ArticleDermatology and therapy2025
A Pilot Study of Differences in Antibody Responses of Intradermal and Intramuscular Injections of Botulinum Toxin Type A.
Article in Dermatology and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Article
- LetibotulinumtoxinA for Rosacea: A Pilot Study.Toxins · 2026Article
- DC-CD4 bispecific tolerogenic nanovesicles induce antigen-specific regulatory T cells and ameliorate collagen-induced arthritis in mice.Nature communications · 2026Article
- Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionBotulinum toxin type A (BoNT/A) is commonly used for both medical and aesthetic purposes. However, approximately 3% of long-term recipients develop resistance, potentially due to antibody formation. Injection technique may influence immunogenicity, yet comparative data remain limited.
methodsThis pilot study evaluated antibody responses following intradermal versus intramuscular injection of six BoNT/A formulations: incobotulinumtoxinA, onabotulinumtoxinA, abobotulinumtoxinA, letibotulinumtoxinA1, letibotulinumtoxinA2, and prabotulinumtoxinA. A total of 120 subjects were divided into intradermal and intramuscular groups, with equal distribution across toxin types. Blood samples were collected and analyzed using ELISA to quantify human IgG (hIgG) targeting whole BoNT/A molecules, functional domains, and complexing proteins.
resultsIntradermal injections consistently induced higher BoNT/A-specific hIgG levels than intramuscular injections, except with letibotulinumtoxinA. Anti-functional domain hIgG levels peaked at day 30 and declined thereafter, aligning with the 90-day retreatment interval commonly recommended. Anti-complexing protein hIgG levels remained relatively stable across time points. Notably, all antibody levels remained below thresholds associated with clinical nonresponse.
conclusionIntradermal injection of BoNT/A appears to elicit a stronger immunogenic response than intramuscular administration, although antibody levels did not reach clinically significant thresholds. These findings underscore the importance of injection technique and interval planning to mitigate immunogenicity. Given the widespread use of intradermal techniques in aesthetic practice, this study provides important clinical insight into optimizing BoNT/A administration. THAI CLINICAL TRIALS REGISTRY NUMBER: TCTR20211215001.
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