【 文献重点摘要 】

BotulinumtoxinA (BoNT-A) is now widely established for the main approved indication of reducing glabellar lines, and is also widely used off-label to improve the appearance of wrinkles and lines in other parts of the face. The number of aesthetic procedures continues to increase as the patient population becomes more diverse, in particular with increasing numbers of people of color and men. Further developments in treatment may continue to expand the audience for BoNT-A by making procedures more comfortable and by delivering a more natural, less static appearance. These may be achieved through use of combinations of BoNT-A with other aesthetic procedures, tailoring the dose of toxin to the patient’s muscle mass or by using novel injection and application techniques. Beyond amelioration of facial lines, encouraging results have been seen with the use of BoNT-A to improve the appearance of hypertrophic and keloid scars and even to prevent them. Studies have been conducted with scars in various parts of the body and further research is ongoing. Dermatological and other medical uses for BoNT-A are also active areas of research. Injections of BoNT-A have been shown to reduce signs and symptoms of acne, rosacea, and psoriasis, to reduce neuromuscular pain, and to bring about significant improvements in a number of rare diseases that are caused or exacerbated by hyperhidrosis. This paper reviews these new uses for BoNT-A, looking at the rationale for their use and discussing the results of published case studies and clinical trials. These areas have shown great promise to date, but more and larger clinical studies will be required before these treatments become a clinical reality. To this end details are also provided of clinical trials currently listed in the main clinical trials database to highlight research areas of particular interest.

肉毒杆菌毒素A(BONT-A)现在被广泛确定为减少眉间皱纹的主要批准适应症，也被广泛用于标签外改善面部其他部位的皱纹和线条的外观。随着患者群体变得更加多样化，尤其是有色人种和男性人数的增加，美容手术的数量继续增加。通过使治疗过程更舒适，并提供更自然、更不静止的外观，治疗的进一步发展可能会继续扩大BONT-A的受众。这可以通过将BONT-A与其他美容程序结合使用、对患者肌肉块定制毒素剂量或使用新的注射和应用技术来实现。除了改善面部线条，使用BONT-A改善增生性瘢痕和瘢痕疙瘩的外观，甚至预防它们，已经看到了令人鼓舞的结果。已经对身体不同部位的疤痕进行了研究，进一步的研究正在进行中。皮肤病和其他医学用途的BONT-A也是活跃的研究领域。注射BoT-A已被证明可以减少痤疮、酒渣鼻和牛皮癣的体征和症状，减少神经肌肉疼痛，并对一些由多汗症引起或加重的罕见疾病有显著改善。本文回顾了BONT-A的这些新用途，考察了它们的使用原理，并讨论了已发表的案例研究和临床试验的结果。到目前为止，这些领域已经显示出巨大的希望，但在这些治疗成为临床现实之前，还需要进行更多和更大规模的临床研究。为此，还提供了目前列在主要临床试验数据库中的临床试验的详细情况，以突出特别感兴趣的研究领域。