Publication: Development of inhibition ELISA to detect antibody-induced failure of botulinum toxin a therapy in cosmetic indications
Issued Date
2019-10-01
Resource Type
ISSN
18727905
00221759
00221759
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2-s2.0-85069917491
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Immunological Methods. Vol.473, (2019)
Suggested Citation
Yuttana Srinoulprasert, Watsachon Kantaviro, Ya Nin Nokdhes, Poramin Patthamalai, Lakkana Dowdon, Runglawan Chawengkiattikul, Rungsima Wanitphakdeedecha Development of inhibition ELISA to detect antibody-induced failure of botulinum toxin a therapy in cosmetic indications. Journal of Immunological Methods. Vol.473, (2019). doi:10.1016/j.jim.2019.112635 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51011
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Title
Development of inhibition ELISA to detect antibody-induced failure of botulinum toxin a therapy in cosmetic indications
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Abstract
© 2019 Secondary treatment failure (STF) of botulinum toxin A (BoNT/A) therapy in cosmetic indication has been postulated as production of antibody against active sites of BoNT/A in unresponsive patients. To prove of concept, detection of anti-BoNT/A antibody is required, however, current enzyme-linked immunosorbent assay (ELISA) detects human IgGs against whole BoNT/A molecule. We developed an inhibition ELISA to quantify antibodies bound to the active sites of BoNT/A using three mouse monoclonal antibodies targeting translocation domain, receptor binding site and catalytic domain of BoNT/A prior to processing ELISA to detect human IgG (hIgG) against BoNT/A. Adults naïve to BoNT/A, or treated and responsive (toxin-response), or treated but unresponsive (toxin-tolerance) were recruited. Detection of hIgG revealed that naïve volunteers had basal level of hIgG against whole BoNT/A, whereas its level was significantly lower than those hIgG in BoNT/A-exposed cohorts. Higher anti-BoNT/A levels in sera from volunteers ever-exposed to BoNT/A indicates that BoNT/A may provoke immune responses in BoNT/A-treated cohorts. Inhibition ELISA demonstrated that levels of BoNT/A-specific hIgG in tolerance patients had a dramatic decrease in mouse monoclonal antibody blockage, suggesting presence of hIgG specific to BoNT/A's three active sites in STF patients. Therefore, our ELISA detected hIgG against whole BoNT/A protein and BoNT/A active sites suggesting that human antibodies may cause STF. To compare with frontalis test, our inhibition ELISA provided good accuracy at 83.1% (50% sensitivity and 89.9% specificity). Our test may help clinicians to diagnose possibility of STF and also to monitor immune status against BoNT/A.