{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T09:18:28Z","timestamp":1793092708449,"version":"4.5.0"},"reference-count":33,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T00:00:00Z","timestamp":1596499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>The three different botulinum toxin type A (BoNT\/A) preparations being licensed in Europe and the U.S. differ in protein content, which seems to be a major factor influencing the antigenicity of BoNT\/A. In the present study, several arguments out of our research pool were collected to demonstrate that the clinical response and antigenicity were different for the three BoNT\/A preparations: some results of (1) a cross-sectional study on clinical outcome and antibody formation of 212 patients with cervical dystonia (CD) being treated between 2 and 22 years; (2) another cross-sectional study on the clinical aspects and neutralizing antibody (NAB) induction of 63 patients having developed partial secondary treatment under abobotulinum (aboBoNT\/A) onabotulinumtoxin (onaBoNT\/A) who were switched to incobotulinumtoxin (incoBoNT\/A) in comparison to 32 patients being exclusively treated with incoBoNT\/A. These results imply that (1) the presence of NAB cannot be concluded from the course of treatment, that (2) an increase in the dose and variability of outcome with treatment duration indicates the ongoing induction of NABs over time, that (3) the higher protein load of BoNT\/A goes along with a higher incidence and prevalence of NAB induction and that (4) the best response to a BoNT\/A is also dependent on the protein load of the preparation.<\/jats:p>","DOI":"10.3390\/toxins12080499","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T05:56:46Z","timestamp":1596520606000},"page":"499","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Clinical Implications of Difference in Antigenicity of Different Botulinum Neurotoxin Type A Preparations: Clinical Take-Home Messages from Our Research Pool and Literature"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3593-1852","authenticated-orcid":false,"given":"Sara","family":"Samadzadeh","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital of D\u00fcsseldorf, Moorenstrasse 5, D-40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beyza","family":"\u00dcrer","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of D\u00fcsseldorf, Moorenstrasse 5, D-40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphaela","family":"Brauns","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of D\u00fcsseldorf, Moorenstrasse 5, D-40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of D\u00fcsseldorf, Moorenstrasse 5, D-40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John-Ih","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of D\u00fcsseldorf, Moorenstrasse 5, D-40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Albrecht","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of D\u00fcsseldorf, Moorenstrasse 5, D-40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1069-7684","authenticated-orcid":false,"given":"Harald","family":"Hefter","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of D\u00fcsseldorf, Moorenstrasse 5, D-40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1212\/WNL.0000000000002560","article-title":"Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology","volume":"86","author":"Simpson","year":"2016","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1007\/s00415-019-09681-7","article-title":"Effective long-term treatment with incobotulinumtoxin (Xeomin\u00ae) without neutralizing antibody induction: A monocentric, cross-sectional study","volume":"267","author":"Hefter","year":"2020","journal-title":"J. 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