULINUM TOXIN: BIOLOGICAL WEAPON, BEAUTY AND THE BLADDER Zahoor Fazili, Howard Marsh, and Shikohe Masood Zahoor FaziliZahoor Fazili More articles by this author , Howard MarshHoward Marsh More articles by this author , and Shikohe MasoodShikohe Masood More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2323AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Botulinum toxin (BT) is a potent neurotoxin with therapeutic applications in ophthalmology, neurology, dermatology and urology METHODS A systematic search of online and published material was conducted including original articles and papers RESULTS In 1822 the German physician Justinus Kerner published the first description of botulism or sausage poisoning. Although he thought there was no cure for the condition he did note that small amounts of sausage poison might be useful for the neurological condition, St Vitus' dance. In describing its potential therapeutic use, he was unaware that he had laid the foundation for the future treatment of a number of conditions. It was then Emile P.van Ermengem from Belgium who in 1895, first isolated Clostridium Botulinum from both food and post-mortem tissues of the victims of food poisoning. In 1916 the British set up the chemical warfare complex at Porton Down in Wiltshire, and amongst other toxins, investigated BT. A single gram of crystalline BT evenly dispersed and inhaled, would kill 1 million people. In 1937, the Japanese formed a biological warfare group, unit 731, and poisoned prisoners in occupied Manchuria with BT. In the US, in 1946 research into BT took place at Fort Detrick. Here Dr Edward Schantz developed different types of BT in their pure crystalline form but became convinced that BT would never become an effective bioweapon and instead explored other uses. In 1972, the US and other countries signed a Biological Weapons treaty banning research into biological warfare. During the late eighties however, both the Soviet Union and Iraq produced BT for bio-warfare. The first therapeutic use of BT was in strabismus by an American, Dr Alan Scott with excellent results. In 1987 a Canadian ophthalmologist Jean Carruthers noticed that the frown lines disappeared in patients who were treated with BT for blepharospasm. She shared this idea with her husband Alastair, a dermatologist and together they popularised a procedure that revolutionised the field of cosmetics. In urology, the first experiments were carried out on the rat bladder. The application of BT in the human bladder was pioneered by Dennis Dykstra for detrusor sphincter dyssynergia in 1988 and Brigitte Schurch for detrusor overactivity in 2000, with promising results. Since then it has also been used with variable results in prostatic hyperplasia and chronic pain syndrome. CONCLUSIONS BT is a highly versatile pharmaceutical which has previously been used as biological weapon and is now a cosmetic agent as well as providing hope for a variety of refractory urological conditions Gillingham Kent, United Kingdom© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e436 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zahoor Fazili More articles by this author Howard Marsh More articles by this author Shikohe Masood More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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