{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T18:28:12Z","timestamp":1792348092983,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2004,11,4]],"date-time":"2004-11-04T00:00:00Z","timestamp":1099526400000},"content-version":"vor","delay-in-days":2499,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[1998,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Immunoresistance (Ab+) to botulinum toxin type A (BTX\u2010A) has been a serous concern since the introduction of BTX\u2010A in the treatment of dystonia and other disorders associated with abnormal muscle contractions. We studied seven patients who developed Ab+ and later reverted to antibodynegative (Ab\u2010) status. These seven patients, six women (mean age, 56 years; range, 41\u201380 years), with an average duration of dystonia for all patients of 197 months (range, 84\u2013360 months), received a total mean cumulative dose of 1659 units (U) (range,810\u20101975 U), with an average dose of 207 U per visit. All of these patients became unresponsive to BTX\u2010A treatment and became Ab+ as determined by mouse bioassay. Their response to BTX\u2010A after they revertedd to Ab\u2010 was analyzed. The average latency between the initial BTX\u2010A treatment and development of Ab+ was 27 months (range, 15\u201343 months). The average duration between the detection of Ab+ status and subsequent reversal to Ab\u2010 status was 30 months (range, 10\u201378 months). Six of these Ab\u2010 patients were reinjected with BTX\u2010A, and all six benefited from repeat injections comparable with their earlier response. Three patients lost their clinical response to subsequent injections and were found to be again Ab+. Two of the five patients who became immunoresistant to BTX\u2010A received botulinum toxin type F (BTX\u2010F) injections and one patient received a single session of BTX\u2010B with improvement in their symptoms. In conclusion, this unique group of patients who were Ab+ and became Ab\u2010 responded favorably to repeat BTX\u2010A injections, but some lost the benefit with subsequent injections. These observations suggest that the anamnestic immunologic response to BTX\u2010A can wane, but can be reactivated by repeat BTX\u2010A treatments. The presence of antibodies did not interfere with the response to BTX\u2010F or BTX\u2010B injections, thus confirming the antigenic specificity of various BTX serotypes.<\/jats:p>","DOI":"10.1002\/mds.870130128","type":"journal-article","created":{"date-parts":[[2005,5,28]],"date-time":"2005-05-28T20:35:04Z","timestamp":1117312504000},"page":"150-154","source":"Crossref","is-referenced-by-count":72,"title":["Variability of the immunologic and clinical response in dystonic patients immunoresistant to botulinum toxin injections"],"prefix":"10.1002","volume":"13","author":[{"given":"Charulata","family":"Sankhla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Jankovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drake","family":"Duane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,11,4]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199104253241707"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.3928\/0191-3913-19800101-06"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(80)35127-0"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000120806"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.45.9.1743"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870090216"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.43.9.1715"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/150.3.407"},{"key":"e_1_2_1_10_2","first-page":"93","volume-title":"Therapy with botulinum toxin","author":"Hatheway CH","year":"1994"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1991.00530240057020"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.37.4.616"},{"key":"e_1_2_1_13_2","first-page":"699","article-title":"Autoimmune and dystonia distribution characteristics of cervical dystonia patients with initial resistance versus delayed resistance versus responsiveness to botulinum toxin therapy","volume":"10","author":"Duane DD","year":"1995","journal-title":"Mov Disord"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02220526"},{"key":"e_1_2_1_14_3","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/1.4.701"},{"key":"e_1_2_1_15_2","volume-title":"Botulism: the organism, its toxins, the disease","author":"Smith LDS","year":"1977"},{"key":"e_1_2_1_16_2","doi-asserted-by":"crossref","first-page":"1906","DOI":"10.1128\/jcm.27.8.1906-1908.1989","article-title":"Evaluation of neutralizing antibodies to type A, B, E, and F botulinum toxins in sera from human recipents of botulinum pentavalent (A, B, C, D, E) toxoid","volume":"27","author":"Siegel LS.","year":"1989","journal-title":"J Clin Microbiol"},{"key":"e_1_2_1_17_2","doi-asserted-by":"crossref","first-page":"2351","DOI":"10.1128\/jcm.26.11.2351-2356.1988","article-title":"Human response of botulinum pentavalent (A, B, C, D, E) toxiod determined by a neutralization test and by an enzymelinked immunosorbent assay","volume":"26","author":"Siegel LS.","year":"1988","journal-title":"J Clin Microbiol"},{"key":"e_1_2_1_18_2","first-page":"697","article-title":"Studies on immunity to toxins of Clostridium botulinum. 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Detoxification of purified type A & type B toxins and the antigenicity of univalent and bivalent aluminium phosphate adsorbed toxoids","volume":"84","author":"Wright GG","year":"1960","journal-title":"J Immunol"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199201303260516"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870080411"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.45.11.2109"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(84)90342-5"},{"key":"e_1_2_1_24_2","first-page":"268","article-title":"Management of factor VIII inhibitors: evolution and current status [Review]","volume":"22","author":"Bloom AL.","year":"1992","journal-title":"Haemostasis"}],"container-title":["Movement Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmds.870130128","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mds.870130128","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:37:39Z","timestamp":1760956659000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mds.870130128"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,1]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1998,1]]}},"alternative-id":["10.1002\/mds.870130128"],"URL":"https:\/\/doi.org\/10.1002\/mds.870130128","archive":["Portico"],"relation":{},"ISSN":["0885-3185","1531-8257"],"issn-type":[{"value":"0885-3185","type":"print"},{"value":"1531-8257","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,1]]}}}