Toxins最新文献

{"title":"Factors Influencing the Effectiveness of Botulinum Toxin Therapy in Bruxism Management.","authors":"Azusa Furuhata, Kazuya Yoshida, Shiroh Isono","doi":"10.3390/toxins17080384","DOIUrl":"https://doi.org/10.3390/toxins17080384","url":null,"abstract":"<p><p>A total of 304 patients with bruxism (206 women, 98 men; mean age: 52.5 years) received 25 units of botulinum toxin injected into the bilateral masseter muscles; the changes in various clinical symptoms and their contributing factors were analyzed 2 months after treatment. The mean masseter muscle electromyographic amplitude (189 μV) and maximal bite force (618.4 N) significantly decreased after botulinum toxin therapy compared to that at baseline (55.4 μV, 527.3 N, respectively; <i>p</i> < 0.001). Maximal mouth opening (44 mm), sleep quality (visual analog scale: 5.3), shoulder and neck stiffness (6.7), and headache (5.4) significantly improved after the injection (47.3 mm, 6.6, 4.7, and 2.6, respectively; <i>p</i> < 0.001). Multivariate analysis revealed that the mean masseter electromyographic amplitude reduction rate was significantly affected by age, sex, and baseline amplitude (all <i>p</i> < 0.001); the maximal bite force reduction rate was influenced by age (<i>p</i> < 0.001), sex (<i>p</i> = 0.007), and baseline bite force (<i>p</i> = 0.008). Age, sex, and muscle activity may affect the therapeutic effects. A more effective outcome for bruxism can be achieved using a tailored approach involving dose adjustment, thereby preventing the side effects attributed to excessive dosage.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12389857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Derivation of Human Toxicokinetic Parameters and Chemical-Specific Adjustment Factor of Citrinin Through a Human Intervention Trial and Hierarchical Bayesian Population Modeling.","authors":"Lia Visintin, Camilla Martino, Sarah De Saeger, Eugenio Alladio, Marthe De Boevre, Weihsueh A Chiu","doi":"10.3390/toxins17080382","DOIUrl":"https://doi.org/10.3390/toxins17080382","url":null,"abstract":"<p><strong>Background: </strong>Citrinin (CIT) is a mycotoxin produced by various fungi contaminating stored cereals and fruits. While biomonitoring and food occurrence data indicate widespread exposure, its public health risks remain unclear due to the lack of human toxicokinetic (TK) data.</p><p><strong>Methods: </strong>A UHPLC-MS/MS method was validated for CIT quantification in capillary blood (VAMS Mitra^® tips), feces, and urine obtaining LLOQs ≤ 0.05 ng/mL. A human TK study was conducted following a single oral bolus of 200 ng/kg bw CIT. Individual capillary blood (VAMS Mitra^® tips), feces, and urine samples were collected for 48 h after exposure. Samples were analyzed to determine CIT's TK profile.</p><p><strong>Results: </strong>TK modeling was performed using a multi-compartmental structure with a hierarchical Bayesian population approach, allowing robust parameter estimation despite the lack of standards for CIT metabolites.</p><p><strong>Conclusions: </strong>The derived TK parameters align with preliminary human data and significantly advance CIT exposure assessment via biomonitoring. A human inter-individual toxicokinetic variability (HK_AF) of 1.92 was calculated based on the derived AUC, indicating that EFSA's current default uncertainty factor for TK variability is adequately protective for at least 95% of the population.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Kv1.3 Channel Blocker from the Venom of the Ant <i>Tetramorium bicarinatum</i>.","authors":"Guillaume Boy, Laurence Jouvensal, Nathan Téné, Jean-Luc Carayon, Elsa Bonnafé, Françoise Paquet, Michel Treilhou, Karine Loth, Arnaud Billet","doi":"10.3390/toxins17080379","DOIUrl":"https://doi.org/10.3390/toxins17080379","url":null,"abstract":"<p><p>Ant venoms are rich sources of bioactive molecules, including peptide toxins with potent and selective activity on ion channels, which makes them valuable for pharmacological research and therapeutic development. Voltage-dependent potassium (Kv) channels, critical for regulating cellular excitability or cell cycle progression control, are targeted by a diverse array of venom-derived peptides. This study focuses on MYRTX_A4-Tb11a, a peptide from <i>Tetramorium bicarinatum</i> venom, which was previously shown to have a strong paralytic effect on dipteran species without cytotoxicity on insect cells. In the present study, we show that Tb11a exhibited no or low cytotoxicity toward mammalian cells either, even at high concentrations, while electrophysiological studies revealed a blockade of hKv1.3 activity. Additionally, Ta11a, an analog of Tb11a from the ant <i>Tetramorium africanum</i>, demonstrated similar Kv1.3 inhibitory properties. Structural analysis supports that the peptide acts on Kv1.3 channels through the functional dyad Y21-K25 and that the disulfide bridge is essential for biological activity, as reduction seems to disrupt the peptide conformation and impair the dyad. These findings highlight the importance of three-dimensional structure in channel modulation and establish Tb11a and Ta11a as promising Kv1.3 inhibitors. Future research should investigate their selectivity across additional ion channels and employ structure-function studies to further enhance their pharmacological potential.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12389897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Cytotoxicity and Metabolomics Analysis Reveals Cell-Type-Specific Responses to Co-Exposure of T-2 and HT-2 Toxins.","authors":"Weihua He, Zuoyin Zhu, Jingru Xu, Chengbao Huang, Jianhua Wang, Qinggong Wang, Xiaohu Zhai, Junhua Yang","doi":"10.3390/toxins17080381","DOIUrl":"https://doi.org/10.3390/toxins17080381","url":null,"abstract":"<p><p>T-2 toxin and HT-2 toxin are commonly found in agricultural products and animal feed, posing serious effects to both humans and animals. This study employed combination index (CI) modeling and metabolomics to assess the combined cytotoxic effects of T-2 and HT-2 on four porcine cell types: intestinal porcine epithelial cells (IPEC-J2), porcine Leydig cells (PLCs), porcine ear fibroblasts (PEFs), and porcine hepatocytes (PHs). Cell viability assays revealed a dose-dependent reduction in viability across all cell lines, with relative sensitivities in the order: IPEC-J2 > PLCs > PEFs > PHs. Synergistic cytotoxicity was observed at low concentrations, while antagonistic interactions emerged at higher doses. Untargeted metabolomic profiling identified consistent and significant metabolic perturbations in four different porcine cell lines under co-exposure conditions. Notably, combined treatment with T-2 and HT-2 resulted in a uniform downregulation of LysoPC (22:6), LysoPC (20:5), and LysoPC (20:4), implicating disruption of membrane phospholipid integrity. Additionally, glycerophospholipid metabolism was the most significantly affected pathway across all cell lines. Ether lipid metabolism was markedly altered in PLCs and PEFs, whereas PHs displayed a unique metabolic response characterized by dysregulation of tryptophan metabolism. This study identified markers of synergistic toxicity and common alterations in metabolic pathways across four homologous porcine cell types under the combined exposure to T-2 and HT-2 toxins. These findings enhance the current understanding of the molecular mechanisms underlying mycotoxin-induced the synergistic toxicity.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12389818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engineered Metal Nanoparticles: A Possible Small Solution to Big Problems Associated with Toxigenic Fungi and Mycotoxins.","authors":"Eva María Mateo, Fernando Mateo, Andrea Tarazona, Misericordia Jiménez","doi":"10.3390/toxins17080378","DOIUrl":"https://doi.org/10.3390/toxins17080378","url":null,"abstract":"<p><p>Mycotoxins are secondary metabolites produced primarily by certain species of the genera <i>Aspergillus</i>, <i>Fusarium</i>, <i>Penicillium</i>, <i>Alternaria</i>, and <i>Claviceps</i>. Toxigenic fungi and mycotoxins are prevalent in staple foods, resulting in significant economic losses and detrimental impacts on public health and food safety. These fungi demonstrate remarkable adaptation to water and heat stress conditions associated with climate change, and the use of synthetic antifungals can lead to the selection of resistant strains. In this context, the development of novel strategies for their prevention and control of food is a priority objective. This review synthesizes the extant knowledge concerning the antifungal and anti-mycotoxin potential of the primary metal nanoparticles (silver, copper) and metal oxide nanoparticles (copper oxide and zinc oxide) studied in the literature. It also considers synthesis methods and the lack of consensus on technical definitions and regulations. Despite methodological gaps and the scarcity of publications analyzing the effect of these NPs on fungal growth and mycotoxin production simultaneously, it can be concluded that these NPs present high reactivity, stability, and the ability to combat these food risks. However, aspects related to their biosafety and consumer acceptance remain major challenges that must be addressed for their implementation in the food industry.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modelling the Bioaccumulation of Ciguatoxins in Parrotfish on the Great Barrier Reef Reveals Why Biomagnification Is Not a Property of Ciguatoxin Food Chains.","authors":"Michael J Holmes, Richard J Lewis","doi":"10.3390/toxins17080380","DOIUrl":"https://doi.org/10.3390/toxins17080380","url":null,"abstract":"<p><p>We adapt previously developed conceptual and numerical models of ciguateric food chains on the Great Barrier Reef, Australia, to model the bioaccumulation of ciguatoxins (CTXs) in parrotfish, the simplest food chain with only two trophic levels. Our model indicates that relatively low (1 cell/cm²) densities of <i>Gambierdiscus</i>/<i>Fukuyoa</i> species (hereafter collectively referred to as <i>Gambierdiscus</i>) producing known concentrations of CTX are unlikely to be a risk of producing ciguateric fishes on the Great Barrier Reef unless CTX can accumulate and be retained in parrotfish over many months. Cell densities on turf algae equivalent to 10 <i>Gambierdiscus</i>/cm² producing known maximum concentrations of Pacific-CTX-4 (0.6 pg P-CTX-4/cell) are more difficult to assess but could be a risk. This cell density may be a higher risk for parrotfish than we previously suggested for production of ciguateric groupers (third-trophic-level predators) since second-trophic-level fishes can accumulate CTX loads without the subsequent losses that occur between trophic levels. Our analysis suggests that the ratios of parrotfish length-to-area grazed and weight-to-area grazed scale differently (allometrically), where the area grazed is a proxy for the number of <i>Gambierdiscus</i> consumed and hence proportional to toxin accumulation. Such scaling can help explain fish size-toxicity relationships within and between trophic levels for ciguateric fishes. Our modelling reveals that CTX bioaccumulates but does not necessarily biomagnify in food chains, with the relative enrichment and depletion rates of CTX varying with fish size and/or trophic level through an interplay of local and regional food chain influences. Our numerical model for the bioaccumulation and transfer of CTX across food chains helps conceptualize the development of ciguateric fishes by comparing scenarios that reveal limiting steps in producing ciguateric fish and focuses attention on the relative contributions from each part of the food chain rather than only on single components, such as CTX production.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Anti-BoNT/A Neutralizing Antibody Possessed Overlapped Epitope with SV2 and Had Prolonged Half-Life In Vivo.","authors":"Shangde Peng, Naijing Hu, Fenghao Peng, Huirong Mu, Zihan Yi, Cong Xing, Liang Zhang, Wen Hu, Xinyi Zhou, Yan Wen, Jiannan Feng, Chunxia Qiao","doi":"10.3390/toxins17080376","DOIUrl":"https://doi.org/10.3390/toxins17080376","url":null,"abstract":"<p><p>The C-terminus of the BoNT/A heavy chain (BoNT/AHC) mediates binding to its receptor, SV2, a critical step for toxicity. Antibody inhibition of this interaction enhances neuronal survival. We previously identified a functional anti-BoNT/AHC nanobody, HM. To extend its in vivo half-life, we designed and prepared two Fc-optimized nanoparticles, HM-Fc5 and HM-Fc6. Structural modeling (homology/docking) of the HM Fv-AHC complex predicted that HM engages key AHC residues (Tyr¹¹⁵⁵, Phe¹¹⁶⁰, Ile¹¹⁶¹, Val¹¹⁸⁴, Asn¹¹⁸⁸, Lys¹¹⁸⁹, Glu¹¹⁹⁰), which overlap with the SV2 binding site. This suggests HM's protective mechanism involves blocking toxin-receptor binding and cellular entry. HM-Fc5 and HM-Fc6 retained the stability and function of the parental HM antibody while exhibiting prolonged in vivo half-life. These optimized nanobodies offer economical candidates potentially enabling longer dosing intervals, beneficial for prophylaxis or chronic disease treatment. Significance Statement: The purpose of the study is to design and prepare two Fc optimized nanoparticles, HM-Fc5 and HM-Fc6, and predict the key residues involved in the interaction between HMs and AHC. The experimental results showed that HM-Fc5 and HM-Fc6 have the same stability as the parent HM antibody but have a longer half-life in vivo. The key residues Tyr¹¹⁵⁵, Phe¹¹⁶⁰, Ile¹¹⁶¹, Val¹¹⁸⁴, Asn¹¹⁸⁸, Lys¹¹⁸⁹, and Glu¹¹⁹⁰ overlap with the SV2 binding site. Our experimental results indicate that these nanobody candidates are not only more economical and convenient, but may also have longer dosing intervals, providing strong evidence and reference for prolonging the in vivo half-life of nanomaterials.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Botulinum Toxin Effects on Biochemical Biomarkers Related to Inflammation-Associated Head and Neck Chronic Conditions: A Systematic Review of Preclinical Research.","authors":"Ines Novo Pereira, Giancarlo De la Torre Canales, Sara Durão, Rawand Shado, Ana Cristina Braga, André Mariz Almeida, Haidar Hassan, Ana Cristina Manso, Ricardo Faria-Almeida","doi":"10.3390/toxins17080377","DOIUrl":"10.3390/toxins17080377","url":null,"abstract":"<p><p>Current research reported that the number of clinical studies found for botulinum toxin (BoNT) key effects on biochemical biomarkers in head and neck chronic conditions linked to inflammation was very low. There are no systematic reviews of animal studies on this topic, and hence our review aimed to evaluate the quality of the preclinical evidence. We searched PubMed, Scopus, and Web of Science databases, and registries up to 29 January 2024. There were 22 eligible records, and data were available for 11 randomised controlled trials. There were concerns about the risk of bias and great variations of data obtained regarding chronic conditions, which included mostly trigeminal neuralgia. The leading biomarkers were proinflammatory cytokines (IL-1β, TNF-α) and synaptosomal-associated protein-25 (SNAP25), followed by neuron activation marker c-Fos and calcitonin gene-related peptide (CGRP). Overall, data found that BoNT significantly altered the under/over-expression of biomarkers evoked by the investigated disease models and had no effect when the levels of these biomarkers were not changed by the induced chronic conditions in animals. However, there were some mixed results and exceptions, and the certainty evidence found was very low to low. Although the sample sizes detected significant effect size (<i>p</i> < 0.05), most studies are based on male inferior animals, which may limit the recommendations for clinical trials. This study is registered on PROSPERO (CRD42023432411).</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Series and Literature Review on Botulinum Toxin Efficacy in Axial Extensor Truncal Dystonia.","authors":"Jarosław Sławek, Iga Alicja Łobińska, Michał Schinwelski, Joanna Kopcewicz-Wiśniewska, Anna Castagna","doi":"10.3390/toxins17080375","DOIUrl":"10.3390/toxins17080375","url":null,"abstract":"<p><p>Axial truncal dystonia can present as either flexion or extension, often with a tendency toward lateral movement. Flexion dystonia is more common and may represent a clinical spectrum associated with parkinsonism. In contrast, extensor trunk dystonia is less frequent and exhibits a diverse range of causes. In this paper, we reviewed the literature on axial extensor trunk dystonia. We identified 11 studies involving 49 patients, of which only 10 had idiopathic trunk dystonia. Treatment with botulinum neurotoxin A (BoNT/A) emerged as the most effective therapy; however, many studies did not provide detailed descriptions of the treatment (4/11) and follow-up periods were not specified or short term (up to one-two years). We present four new, well-documented patients with the idiopathic form of extensor trunk dystonia who were treated with BoNT/A with moderate to significant effect according to Global Clinical Impression scale (GCI) and Burke-Fahn-Marsden (BFM) dystonia scale. These cases include long-term follow-up for three patients, all without any adverse events. While the diagnostic process and treatment can be challenging, we recommend using BoNT/A with adjusted doses tailored to the appropriate muscle groups as a first-line treatment.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12389960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Post-Care Recommendations Following Upper-Face Botulinum Toxin Treatment Scientifically Necessary? A Retrospective Study Based on 5000 Patients.","authors":"Adriano Santorelli, Giovanni Salti, Maurizio Cavallini, Salvatore Piero Fundarò, Matteo Basso, Martina Ponzo, Stefano Avvedimento, Stefano Uderzo","doi":"10.3390/toxins17080372","DOIUrl":"10.3390/toxins17080372","url":null,"abstract":"<p><strong>Background: </strong>Patient care following botulinum toxin injections has long been guided by anecdotal instructions, often based on theoretical considerations. This study evaluates the necessity of extended post-treatment instructions by analyzing outcomes and satisfaction in patients who followed only a 10 min precaution protocol.</p><p><strong>Materials and methods: </strong>A retrospective, multicentric study was conducted across six Italian centers, analyzing 5014 patients treated with botulinum toxin for upper facial wrinkles between 2015 and 2020. Outcomes included adverse effects-particularly upper eyelid ptosis-and patient satisfaction. Follow-up was performed at two weeks.</p><p><strong>Results: </strong>No cases of upper eyelid ptosis were observed. Among 4000 patients who attended follow-up, adverse effects occurred in only 5.99%, notably lower than rates reported in the literature. Of the 2010 patients who completed the satisfaction questionnaire, 90% reported being very satisfied. These findings support the safety of limiting post-treatment instructions to 10 min.</p><p><strong>Conclusions: </strong>Our findings indicate that omitting extended post-injection instructions does not negatively impact patient satisfaction or complication rates. Given the toxin's rapid internalization and localized effect, extended behavioral restrictions may be redundant. However, the absence of a control group and lack of statistical analyses limit the strength of these conclusions. In addition, this is a short-term study. Future prospective, randomized trials are needed to develop evidence-based post-care protocols to optimize esthetic outcomes, patient safety, and long-term efficacy.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 8","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}