The problem

At least 10% of hypertensive patients present resistant hypertension, a condition that cannot be managed by anti-hypertensive drugs.  New, effective treatments are highly needed in this case (Ref).

Key findings

– Botulinum toxin E (BoNT/E) inhibits renin release and can thus contribute to lowering arterial blood pressures (Ref).

– Botulinum toxin E, unlike Botulinum toxin A, is not approved as a therapeutic entity for any medical indication.

– Botulinum toxin A has been used in a clinical setting to lower hypertension caused by diaphragmatic crus compression of the left renal artery (Ref) and through celiac plexus block  to effectively treat resistant hypertension (Ref).

– Injections of Botulinum toxin A-impregnated Novochizol^TM (BoNT/A-Novochizol^TM) into renal arteries lead to prolonged decreases in blood pressure with inhibition of rennin release (swine model):

–  BoNT/A-Novochizol^TM injected into renal arteries enters renal cells where it inhibits renin release, leading to lower blood pressure, most likely via a general mechanism that inhibits vesicular secretion in a variety of cell types. If so, the same formulation is expected to have a variety of mechanisms of action relevant to different diseases.

The delivery is localized, without systemic distribution: