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2 - Botulinum toxin: history of clinical development

Published online by Cambridge University Press:  28 July 2009

Daniel Truong
Affiliation:
Orange Coast Memorial Medical Center
Dirk Dressler
Affiliation:
Hannover Medical School, Hannover, Germany
Mark Hallett
Affiliation:
George Washington University School of Medicine and Health Sciences, Washington, DC
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Summary

The clinical development of botulinum toxin began in the late 1960s with the search for an alternative to surgical realignment of strabismus. At that time, surgery of the extraocular muscles was the sole treatment. However, it was unsatisfactory due to variable results, consequent high reoperation rates, and its invasive nature. In an attempt to find an alternative, Alan B. Scott, an ophthalmologist from the Smith-Kettlewell Eye Research Institute in San Francisco, CA, USA, had been investigating the effects of different compounds injected into the extraocular muscles to chemically weaken them. The drugs tested initially proved unreliable, short acting or necrotizing (Scott et al., 1973). About this time, Scott became aware of Daniel Drachman, a renowned neuroscientist at Johns Hopkins University, and his work, in which he had been injecting minute amounts of botulinum toxin directly into the hind limbs of chicken to achieve local denervation (Drachman, 1972). Drachman introduced Scott to Edward Schantz (1908–2005) who was producing purified botulinum toxins for experimental use and generously making them available to the academic community. Schantz himself credits Vernon Brooks with the idea that botulinum toxin might be used for weakening muscle (Schantz, 1994). Brooks worked on the mechanism of action of botulinum toxin for his Ph.D. under the mentorship of Arnold Burgen, who suggested the project to him (Brooks, 2001). Schantz had left the US Army Chemical Corps at Fort Detrick, Maryland in 1972 to work at the Department of Microbiology and Toxicology, University of Wisconsin, Madison, WI, USA. Using acid precipitation purification techniques worked out at Fort Detrick by Lamanna and Duff, Schantz was able to make the purified botulinum toxins.

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Publisher: Cambridge University Press
Print publication year: 2009

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References

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