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Published in: Current Allergy and Asthma Reports 8/2016

01-08-2016 | Rhinitis (JJ Oppenheimer and J Corren, Section Editors)

Botulinum Toxin for Rhinitis

Authors: Cengiz Ozcan, Onur Ismi

Published in: Current Allergy and Asthma Reports | Issue 8/2016

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Abstract

Purpose of Review

Rhinitis is a common clinical entity. Besides nasal obstruction, itching, and sneezing, one of the most important symptoms of rhinitis is nasal hypersecretion produced by nasal glands and exudate from the nasal vascular bed. Allergic rhinitis is an IgE-mediated inflammatory reaction of nasal mucosa after exposure to environmental allergens. Idiopathic rhinitis describes rhinitis symptoms that occur after non-allergic, noninfectious irritants. Specific allergen avoidance, topical nasal decongestants, nasal corticosteroids, immunotherapy, and sinonasal surgery are the main treatment options. Because the current treatment modalities are not enough for reducing rhinorrhea in some patients, novel treatment options are required to solve this problem.

Recent Findings

Botulinum toxin is an exotoxin generated by Clostridium botulinum. It disturbs the signal transmission at the neuromuscular and neuroglandular junction by inhibiting the acetylcholine release from the presynaptic nerve terminal. It has been widely used in neuromuscular, hypersecretory, and autonomic nerve system disorders. There have been a lot of published articles concerning the effect of this toxin on rhinitis symptoms. Based on the results of these reports, intranasal botulinum toxin A administration appears to be a safe and effective treatment method for decreasing rhinitis symptoms in rhinitis patients with a long-lasting effect.

Summary

Botulinum toxin type A will be a good treatment option for the chronic rhinitis patients who are resistant to other treatment methods.
Literature
1.•
go back to reference Bousquet J, Khaltaev N, Cruz AA, et al. Allergic Rhinitis and Its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen. Allergy. 2008;63 suppl 86:8–160. This report is about updating the new classification of allergic rhinitis.CrossRefPubMed Bousquet J, Khaltaev N, Cruz AA, et al. Allergic Rhinitis and Its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen. Allergy. 2008;63 suppl 86:8–160. This report is about updating the new classification of allergic rhinitis.CrossRefPubMed
2.
go back to reference International Consensus Report on Diagnosis and Management of Rhinitis. International Rhinitis Management Working Group. Allergy. 1994;49 Suppl 19:1–34. International Consensus Report on Diagnosis and Management of Rhinitis. International Rhinitis Management Working Group. Allergy. 1994;49 Suppl 19:1–34.
3.
go back to reference Ozcan C, Vayisoglu Y, Dogu O, Gorur K. The effect of intranasal injection of botulinum toxin A on the symptoms of vasomotor rhinitis. Am J Otolaryngol. 2006;27:314–8.CrossRefPubMed Ozcan C, Vayisoglu Y, Dogu O, Gorur K. The effect of intranasal injection of botulinum toxin A on the symptoms of vasomotor rhinitis. Am J Otolaryngol. 2006;27:314–8.CrossRefPubMed
4.•
go back to reference Rohrbach S, Junghans K, Köhler S, Laskawi R. Minimally invasive application of botulinum toxin A in patients with idiopathic rhinitis. Head Face Med. 2009;5:18. This study is the first clinical study presenting the effect of sponge-soaked application of botulinum toxin-A.CrossRefPubMedPubMedCentral Rohrbach S, Junghans K, Köhler S, Laskawi R. Minimally invasive application of botulinum toxin A in patients with idiopathic rhinitis. Head Face Med. 2009;5:18. This study is the first clinical study presenting the effect of sponge-soaked application of botulinum toxin-A.CrossRefPubMedPubMedCentral
5.•
go back to reference Bachert C. Persistent rhinitis—allergic or nonallergic? Allergy. 2004;59 Suppl 76:11–5. This review outlines how to differentiate allergic rhinitis from the non-allergic rhinitis and what is important to diagnose non-allergic rhinitis.CrossRefPubMed Bachert C. Persistent rhinitis—allergic or nonallergic? Allergy. 2004;59 Suppl 76:11–5. This review outlines how to differentiate allergic rhinitis from the non-allergic rhinitis and what is important to diagnose non-allergic rhinitis.CrossRefPubMed
6.•
go back to reference Shaari CM, Sanders I, Wu BL, Biller HF. Rhinorrhea is decreased in dogs after nasal application of botulinum toxin. Otolaryngol Head Neck Surg. 1995;112:566–71. This experimental study firstly showed the effect of BTX-A on nasal secretion.PubMed Shaari CM, Sanders I, Wu BL, Biller HF. Rhinorrhea is decreased in dogs after nasal application of botulinum toxin. Otolaryngol Head Neck Surg. 1995;112:566–71. This experimental study firstly showed the effect of BTX-A on nasal secretion.PubMed
7.
8.
go back to reference Ismi O, Ozcan C, Karabacak T, et al. Local of neurotrophin-3 in neuronal inflammation of allergic rhinitis: preliminary report. Balk Med J. 2015;32:364–70.CrossRef Ismi O, Ozcan C, Karabacak T, et al. Local of neurotrophin-3 in neuronal inflammation of allergic rhinitis: preliminary report. Balk Med J. 2015;32:364–70.CrossRef
9.
go back to reference Tai CF, Baraniuk JM. A tale of two neurons in the upper airways: pain versus itch. Curr Allergy Asthma Rep. 2003;3:215–20.CrossRefPubMed Tai CF, Baraniuk JM. A tale of two neurons in the upper airways: pain versus itch. Curr Allergy Asthma Rep. 2003;3:215–20.CrossRefPubMed
10.
go back to reference Laing TA, Laing ME, O’Sullivan ST. Botulinum toxin for treatment of glandular hypersecretory disorders. J Plast Reconstr Aesthet Surg. 2008;61:1024–8.CrossRefPubMed Laing TA, Laing ME, O’Sullivan ST. Botulinum toxin for treatment of glandular hypersecretory disorders. J Plast Reconstr Aesthet Surg. 2008;61:1024–8.CrossRefPubMed
11.
go back to reference Bentivoglio AR, Del Grande A, Perracca M, Ialonga T. Clinical differences between botulinum neurotoxin type A and B. Toxicon. 2015;107:77–84.CrossRefPubMed Bentivoglio AR, Del Grande A, Perracca M, Ialonga T. Clinical differences between botulinum neurotoxin type A and B. Toxicon. 2015;107:77–84.CrossRefPubMed
12.
13.
go back to reference Naumann M, Jost W. Botulinum toxin treatment of secretory disorders. Mov Disord. 2004;19 suppl 8:137–41.CrossRef Naumann M, Jost W. Botulinum toxin treatment of secretory disorders. Mov Disord. 2004;19 suppl 8:137–41.CrossRef
14.
go back to reference Persaud R, Garas G, Silva S, Stamatoglou C, Chatrath P, Patel K. An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions. J R Soc Med Sh Rep. 2013;4:10.PubMedPubMedCentral Persaud R, Garas G, Silva S, Stamatoglou C, Chatrath P, Patel K. An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions. J R Soc Med Sh Rep. 2013;4:10.PubMedPubMedCentral
15.
go back to reference Naumann M, Dressler D, Hallett M, et al. Evidence-based review and assessment of botulinum neurotoxin for the treatment of secretory disorders. Toxicon. 2013;67:141–52.CrossRefPubMed Naumann M, Dressler D, Hallett M, et al. Evidence-based review and assessment of botulinum neurotoxin for the treatment of secretory disorders. Toxicon. 2013;67:141–52.CrossRefPubMed
17.
go back to reference Wen WD, Yuan F, Wang JL, Hou YP. Botulinum toxin therapy in the ovalbumin-sensitized rat. Neuroimmunomodulation. 2007;14:78–83.CrossRefPubMed Wen WD, Yuan F, Wang JL, Hou YP. Botulinum toxin therapy in the ovalbumin-sensitized rat. Neuroimmunomodulation. 2007;14:78–83.CrossRefPubMed
18.
go back to reference Kim KS, Kim SS, Yoon JH, Han JW. The effect of botulinum toxin type A injection for intrinsic rhinitis. J Laryngol Otol. 1998;112:248–51.CrossRefPubMed Kim KS, Kim SS, Yoon JH, Han JW. The effect of botulinum toxin type A injection for intrinsic rhinitis. J Laryngol Otol. 1998;112:248–51.CrossRefPubMed
19.
go back to reference Dykewicz MS, Hamilos DL. Rhinitis and sinusitis. J Allergy Clin Immunol. 2010;125:103–15.CrossRef Dykewicz MS, Hamilos DL. Rhinitis and sinusitis. J Allergy Clin Immunol. 2010;125:103–15.CrossRef
20.
go back to reference Aoishi K, Takahashi H, Hato N, et al. Treatment of allergic rhinitis with intranasal infusion of botulinum toxin type A in mice. 2016; 147:132-6. Aoishi K, Takahashi H, Hato N, et al. Treatment of allergic rhinitis with intranasal infusion of botulinum toxin type A in mice. 2016; 147:132-6.
21.•
go back to reference Rohrbach S, Olthoff A, Laskawi R, Giefer B, Götz W. Botulinum toxin type A induces apoptosis in glands of guinea pigs. Ann Otol Rhinol Laryngol. 2001;110:1045–50. This experimental study is the first study showing histological changes especially apoptosis of nasal glands after intranasal botulinum toxin application.CrossRefPubMed Rohrbach S, Olthoff A, Laskawi R, Giefer B, Götz W. Botulinum toxin type A induces apoptosis in glands of guinea pigs. Ann Otol Rhinol Laryngol. 2001;110:1045–50. This experimental study is the first study showing histological changes especially apoptosis of nasal glands after intranasal botulinum toxin application.CrossRefPubMed
22.
go back to reference Gunes MS, Kulahli I, Kokoglu K, et al. Evaluation of the effect of intranasal infiltrated botulinum toxin-A on a model of allergic rhinitis in rabbits: an experimental study. Int J Pediatr Otorhinolaryngol. 2016;83:51–6.CrossRefPubMed Gunes MS, Kulahli I, Kokoglu K, et al. Evaluation of the effect of intranasal infiltrated botulinum toxin-A on a model of allergic rhinitis in rabbits: an experimental study. Int J Pediatr Otorhinolaryngol. 2016;83:51–6.CrossRefPubMed
23.
go back to reference Zhu Z, Stone HF, Thach TQ, Garcia L, Ruegg CL. A novel botulinum neurotoxin topical gel: treatment of allergic rhinitis in rats and comparative safety profile. Am J Rhinol Allergy. 2012;26:450–4.CrossRefPubMed Zhu Z, Stone HF, Thach TQ, Garcia L, Ruegg CL. A novel botulinum neurotoxin topical gel: treatment of allergic rhinitis in rats and comparative safety profile. Am J Rhinol Allergy. 2012;26:450–4.CrossRefPubMed
24.
go back to reference Rohrbach S, Laskawi R. Minimally invasive application of Botulinum toxin type A in nasal hypersecretion. ORL J Otorhinolaryngol Relat Spec. 2001;63:382–4.CrossRefPubMed Rohrbach S, Laskawi R. Minimally invasive application of Botulinum toxin type A in nasal hypersecretion. ORL J Otorhinolaryngol Relat Spec. 2001;63:382–4.CrossRefPubMed
25.•
go back to reference Unal M, Sevim S, Dogu O, Vayisoglu Y, Kanik Y. Effect of botulinum toxin type A on nasal symptoms in patients with allergic rhinitis: a double-blind, placebo-controlled clinical trial. Acta Otolaryngol. 2003;123:1060–3. This report firstly showed the effect of intraturbinal injection of BTX-A in allergic rhinitis patients.CrossRefPubMed Unal M, Sevim S, Dogu O, Vayisoglu Y, Kanik Y. Effect of botulinum toxin type A on nasal symptoms in patients with allergic rhinitis: a double-blind, placebo-controlled clinical trial. Acta Otolaryngol. 2003;123:1060–3. This report firstly showed the effect of intraturbinal injection of BTX-A in allergic rhinitis patients.CrossRefPubMed
26.
go back to reference Wang J, Chen F, Meng M, Zhang X, Chen Y, Huang W, et al. The influence of botulinum toxin type A on vasomotor rhinitis and morphological study. [Article in Chinese]. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2003;17:643–5.PubMed Wang J, Chen F, Meng M, Zhang X, Chen Y, Huang W, et al. The influence of botulinum toxin type A on vasomotor rhinitis and morphological study. [Article in Chinese]. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2003;17:643–5.PubMed
27.
go back to reference Yang TY, Jung YG, Kim YH, Jang TY. A comparison of the effects of botulinum toxin A and steroid injection on nasal allergy. Otolaryngol Head Neck Surg. 2008;139:367–71.CrossRefPubMed Yang TY, Jung YG, Kim YH, Jang TY. A comparison of the effects of botulinum toxin A and steroid injection on nasal allergy. Otolaryngol Head Neck Surg. 2008;139:367–71.CrossRefPubMed
28.
go back to reference Sapci T, Yazici S, Evcimik MF, et al. Investigation of the effects of intranasal botulinum toxin type A and ipratropium bromide nasal spray on nasal hypersecretion in idiopathic rhinitis without eosinophilia. Rhinology. 2008;46:45–51.PubMed Sapci T, Yazici S, Evcimik MF, et al. Investigation of the effects of intranasal botulinum toxin type A and ipratropium bromide nasal spray on nasal hypersecretion in idiopathic rhinitis without eosinophilia. Rhinology. 2008;46:45–51.PubMed
29.
go back to reference Nowak K, Szyfter W. Application of botulinum toxin A in chronic intrinsic rhinitis. [Article in Polish]. Otolaryngol Pol. 2011;65:103–5.CrossRefPubMed Nowak K, Szyfter W. Application of botulinum toxin A in chronic intrinsic rhinitis. [Article in Polish]. Otolaryngol Pol. 2011;65:103–5.CrossRefPubMed
30.•
go back to reference Braun T, Gürkov R, Kramer MF, Krause E. Septal injection of botulinum neurotoxin A for idiopathic rhinitis: a pilot study. Am J Otolaryngol. 2012;33:64–7. This article showed the effect of nasal septal BTX-A injection in idiopathic rhinitis patients.CrossRefPubMed Braun T, Gürkov R, Kramer MF, Krause E. Septal injection of botulinum neurotoxin A for idiopathic rhinitis: a pilot study. Am J Otolaryngol. 2012;33:64–7. This article showed the effect of nasal septal BTX-A injection in idiopathic rhinitis patients.CrossRefPubMed
31.
go back to reference Abtahi SM, Hashemi SM, Abtahi SM, Bastani B. Septal injection in comparison with inferior turbinates injection of botulinum toxin A in patients with allergic rhinitis. J Res Med Sci. 2013;18:400–4.PubMedPubMedCentral Abtahi SM, Hashemi SM, Abtahi SM, Bastani B. Septal injection in comparison with inferior turbinates injection of botulinum toxin A in patients with allergic rhinitis. J Res Med Sci. 2013;18:400–4.PubMedPubMedCentral
32.
go back to reference Hashemi SM, Okhovat A, Amini S, Pourghasemian M. Comparing the effects of botulinum toxin-A and cetirizine on the treatment of allergic rhinitis. Allergol Int. 2013;62:245–9.CrossRefPubMed Hashemi SM, Okhovat A, Amini S, Pourghasemian M. Comparing the effects of botulinum toxin-A and cetirizine on the treatment of allergic rhinitis. Allergol Int. 2013;62:245–9.CrossRefPubMed
33.
go back to reference Shemshadi H, Azimian M, Kamrani AAK, Onsori MA. Botulinum toxin type A on an intranasal sponge for chronic allergic rhinitis: randomized clinical trial. Iran Rehabil J. 2013;11:5–11. Shemshadi H, Azimian M, Kamrani AAK, Onsori MA. Botulinum toxin type A on an intranasal sponge for chronic allergic rhinitis: randomized clinical trial. Iran Rehabil J. 2013;11:5–11.
34.
go back to reference Mozafarinia K, Abna M, Khanjani N. Effect of botulinum neurotoxin A injection into the submucoperichondrium of the nasal septum in reducing idiopathic non-allergic rhinitis and persistent allergic rhinitis. Iran J Otorhinolaryngol. 2015;27:253–9.PubMedPubMedCentral Mozafarinia K, Abna M, Khanjani N. Effect of botulinum neurotoxin A injection into the submucoperichondrium of the nasal septum in reducing idiopathic non-allergic rhinitis and persistent allergic rhinitis. Iran J Otorhinolaryngol. 2015;27:253–9.PubMedPubMedCentral
35.
36.
go back to reference Vayisoglu Y, Ozcan C, Pekdemir H, Gorur K, Pata YS, Camsari A. Autonomic nervous system evaluation using heart rate variability parameters in vasomotor rhinitis patients. J Otolaryngol. 2006;35:338–42.CrossRefPubMed Vayisoglu Y, Ozcan C, Pekdemir H, Gorur K, Pata YS, Camsari A. Autonomic nervous system evaluation using heart rate variability parameters in vasomotor rhinitis patients. J Otolaryngol. 2006;35:338–42.CrossRefPubMed
Metadata
Title
Botulinum Toxin for Rhinitis
Authors
Cengiz Ozcan
Onur Ismi
Publication date
01-08-2016
Publisher
Springer US
Published in
Current Allergy and Asthma Reports / Issue 8/2016
Print ISSN: 1529-7322
Electronic ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-016-0636-3

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