Toxicon最新文献

{"title":"An outbreak of Urochloa decumbens intoxication in goats from Northeast Brazil","authors":"Silvio M.C. Fonseca ,&nbsp;Givaldo B. Silva Filho ,&nbsp;Elizandra T. Melo ,&nbsp;Andrezza C. Andrade ,&nbsp;José R.P. Santos ,&nbsp;Maria Luiza S.L. Frota ,&nbsp;Joaquim Evêncio-Neto ,&nbsp;Telma S. Lima ,&nbsp;Paula R. Pereira ,&nbsp;David Driemeier ,&nbsp;Fábio de Souza Mendonça","doi":"10.1016/j.toxicon.2025.108472","DOIUrl":"10.1016/j.toxicon.2025.108472","url":null,"abstract":"<div><div><em>Urochloa decumbens</em> is an important forage grass for Brazilian livestock and is widespread throughout the national territory. Despite its nutritional properties, <em>U. decumbens</em> is one of the most common causes of hepatogenous photosensitization in cattle and sheep in the country, and poisoning in goats is extremely rare<em>.</em> This study aimed to report the epidemiology, clinical signs, and gross and microscopic lesions of an outbreak of <em>U. decumbens</em> intoxication in goats in Northeastern Brazil. In this study, we propose the characterization of a previously unreported subacute clinical condition, which exhibited morbidity and lethality rates of 58 % and 57 %, respectively. Clinical signs were noted 30 days after an unexpected rainy season and consisted of photophobia, erythema of depigmented skin, transient facial and vulvar edema, inappetence, and purulent nasal and ocular discharge, that evolved to recumbency and death. The mean serum levels of AST and GGT were markedly increased. Gross lesions consisted of widespread icterus, crusts on the tips of the ears, and diffusely yellow-ochre livers with an irregular subcapsular surface. Microscopically, there was severe periportal mononuclear hepatitis with birefringent crystals within bile ducts and ductal proliferation. Twenty days after the removal of the herd from <em>U. decumbens</em>, lesions regressed, and the goats fully recovered. This study documents a rare outbreak of <em>U. decumbens</em> intoxication in goats in Northeastern Brazil, highlighting its potential to cause severe hepatogenous photosensitization. These findings reinforce the need for vigilance in regions where <em>U. decumbens</em> is widespread, particularly during rainy periods, and suggest that goats may face significant health risks under conducive environmental or management conditions.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"265 ","pages":"Article 108472"},"PeriodicalIF":2.6,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytotoxic activity of the crude venom from Odontomachus affinis ants is mediated by thiol oxidation and mitochondrial dysfunction","authors":"Jorge Luis Maria Ruiz ,&nbsp;Vyctória dos Santos Ramos ,&nbsp;Débora Cristina de Oliveira Gonçalves ,&nbsp;Thamires Regine Corga da Silva Angelo ,&nbsp;Priscila dos Santos Pazini ,&nbsp;Ricardo José Soares Torquato ,&nbsp;Wagner Alves de Souza Júdice ,&nbsp;Antonio Miranda ,&nbsp;Edgar Julian Paredes-Gamero ,&nbsp;Maria Santina de Castro Morini ,&nbsp;Tiago Rodrigues","doi":"10.1016/j.toxicon.2025.108469","DOIUrl":"10.1016/j.toxicon.2025.108469","url":null,"abstract":"<div><div>Animal toxins, including ant venoms, contain numerous compounds with potential biomedical and therapeutic applications. Ant venoms are mostly composed by peptides and proteins that might elicit inflammatory responses and cytotoxicity. The venom of <em>Odontomachus affinis</em>, a predatory ant species endemic to Brazil, is still poorly studied. Here, we evaluated the cytotoxic activity of the venom extracted from <em>O. affinis</em> glands and investigated the underlying mechanisms. Glands from 826 ants were dissected, followed by venom extraction and characterization by UV–vis and fluorescence spectroscopy and also by chromatography/mass spectroscopy. Cell viability was determined by MTT and trypan blue assays and the type of cell death by flow cytometry using annexin V-FITC/PI. Plasma membrane integrity was evaluated by LDH release. Mitochondrial bioenergetics were evaluated by the estimation of mitochondrial O₂ consumption and transmembrane potential. Also, protein thiol groups and reduced glutathione (GSH) were evaluated by spectroscopy. The crude extract of <em>O. affinis</em> exhibited a structured absorbance band in the UV region with maximal absorbance at 280 nm and a fluorescence emission band at 350–360 nm region. The chromatogram revealed at least 11 different molecules in its composition. <em>Odontomachus</em> <em>affinis</em> venom exhibited a concentration-dependent cytotoxicity in hepatoma and leukemia tumor cells, which was also observed in normal blood cells. Also, venom had the ability to affect mitochondria, increasing O₂ consumption. The mechanistic investigation conducted in leukemia cells revealed that venom induced-cell death was accompanied by plasma membrane permeabilization and oxidation of protein thiol groups and glutathione, which was associated with the dissipation of mitochondrial potential. Thus, <em>O. affinis</em> crude venom exhibits cytotoxic activity by triggering of mitochondrial permeabilization, affecting mitochondrial bioenergetics and cellular redox state. This study contributes to the comprehension of the mechanisms of toxicity of <em>O. affinis</em> venom and also prospects its potential as a source for novel bioactive molecules.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"265 ","pages":"Article 108469"},"PeriodicalIF":2.6,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First epidemiological reports of scorpion stings by Tityus confluens Borelli, 1899 (Scorpiones: Buthidae) in southern Brazil: an upcoming medically important species in Paraná","authors":"Paulo A.M. Goldoni ,&nbsp;Luiz F.M. Iniesta ,&nbsp;Juliana Cequinel ,&nbsp;Emanuel Marques-da-Silva ,&nbsp;Antonio D. Brescovit","doi":"10.1016/j.toxicon.2025.108468","DOIUrl":"10.1016/j.toxicon.2025.108468","url":null,"abstract":"<div><div>Scorpion envenomation is a growing public health concern in Brazil. The species <em>Tityus confluens</em> Borelli, 1899 has historically been overlooked as a major threat, although its recent presence in Paraná raises new concerns. This study documents for the first time 30 epidemiological reports of <em>T. confluens</em> stings in Paraná, primarily in Foz do Iguaçu (86.7 %) between 2012 and 2024. Most cases involved males (66.7 %), with victims exhibiting local symptoms such as pain (100 %), edema (60 %), and less commonly other manifestations as erythema and tingling (3.3 %). The most commonly stung body part were hands (15 reports, 50 %). No fatalities were recorded, and all cases were successfully managed with pain control measures, following national treatment guidelines. The presence of <em>T. confluens</em> in urban and rural areas, combined with taxonomic uncertainties and potential misidentifications in epidemiological databases, suggests the need for improved species identification and monitoring. Given to its synanthropic behavior, parthenogenetic reproduction, and reports of severe envenomation in Argentina, Bolivia, and Paraguay, <em>T. confluens</em> warrants further study as a potential medical concern in Brazil.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"264 ","pages":"Article 108468"},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacotherapeutic potential of artemetin against amiodarone instigated sub-chronic hepatotoxicity via modulating TLR4/HMGB1/RAGE and NF-κB signaling pathways: An in-vivo and in-silico approach.","authors":"Fuad M Alzahrani, Aqsa Bibi, Iqra Yasin, Arifa Mehreen, Khalid J Alzahrani, Khalaf F Alsharif","doi":"10.1016/j.toxicon.2025.108471","DOIUrl":"https://doi.org/10.1016/j.toxicon.2025.108471","url":null,"abstract":"<p><p>Amiodarone (AMI) has been widely used in cardiac patients to prevent the onset of life-threating cardiac arrhythmias. However, its excessive use induces various organ damages including the liver. Artemetin (ART) is a flavonoid that exhibits immense medicinal values. This investigation explored the palliative potential of ART against AMI induced sub-chronic hepato-toxicity. Thirty-two rats (Sprague Dawley) were randomly apportioned into control, AMI (40 mgkg^-1), AMI (40 mgkg^-1) + ART (1.5 mgkg^-1) and ART (1.5mg/kg) alone treated group. Our findings elucidated that AMI administration instigate severe hepatocellular inflammation which is evident by elevated gene expression of interleukin-6 (IL-6), receptor for advanced glycation end products (RAGE), tumor necrosis factor- α (TNF-α), cyclooxygenase-2 (COX-2), monocyte chemoattractant protein-1 (MCP-1), high mobility group box1 (HMGB1), interleukin-1β (IL-1β), nuclear factor- kappa B (NF-κB), toll-like receptor 4 (TLR4). AMI exposure promoted the levels of reactive oxygen species (ROS) and malondialdehyde (MDA) while suppressing the activities of superoxide dismutase (SOD), heme oxygenase-1 (HO-1), glutathione reductase (GSR), glutathione Peroxidase (GPx), catalase (CAT), and glutathione (GSH). Besides, AMI intoxication lowered the levels of albumin and total proteins while increasing the levels of ALT, GGT, AST, and ALP. Moreover, AMI administration exacerbated Caspase-9, Bax and Caspase-3 while diminishing Bcl-2 concentrations. The normal morphology of hepatic tissues was disrupted following the AMI exposure. Nonetheless, ART treatment significantly alleviated hepatic damage via regulating abovementioned biochemical as well as histological impairments. Our results demonstrated that ART can strongly interact with the active sites of these proteins and exhibit potential as hepatoprotective agent.</p>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":" ","pages":"108471"},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an analytical model for assessing the adsorptive properties of traditional medicinal formulations from Burkina Faso in relation to snake venom proteins","authors":"Moumouni Bande ,&nbsp;Cédric Delporte ,&nbsp;Abdoul Karim Sakira ,&nbsp;Axelle Bourez ,&nbsp;Virginie Imbault ,&nbsp;Xavier Bisteau ,&nbsp;Charles Sombie ,&nbsp;Touridomon Issa Some ,&nbsp;Pierre Van Antwerpen","doi":"10.1016/j.toxicon.2025.108470","DOIUrl":"10.1016/j.toxicon.2025.108470","url":null,"abstract":"<div><h3>Introduction</h3><div>The traditional treatment of snakebite envenomations across most regions of Burkina Faso relies on the use of formulations derived from the calcination of plants or specific plant parts. These preparations are subsequently administered either orally and/or applied topically to incisions made at the envenomation site.</div></div><div><h3>Objective</h3><div>Given the use of carbonised plants, this study was initiated to develop an analytical model for evaluating the adsorptive properties of these remedies in relation to the proteins found in snake venom.</div></div><div><h3>Method</h3><div>Traditional snakebite treatments were collected from three regions of the country and transported to the laboratory for analysis. The initial step involved characterising the physical and chemical properties of the remedies, such as granulometry and pH. Subsequent tests assessed the ability of the remedies to adsorb toxic venom proteins, using liquid chromatography coupled with high-resolution mass spectrometry (LC-HRMS). For those remedies exhibiting significant adsorption potential, the adsorbed venom proteins were identified using proteomics analysis.</div></div><div><h3>Results</h3><div>the results demonstrated that the recipe from Kampti, as well as activated charcoal (used as a reference adsorbent), exhibited noteworthy adsorption capacities. Both products showed a statistically significant reduction in the total quantity of venom adsorbed proteins. Kampti's recipe was particularly effective in adsorbing phospholipase A3, short neurotoxins 1 and snake venom metalloprotease.</div></div><div><h3>Conclusion</h3><div>This study bridges traditional ethnopharmacology with modern analytical chemistry, offering a promising framework for developing accessible and cost-effective adjunct therapies for snakebite envenomation in resource-limited settings.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"265 ","pages":"Article 108470"},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological Characterization of Vampire Bat-Derived CGRP at the Human CGRP Receptor in the Xenopus oocyte system.","authors":"Kathleen Carleer, Kavit Raval, Slavica Tudzarova, Jan Tytgat","doi":"10.1016/j.toxicon.2025.108466","DOIUrl":"https://doi.org/10.1016/j.toxicon.2025.108466","url":null,"abstract":"<p><p>Vampire bats (Desmodus rotundus) possess an oral venom system consisting of submandibular glands that produce bioactive compounds, delivered to prey via their sharp incisors. The venom has long been recognized for its anticoagulant and proteolytic properties, which disrupt blood clot formation and interfere with the coagulation cascade. A peptide with high structural similarity to human calcitonin gene-related peptide (hCGRP), a potent vasodilator, was recently discovered in the venom of Desmodus rotundus. This vampire bat-derived CGRP (vCGRP) elicited relaxation of pre-contracted rat mesenteric arteries, displaying efficacy and potency comparable to hCGRP. The authors proposed that vCGRP mediates vasorelaxation through activation of CGRP receptors (CGRPR) and voltage-dependent potassium (Kv) channels, thereby enhancing blood meal absorption via sustained blood flow. Our study builds on these findings by demonstrating that vCGRP is a potent agonist of hCGRPR and activates G protein-coupled inwardly rectifying potassium (GIRK1/2) channels. While the observed GIRK1/2 activation is consistent with membrane hyperpolarization mechanisms that may support vascular relaxation, our findings do not directly demonstrate vasodilation. Instead, they provide a detailed functional assessment of vCGRP-CGRPR signaling and downstream GPCR-ion channel activation. Notably, from the system studied here we found no involvement of Gs or Gq proteins, nor of Kv channels, in this signaling pathway. With a potency of 9 nM, vCGRP represents a highly effective mimic evolved to specifically and potently engage CGRPR in prey.</p>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":" ","pages":"108466"},"PeriodicalIF":2.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sirt1 Mitigates HT-2 Toxin-Induced Chondrocyte Injury Potentially via the Wnt/β-Catenin Signaling Pathway.","authors":"Haonan Li, Qi Zhang, Fang Qi, Qian Yu, Chenxi Wang, Ying Liu, Haoyu DU, Yue Zhao, Jun Yu","doi":"10.1016/j.toxicon.2025.108465","DOIUrl":"10.1016/j.toxicon.2025.108465","url":null,"abstract":"<p><p>Sirt1 is crucial for cartilage homeostasis, and its dysregulation is implicated in Kashin-Beck disease (KBD), an osteochondropathy linked to HT-2 toxin exposure. This study investigated Sirt1's role in HT-2 toxin-induced chondrocyte injury. Human fetal chondrocytes treated with HT-2 toxin (0, 5, 10, 20ng/mL) for 48 hours showed dose-dependent viability reduction, extracellular matrix (ECM) degradation (↓Collagen II, ↓TIMP1, ↑MMP13), and senescence (↑P21, ↑β-galactosidase). HT-2 toxin suppressed Sirt1 while activating Wnt/β-catenin signaling (↑WNT3A, ↑β-catenin). Resveratrol (25μM), a Sirt1 agonist, restored TIMP1 and Collagen II levels and reduced P21 without affecting MMP13, while inhibiting the WNT3A/β-catenin pathway. These results demonstrate that Sirt1 activation mitigates HT-2 toxin-induced chondrocyte damage by inhibiting Wnt/β-catenin signaling.</p>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":" ","pages":"108465"},"PeriodicalIF":2.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Utility of Point-of-Care Testing for Diagnosing Snake Envenomation in Australian Snake Bites: A scoping review.","authors":"Madison Bailey, Clinton Gibbs, Clare Heal, Chloe E Gane, Leanne Hall","doi":"10.1016/j.toxicon.2025.108464","DOIUrl":"10.1016/j.toxicon.2025.108464","url":null,"abstract":"<p><strong>Introduction: </strong>Most snake bites in Australia do not result in envenomation. However, when it does occur, envenomation can lead to a range of clinical syndromes, depending on the snake species involved. Diagnosis of envenomation, which relies primarily on laboratory investigations, poses a significant challenge when rapid identification of envenomation is essential for the timely administration of antivenom. Finding a solution to this challenge could enable earlier diagnosis and subsequent treatment of snake envenomation. This review assesses the existing literature on point-of-care testing methods for diagnosing snake envenomation across Australia.</p><p><strong>Methods: </strong>Six relevant databases were searched using appropriate subject headings and keywords, related to \"snake\" AND \"bite\" AND \"Australia\" with no time or language restrictions. Two reviewers screened titles and abstracts and full text articles. Data from included studies was extracted in duplicate.</p><p><strong>Results: </strong>1,260 articles were initially identified following removal of duplicates. After screening for eligibility, 12 relevant studies were identified. These articles explored four key areas of point-of-care testing in snake envenomation diagnosis: venom detection, coagulopathy detection, biomarker detection and cardiac assessment. No point-of-care test was found to sufficiently confirm envenomation to guide administration of antivenom in those with a suspected snake bite in Australia.</p><p><strong>Conclusion: </strong>This review underscores the need for continued research to explore novel approaches for the rapid diagnosis of snake envenomation. Improved diagnostic tools could enhance patient outcomes and potentially allow rural and remote areas without laboratory facilities to diagnose or rule out envenomation without patient transfer. However, the current literature is limited, and existing point-of-care methods lack sufficient accuracy to guide clinical practice.</p>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":" ","pages":"108464"},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunization of rabbits with nanovenom composed of Dendroaspis polylepis venom and silica nanoparticles: a first in vivo approach","authors":"Federico G. Baudou ,&nbsp;María Herrera ,&nbsp;Mariángela Vargas ,&nbsp;Mauren Villalta ,&nbsp;Florencia S. Conti ,&nbsp;Exequiel Giorgi ,&nbsp;Laura Leiva ,&nbsp;José María Gutiérrez ,&nbsp;Adolfo R. de Roodt ,&nbsp;Mauricio de Marzi","doi":"10.1016/j.toxicon.2025.108462","DOIUrl":"10.1016/j.toxicon.2025.108462","url":null,"abstract":"<div><div><em>Dendroaspis polylepis</em> inflicts severe neurotoxic envenomings due to its high content of potent neurotoxins. The poor immunogenicity of these toxins represents a significant challenge in antivenom (AV) generation. Silica nanoparticles (SiNPs) have been proposed for use in medicine due to their ability to stimulate the immune system. This study explored the possible use of SiNPs as adjuvant (ADJ) mixed with <em>D. polylepis</em> venom (nanovenoms, NV) for immunization in rabbits, compared to venom emulsified with the traditional Freund ADJ and with venom alone. ELISA results show that sera from rabbits immunized with NV developed an antibody response similar to sera from rabbits immunized with Freund adjuvant, and did not develop significant lesions at the injection site. Western blot analysis indicates that NV sera group showed a strong recognition of neurotoxins and neutralized a challenge dose of venom (1.5 LD₅₀), increasing the survival time of mice. In conclusion, NV proved to be a good ADJ in immunization with <em>D. polylepis</em> venom and could be tested for AV industrial production.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"264 ","pages":"Article 108462"},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localization modalities for botulinum neurotoxin injection","authors":"Barbara Illowsky Karp ,&nbsp;Ann Ly ,&nbsp;Katharine E. Alter","doi":"10.1016/j.toxicon.2025.108460","DOIUrl":"10.1016/j.toxicon.2025.108460","url":null,"abstract":"<div><div>Botulinum toxin is a targeted therapeutic that acts primarily at the site of injection. Various approaches have been taken to guide injection into the selected muscle, gland, organ or other body area. Guidance methodologies that can be used in the office setting for skeletal muscle and salivary gland percutaneous injection include uninstrumented manual needle placement, electromyography (EMG), electromyography with electrical stimulation (e-stim), ultrasound (US) and combined guidance (US + EMG or US + e-stim). This article reviews the advantages, disadvantages, and accuracy of each method and the impact of each guidance technique on therapeutic outcome for muscle and salivary gland injections. Overall, manual placement may suffice for large and superficial muscles, however, all instrumented techniques improve accuracy. Electromyography can uniquely provide information on muscle activity, while e-stim can aid injection in patients who cannot voluntarily activate a selected muscle. Ultrasound is the only technique that can visualize internal structures, allowing identification of a safe trajectory for injection of small or deep targets that might otherwise be inaccessible.</div></div>","PeriodicalId":23289,"journal":{"name":"Toxicon","volume":"264 ","pages":"Article 108460"},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}