Toxins最新文献

{"title":"Dual-Toxin-Producing <i>Clostridium botulinum</i> Strain Isolated from a Foodborne Botulism Case in Korea: Genomic and Functional Insights.","authors":"Eun-Sun Choi, Chi-Hwan Choi, Jun-Ho Jeon, So-Hyeon Kim, Hyun-Ju Song, Hwajung Yi, Gi-Eun Rhie, Yoon-Seok Chung","doi":"10.3390/toxins17060299","DOIUrl":"10.3390/toxins17060299","url":null,"abstract":"<p><p><i>Clostridium botulinum</i> produces one of the most potent biological toxins and causes botulism, a rare but potentially fatal neuroparalytic disease. In 2014, a foodborne botulism case was reported in Korea, and a strain (CB-2014001) was isolated. Initial characterization identified it as a BoNT/B-producing strain based on mouse bioassay and conventional PCR. However, subsequent genomic analysis revealed the presence of dual BoNT gene clusters, bont/B and bont/F, corresponding to subtypes B5 and F2, respectively. Therefore, we aimed to analyze the genetic characteristics and toxin expression profiles of the isolated strain. The strain showed high sequence identity with Bf-type strains such as CDC 3281 and An436. Functional assays confirmed simultaneous expression of both BoNT/B and /F toxins at 35 °C, and temperature-dependent assays revealed predominant expression of BoNT/F at 30 °C and BoNT/B at 37 °C, indicating that toxin expression is influenced by environmental temperature. These findings highlight the potential for differential pathogenicity based on culture conditions and underscore the importance of developing diagnostic tools capable of detecting multiple <i>bont</i> genes. To our knowledge, this is the first report of a dual-toxin-producing <i>C. botulinum</i> strain associated with foodborne botulism in Korea, providing important insights into botulism diagnosis, treatment strategies, and public health preparedness.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485806","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":"Calcimimetics and Vascular Calcification.","authors":"Avinash Chandu, Carolt Arana, Juan Daniel Díaz-García, Mario Cozzolino, Paola Ciceri, José-Vicente Torregrosa","doi":"10.3390/toxins17060297","DOIUrl":"10.3390/toxins17060297","url":null,"abstract":"<p><p>In patients with chronic kidney disease (CKD), cardiovascular events (CVA) are the main cause of morbidity and mortality. Vascular calcification, linked to bone mineral metabolism disorders such as elevated serum phosphate, parathyroid hormone (PTH), and FGF23, well-known uremic toxins, aggravate this risk. Calcimimetics are allosteric activators of the calcium-sensing receptor (CaSR), a G protein-coupled receptor that regulates PTH secretion and synthesis in response to changes in extracellular calcium in the parathyroid glands. Through direct and indirect mechanisms, they have demonstrated their efficacy in reducing the progression of vascular, valvular, and soft tissue calcification in experimental studies. Although clinical studies in dialysis patients did not achieve statistical significance in their primary objectives, positive results in subgroup analyses suggest that the lack of significance may be attributable to the short follow-up period. This finding highlights the need to consider early treatment strategies, especially in advanced stages of chronic kidney disease, to more effectively address the progression of vascular calcification through serum uremic toxins control.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485858","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":"Cladoceran <i>Chydorus sphaericus</i> and Colonial Cyanobacteria: Potentially a Toxic Relationship?","authors":"Helen Agasild, Ilmar Tõnno, Margarita E Gonzales Ferraz, Peeter Nõges, Priit Zingel, Lea Tuvikene, René Freiberg, Tiina Nõges, Kristel Panksep","doi":"10.3390/toxins17060298","DOIUrl":"10.3390/toxins17060298","url":null,"abstract":"<p><p><i>Chydorus sphaericus</i> is often a dominant cladoceran zooplankton species in water bodies experiencing harmful cyanobacterial blooms. However, its relationship with toxin-producing algae remains largely unexplored. In this study, the feeding behavior of <i>C. sphaericus</i> on colonial cyanobacteria and potentially toxic <i>Microcystis</i> was investigated in a temperate, shallow, eutrophic lake. Liquid chromatographic analyses of phytoplankton marker pigments in <i>C. sphaericus</i> gut content revealed that pigments characteristic of cyanobacteria (identified a zeaxanthin, echinenone, and canthaxanthin) comprised the majority of its diet. Among them, colonial cyanobacteria (marked by the pigment canthaxanthin) were the highly preferred food source despite their minor contribution to phytoplankton biomass. qPCR targeting <i>Microcystis</i> genus-specific <i>mcyE</i> synthase genes, which are involved in microcystin biosynthesis, indicated that potentially toxic strains of <i>Microcystis</i> were present in <i>C. sphaericus</i> gut content throughout its temporal and spatial presence in the lake. The results suggest that the common small cladoceran in eutrophic waters, <i>C. sphaericus</i>, has a close trophic interaction with colonial cyanobacteria (including <i>Microcystis</i>) and may represent an important vector for transferring toxigenic <i>Microcystis</i> to the food web, even under conditions of low <i>Microcystis</i> biomass in the lake water.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485859","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":"Bioaccumulation, Distribution and Biotransformation of Cylindrospermopsin in Potato (<i>Solanum tuberosum</i>) After Exposure by Surface or Sprinkler Irrigation.","authors":"Fredy Duque, Ana Isabel Prieto, Antonio Cascajosa-Lira, Luis Carlos Montenegro, Alexandre Campos, Angeles Jos, Ana M Cameán","doi":"10.3390/toxins17060301","DOIUrl":"10.3390/toxins17060301","url":null,"abstract":"<p><p>Cylindrospermopsin is an emerging cyanotoxin that can lead to phytotoxicity through different mechanisms. The presence of CYN in irrigation waters is of concern due to potential accumulation in plants, increasing the risk of human exposure by the consumption of vegetables. In this case, it is proposed to evaluate the effects of CYN on a crop considered staple food in Colombia, such as <i>Solanum tuberosum</i>, group Phureja var Criolla Colombia, known as \"yellow potato\". This work evaluates for the first time the effects of CYN in potato plants exposed to this toxin using two different irrigation systems, surface and sprinkler irrigation. The parameters evaluated were CYN bioaccumulation and biotransformation in different parts of the potato plants irrigated with water containing CYN at environmentally relevant concentrations (84.65, 33.80, 3.05 and 3.05 µg/L after first, second, and third to fourth applications, respectively) and changes in nutritional mineral content in tubers. For this purpose, the concentrations of CYN and its potential metabolites in leaves, stem, roots, and tubbers of the plants exposed to the toxin were determined by Ultra-high Performance Liquid Chromatography-MS/MS (UHPLC-MS/MS). Mineral content was determined by Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES). CYN bioaccumulation was detected only in aerial parts of plants with sprinkler irrigation. A total of 57 CYN metabolites were found, and the main differences obtained in CYN biotransformation are linked to tissues and exposure conditions. There are significant differences in levels of Ca, K, Mg, Na, P, Cu, Fe, Mn, and Zn in tubers depending on CYN treatment, with higher contents after surface irrigation, and lower content with sprinkler application. These results demonstrate that the exposure conditions are an important factor for the potential presence and effects of CYN in potato plants.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485856","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":"Subchronic Exposure to Microcystin-LR Induces Hepatic Inflammation, Oxidative Stress, and Lipid Metabolic Disorders in Darkbarbel Catfish (<i>Tachysurus vachelli</i>).","authors":"Huaxing Zhou, Tong Li, Huan Wang, Ye Zhang, Yuting Hu, Amei Liu, Guoqing Duan","doi":"10.3390/toxins17060300","DOIUrl":"10.3390/toxins17060300","url":null,"abstract":"<p><p>Microcystin-leucine arginine (MC-LR) is a prominent water pollutant known for its potent hepatic toxicity. However, the effects of subchronic exposure to environmentally relevant concentrations of MC-LR on the fish liver remain poorly understood. This study aimed to systematically evaluate the impact of subchronic MC-LR exposure on the liver of darkbarbel catfish (<i>Tachysurus vachelli</i>). A total of 270 one-year-old fish were exposed to MC-LR (0, 2, and 5 μg/L) for 28 days and sampled on days 14 (D14) and 28 (D28). Histopathological analysis revealed marked hepatic inflammation in the MC-LR treatment groups, manifested as cellular degeneration, hyperemia, and inflammation. MC-LR exposure induced oxidative stress, evidenced by elevated malondialdehyde (MDA) levels and compensatory upregulation of superoxide dismutase (SOD) activity on D28. While hepatic lipid profiles were not altered by low-dose MC-LR, significant elevation of low-density lipoprotein cholesterol (LDL-C) specifically on D28 indicated incipient lipid metabolic disorder. Metabolomic analysis demonstrated a higher sensitivity, highlighting the stress response of the liver to low-dose MC-LR exposure. The results suggest MC-LR exposure disrupted hepatic phosphatidylcholine (PC) biosynthesis and inhibited lipoprotein formation, thereby impairing lipid transport and contributing to lipid metabolic disorders. In summary, subchronic exposure to environmentally relevant concentrations of MC-LR-induced hepatic tissue inflammation, oxidative stress, and lipid metabolic disorders in darkbarbel catfish.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485896","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":"Cyanobacterial Blooms and the Presence of Cyanotoxins in the Brazilian Amazon.","authors":"Maria Paula Cruz Schneider, Elane Cunha, Lucas Silva, James Leão, Vanessa Costa Tavares, Eliane Brabo de Sousa, Silvia Faustino","doi":"10.3390/toxins17060296","DOIUrl":"10.3390/toxins17060296","url":null,"abstract":"<p><p>The records of blooms and cyanotoxins in the Brazilian Legal Amazon are scarce and do not represent the reality observed in recent years when there was an increase in notifications and studies carried out in this region. In this article, we carefully analyzed 48 studies to identify the locations where the blooms occurred, the most frequent species, and the tests performed to detect cyanotoxins within the territory of the Brazilian Legal Amazon. The analyzed studies identified approximately 145 taxa of cyanobacteria, and the most frequent species belong to the genera <i>Microcystis</i> and <i>Planktothrix</i>. The most frequently detected cyanotoxin was microcystin, and, in some locations, even with a low cell density, there was the production of toxins. In most cases, <i>Microcystis</i> and <i>Dolichospermum</i> were the major genera associated with blooms and toxin production. The state of Pará had the highest number of records of toxin-producing cyanobacteria, including records of seasonal events, while Acre had no records. This work contributes to our knowledge of the geographic distribution and occurrence of cyanobacteria and cyanotoxins in the Brazilian Amazon and proposes new strategies for improving the monitoring of cyanotoxins in the Amazon region.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485866","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":"From Physicochemical Classification to Multidimensional Insights: A Comprehensive Review of Uremic Toxin Research.","authors":"Mario Cozzolino, Lorenza Magagnoli, Paola Ciceri","doi":"10.3390/toxins17060295","DOIUrl":"10.3390/toxins17060295","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a global health burden, with uremic toxins (UTs) playing a central role in its pathophysiology. In this review, we systematically examined the evolution of UT classification from the 2003 European Uremic Toxin Work Group (EUTox) system based on molecular weight and protein-binding properties to the 2023 multidimensional framework integrating clinical outcomes, clearance technologies, and artificial intelligence. We highlighted the toxicity mechanisms of UTs across the cardiovascular, immune, and nervous systems and evaluated traditional (e.g., low-/high-flux hemodialysis) and advanced (e.g., high-cutoff dialysis and hemoadsorption) clearance strategies. Despite progress, challenges persist in toxin detection, clearance efficiency, and personalized therapy. Future directions include multi-omics-based biomarker discovery, optimized dialysis membranes, advanced adsorption technology, and AI-driven treatment personalization. This synthesis aims to bridge translational gaps and guide precision medicine in nephrology.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485809","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":"CYP1B1 Knockout in a Bovine Hepatocyte-like Cell Line (BFH12) Unveils Its Role in Liver Homeostasis and Aflatoxin B1-Induced Hepatotoxicity.","authors":"Silvia Iori, Ludovica Montanucci, Caterina D'Onofrio, Maija Lahtela-Kakkonen, Lorena Lucatello, Anisa Bardhi, Andrea Barbarossa, Francesca Capolongo, Anna Zaghini, Marianna Pauletto, Mauro Dacasto, Mery Giantin","doi":"10.3390/toxins17060294","DOIUrl":"10.3390/toxins17060294","url":null,"abstract":"<p><p>CYP1B1 is a key enzyme involved in xenobiotic and endogenous metabolism, yet its physiological role in bovine liver homeostasis remains unclear. In this study, we generated a <i>CYP1B1</i> knockout (<i>CYP1B1</i>^KO) bovine hepatocyte-like cell line to indirectly investigate its role in liver function. Transcriptomic analysis revealed alterations in immune regulation, epithelial barrier integrity, and detoxification pathways, with concurrent compensatory <i>CYP1A1</i> upregulation. Beyond its physiological role, CYP1B1 was found to actively participate in Aflatoxin B1 (AFB1) metabolism, a mycotoxin posing significant health risks to humans and livestock. Molecular docking suggested that CYP1B1 facilitates the conversion of AFB1 into AFM1 and AFBO. In agreement with these predictions, <i>CYP1B1</i>^KO cells exposed to AFB1 showed reduced AFM1 production and decreased cytotoxicity. Further transcriptomic analysis indicated that <i>CYP1B1</i>^KO cells exhibited mitigated oxidative stress and inflammatory responses, along with downregulation of <i>CYP3A74</i>, a key enzyme in AFB1 bioactivation. This suggests that <i>CYP1B1</i> KO reduces AFB1 toxicity by directly limiting AFB1 bioactivation and indirectly modulating the broader hepatic CYP network, further limiting the formation of toxic intermediates. These findings provide novel insights into <i>CYP1B1</i>'s function in bovine hepatocytes, highlighting its dual role in maintaining liver homeostasis and mediating AFB1 metabolism. The observed interplay between CYP1B1, CYP1A1, and CYP3A74 underscores the complexity of AFB1 biotransformation and warrants further investigation into the coordinated regulation of xenobiotic metabolism in cattle.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485867","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":"Lipopolysaccharide Induces Mitochondrial Fragmentation and Energetic Shift in Reactive Microglia: Evidence for a Cell-Autonomous Program of Metabolic Plasticity.","authors":"Marcelle Pereira Dos Santos, Vitor Emanuel Leocadio, Lívia de Sá Hayashide, Mariana Marques, Clara Fernandes Carvalho, Antonio Galina, Luan Pereira Diniz","doi":"10.3390/toxins17060293","DOIUrl":"10.3390/toxins17060293","url":null,"abstract":"<p><p>Microglia, the resident immune cells of the central nervous system (CNS), play essential roles in maintaining brain homeostasis. While transient activation is protective, chronic microglial reactivity contributes to neuroinflammatory damage and neurodegeneration. The mitochondrial mechanisms underlying this shift remain poorly understood. Here, we investigated whether lipopolysaccharide (LPS) induces coordinated mitochondrial and metabolic alterations in BV-2 microglial cells. LPS stimulation (100 ng/mL, 24 h) induced a reactive phenotype, with increased Iba1 (+82%), F4/80 (+132%), and Cd68 (+44%), alongside elevated hydrogen peroxide (~6-fold) and nitrite (~45-fold). Cytotoxicity increased by 40% (LDH assay), and cell viability dropped to ~80% of the control (MTT). Extracellular lactate increased, indicating glycolytic reprogramming. However, LPS-primed cells showed greater ATP depletion under antimycin A challenge, reflecting impaired metabolic flexibility. Hoechst staining revealed a ~4-fold increase in pyknotic nuclei, indicating apoptosis. Mitochondrial dysfunction was confirmed by a 30-40% reduction in membrane potential (TMRE, JC-1), a ~30% loss of Tomm20, and changes in dynamics: phospho-Drp1 increased (+23%), while Mfn1/2 decreased (33%). Despite a ~70% rise in Lamp2 signal, Tomm20-Lamp2 colocalization decreased, suggesting impaired mitophagy. High-resolution respirometry revealed decreased basal (-22%), ATP-linked (24%), and spare respiratory capacity (41%), with increased non-mitochondrial oxygen consumption. These findings demonstrate that LPS induces mitochondrial dysfunction, loss of metabolic adaptability, and increased apoptotic susceptibility in microglia. Mitochondrial quality control and energy flexibility emerge as relevant targets to better understand and potentially modulate microglial responses in neuroinflammatory and neurodegenerative conditions.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485871","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":"Patient Satisfaction with Aesthetic Outcomes Following OnabotulinumtoxinA Treatment for Chronic Migraine: A Cross-Sectional Study.","authors":"Magdalena Boczarska-Jedynak, Marta Bott-Karoń, Karol Marschollek, Mariola Antolak, Maciej Świat, Marta Waliszewska-Prosół","doi":"10.3390/toxins17060292","DOIUrl":"10.3390/toxins17060292","url":null,"abstract":"<p><p>OnabotulinumtoxinA (OnaBoNT-A) is approved for chronic migraine prevention and follows the PREEMPT protocol with injections in the glabellar and forehead regions. While aesthetic changes are considered a side effect, their effect on patient satisfaction has not been thoroughly assessed. This study evaluated patient satisfaction with facial aesthetic outcomes after repeated OnaBoNT-A treatment for chronic migraine. Conducted at specialist headache centers, it included adult patients with chronic migraine who had received at least three OnaBoNT-A cycles. Participants completed a structured questionnaire on demographics, migraine history, facial wrinkles and age perception, appearance satisfaction, psychological impact, treatment satisfaction, and adverse aesthetic events. A total of 124 patients (92.7% female; median age 42.5 years) participated. OnaBoNT-A reduced wrinkle severity (<i>p</i> < 0.0001). Most patients (74.2%) reported aesthetic improvement post-treatment. The majority of patients (76.7%) declared that treatment met or exceeded expectations. 32% reported looking younger post-treatment, with a median perceived age difference of 5 years. Adverse event frequency was similar to pivotal trial outcomes, mostly mild, with no treatment discontinuations. OnaBoNT-A for chronic migraine, following the PREEMPT protocol, provides significant therapeutic benefits and high patient satisfaction regarding aesthetic outcomes. Although aesthetic side effects were generally mild, they were not uncommon.</p>","PeriodicalId":23119,"journal":{"name":"Toxins","volume":"17 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485878","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}