|Title of Invention||
A PHARMACEUTICAL COMPOSITION FOR THE PROPHYLAXIS AND/OR THERAPY OF BROMHIDROSIS AND IMPROVEMENT OF GENERAL BODY ODOUR
|Abstract||A pharmaceutical composition for the prophylaxis and/or therapy of bromhidrosis and improvement of general body odour, comprising the botulinus toxins of the kind as herein described or derivatives or fragments thereof, wherein the said toxins are present in a range of a therapeutically effective amount, along with pharmaceutically acceptable excipients of the kind as herein described.|
|Full Text||The present invention relates to a pharmaceutical composition for the prophylaxis and/or
therapy of bromhidrosis and improvement of general body odour, comprising botulinus
toxins. The claimed compositions are synergestic in nature having unexpected and
In cosmetics there are methods for generating a pleasant odour with foreign substances
(perfumes); in medicine there are methods for the reduction of a pathological malodorant body
odour (bromhidrosis). However, either of them is not distinct from the possibility to increase the
quality rating or acceptability of the body"s odour.
Body odour is a generally known and widespread phenomenon. It can occur in different
individuals under comparable conditions in very different intensities and be perceived differently
by the affected people themselves as well as by their fellow men.
In contrary to the common idea the body sweat, i e. the secretion of the eccrine perspiratory
glands, is totally odourless. Therefore excessive perspiration must not be confused with excessive
body odour. In its composition sweat is a clear aqueous fluid consisting predominantly of sodium-
potassium-, calcium-, magnesium- and chloride ions and besides that contains lactate, urea and
traces of arnino acids, biogenic amines and vitamins. Under exceptional circumstances
medicaments can be excreted via the sweat such as griseofulvin and ketokonazol but which does
not play a significant role for the body odour. The more sweat is produced, for example under
extreme conditions like in the sauna, the more the sweat is diluted, i.e. all the more aqueous the
sweat becomes. An excessive unnatural production of sweat under normal physiological
conditions is known as a disease pattern, the so-called hyperhidrosis. Therefore the excessive
sweating (hyperhidrosis) is not the direct cause for body odour. On the contrary: it was explicitly
emphasised in medical textbooks and publications that patients suffering from excessive underarm
perspiration (Hyperhidrosis axillaris) typically do not deve1op a strong body odour . This is
explained by the fact that the odourless, in huge quantities outpouring sweat quasi "flushes away"
the odour producing substances from the skin. However, in contrast to the eccrine perspiratory
glands the so-called scent glands (apocrine and apo-eccrine glands) can release a discernible
smelling secretion. This secretion can in turn be converted into malodorant substances on the
surface of the skin by bacteria. The scent glands can therefore be assigned a causative role in the
occurrence of the body odour. Scent glands can be found in great numbers e.g. in the human
armpit, but they get active usually only after puberty. Accordingly, the body odour is usually
much stronger in adults than in children.
In a simplified way body odour can be caused by two essential factors:
1. The secretions produced by the scent glands show a characteristic odour being perceived by
other people in very different extents.
2. The secretions of the scent glands, derivatives of steroids and other body substances like e.g.
the grease of the skin, can be degraded by the microflora of the skin resulting in a series of
products of decomposition. Such products of decomposition generated by bacteria can for
example produce a penetrative or rancid odour. Certain amino acids can account for the body
Thus the body odour is in summary mostly a matter of the mixture of different components which
are not yet totally analysed in their composition and which individually can be very different. For
this reason, analyses concerned with the body odour, are not performed only by biochemical
measurements but independent test persons are adopted who perform an assessment of the body
odour by their olfactory organ and by this means indicate on scales how intensive or how
unpleasant a certain odour is.
In the case of an extremely strong and unpleasant occurrence, the body odour is defined as a
disease named with the term "bromhidrosis". However, body odour can also be perceived in a
wide range of perceptions between unpleasant, disgusting up to pleasant or even infatuating and
stimulating. Thus, in behavioural psychology the effect of body odour is not judged only by the
intensity (how strong does something smell) but also the emotional valence (how good or how
bad does something smell).
The measures known by now for obtaining a pleasant body odour consist basically in the use of
perfumes, fragrants, substances and deodorants for covering the own body odour.
Moreover therapies for the reduction of an unpleasant body odour are primarily aimed against
bacteria of the skin and their activity in decomposition on the skin. Thus, in the case of
bromhidrosis are recommended for example:
• frequent washing and changing of the underwear
• frequent application of soaps or syndets for rinsing of intensively smelling substances
• application of deodorants
• disinfectants or skin cleansers that reduce and destroy, respectively, the bacterial flora of the
The disadvantage of the above mentioned measures is: the more intensively they are applied, the
more they lead to an irritation of the skin and to a disturbance of the skin"s function as a barrier
which may lead to unpleasant eczematoid reactions accompanied by redness and itching. In
addition specially the fragrant substances in deodorants exhibit a high allergenic power abetting an
immunological allergisation which may lead to livelong existing allergies.
Although the suppression of the secretion of sweet e.g. by the use of metal-salt containing
solutions such as aluminium chloride, is recommended in order to bring about a mechanical
obstruction of the channels of the perspiratory glands thereby repressing the sweat flow.
However, these and similar therapies lead also often to unwanted irritations of the skin.
Furthermore they are not suited to affect the body odour directly taking the above mentioned
odourless features of the sweat into account, but may at best accomplish an indirect change of the
Thus, in summary all conventional measures disregard the importance of the scent glands and
their manipulation for the improvement of the body odour.
Therefore the problem of the invention consists in the provision of a medicament for the treatment
of bromhidrosis and in the provision of a cosmetic means for the improvement of the body odour.
The problem is solved by the subject-matter defined in the patent claims.
The invention is illustrated by the accompanying figures.
Figure 1 shows the assessment of the intensity of the body odour (0=no odour perceptible,
6=maximally intensive odour) after one-sided treatment with botulinus toxin in a diagram.
Control-treated armpits: n=16, median=2.88, SD=1.43. Botulinus toxin-A-treated armpits: n=16,
median=1.75, SD=0.86. Significance of the difference (Wilcoxon-test): p=0.02. BTA means
Figure 2 shows the assessment of the quality rating (valency) of the body odour (-3=extremely
unpleasant; +3=extremely pleasant) after one-sided treatment with botulinus toxin in a diagram.
Control-treated armpits: n=16, median=1. 13, SD=0.89. Botulinus toxin-A-treated armpits: n=16,
median=0.5, SD=0.75. Significance of the difference (Wilcoxon-test): p=0.001. BTA means
One aspect of the present invention relates to the use of botulinus toxin for the manufacture of a
medicament for prophylaxis or therapy of bromhidrosis. A further aspect relates to the use of
botulinus toxin for the preparation of a cosmetic agent for the improvement of the body odour.
Therefore the present invention relates to a new method for the manipulation of the body odour
e.g. in terms of a reduction (less intensive and improvement (sensed as more pleasant) of the
body odour. Thereby it is not about a mere reduction of the secretion of sweat since sweat is an
odourless fluid but it is about a change in the features of the smell of the armpit or other areas of
the skin which generate a perceptible and unpleasant odour.
Botulinus toxins are a group of highly potent bacterial toxins being produced by Clostridium
botidinum under unaerobic conditions. The subtype botulinum toxin-A is approved as a
medicamentous agent for the treatment of selected neuromuscular diseases in the US since 1989
and in Germany since 1991 and 1993, respectively. In Germany botulinus toxin-A is available
under the trade name Botox® (distribution by the company Merz, Frankfurt; manufacture:
Allergan, Irvine Ca., USA) and under the trade name Dysport® (distribution by the company
Ispen-pharma, Ettlingen). Since 2001 a further preparation named NeuroBloc® (company Elan,
Munich) has been available which contains the subtype botulinus toxin-B.
The pharmacology, pharmaceutical manufacture as well as numerous clinical applications of
botulinus-toxin are elaborately described in the technical literature [1,2] The clinical effect of the
botulinus toxins is due to a blockade of the release of acetylcholine. Therefore all nerve endings
can be blocked which use acetylcholine as a transmitter.
The successful application of botulinus toxin-A in treatment of the excessive sweating
(hyperhidrosis) has been repeatedly described in the technical literature . On the contrary, the
influence on the body odour was not known up to now. In fact, it was discussed in a scientific
publication on the treatment of hyperhidrosis that the injection of botulinus toxin had no influence
on the body odour .
However, it was found surprisingly by the inventor in clinical observations that botulinus toxin is
effective in the case of bromhidrosis and can even improve the body odour of healthy people. The
latter is by no means the corollary of a successful bromhidrosis therapy since the reduction of an
unpleasant or even pathological body odour should merely lead to a less disturbing or at best
neutral body odour but not to the generation of an independent positive body odour.
Therefore one aspect of the present invention consist in the provision of a substance leading to the
fact that the body"s own odour displays an increasingly positive and more pleasant effect,
respectively, on other fellow men and therefore gives a competitive edge to the user in the case of
all interpersonal relations in which the olfactory perception plays a direct or an indirect role.
In this case the botulinus toxin can not only be used in its wild type form but also its derivatives,
fragments or a botulinus toxin with sundry changes e.g. chemical modifications. Thereby
"derivatives" means that the amino acid sequence of the botulinus toxin may contain substitutions,
deletions, insertions or additions. Thereby "fragments" means that only certain parts of the
botulinus toxin may be used as long as these parts display the biological activity of the wild type
Preferably the botulinus toxin is introduced into the skin via intracutaneous injection. This can be
accomplished for example by the use of a syringe with acute hypodermic needles and gauge
needles (e.g. 30 gauge), respectively, or by any other method for injection (e.g. high pressure and
needle less injection, respectively). The injections are evenly distributed e.g. in a distance of 0.5 to
5 cm over the area of skin to be treated. Other injections e.g. subcutaneous or intra epidermal
ones are possible as well.
Also other forms of application such as spreading of the botulinus toxin in a suitable preparation
(e.g. gel, creme, ointment, spray) with or without additives assisting the penetration of skin, are
suited, as long as a transcutaneous absorption of the active agent is provided. Equally, the active
agent can be applied on and introduced into the skin, respectively, using a water bath or a bath of
an ulterior solvent with or without the application of feeble current (iontophoresis).
Preferably a ready-for-use injection solution of botulinus toxin is prepared. Such can be prepared
e.g. by dissolving of one packaging unit of the preparation Botox® or of the preparation Dysport®
in sterile physiological saline solution (e.g. 1-10 ml or a volume freely to be determined). Or the
preparation Neurobloc®" is used which is available already in a dissolved form. Or any subtypes of
botulinus toxins (e.g. A, B, C, D, E, F, G) and derivatives, fragments or forms of these botulinus
toxins are used, respectively, which are changed in any respect. Or combinations of several
botulinus toxin subtypes or combinations with other substances and auxiliary substances,
respectively, are used which are suited for one of the above mentioned modes of application. The
concentration of the active agent in the solution (determined in mouse units per ml) can be chosen
freely according to the individual needs and experiences.
Preferably, the armpit is suited for the treatment, however, any other region of the body can be
treated with it such as the inguinal region, the gluteal region, the feet. Any form of a supporting
pre- or after-treatment, e.g. by spreading of an analgetic creme, cooling, maceration of the skin or
a creme or ointment changing the odour, or other external applications of any kind can be
combined with one of the above mentioned forms of application.
The following examples serve for illustration and are not to be mistaken as limiting the invention.
A patient with strong body odour emanating from the armpit received 50 units Botox"® solved in
2 ml NaCl distributed on 10 intracutaneous injection points per armpit. After one week he
detected a considerable decrease of the intensity of his body odour though having the same
Example 2 - pilot study
A group of 16 test persons was examined after education and acquiescence in written form. Each
test person was asked not to use a deodorant, perfume or perfume soap etc., not to eat onions,
asparagus or garlic and not to have intimate or close contact with partners for three days. On the
third day each test person was asked to wear a white T-shirt (100% cotton, pre-washed) for 24
hours from noon time to noon time. After this the underarm parts of the T-shirts were cut out and
put separately into air-tightly lockable glass flasks. These were labelled anonymously and then
presented to the participants as olfactory samples with each participant taking a smell of all
olfactory samples without knowing whom they were derived from. After this each participant
received an injection treatment in both armpits with ten cut-in points per side. On the one side
thereby 100 units botulinus toxin-A (Dysport®) solved in 2 ml isotonic NaCl-solution where
administered and on the other side 2 ml isotonic saline solution. Neither the physician nor the
participant knew which side was treated with the active agent or with the control solution
(double-blind). After one week the T-shirt olfactory test was repeated under exactly the same
conditions. After the statistical analysis a highly significant difference between the both sides was
to be found: the armpits treated with botulinus toxin and the T-shirt cut-outs, respectively,
smelled less intensive and less unpleasant and more pleasant, respectively, than the controls.
Example 3 - pilot study
56 women were asked to assess the olfactory samples of 16 foreign donors. The methodology for
the preparation of the olfactory samples was analogous to example 2, i.e. there were two samples
from each donor: one from the botulinus toxin-treated armpit and one from the untreated armpit.
The women were asked to assess the following:
1. Which of the two samples smells more pleasant (double-blind approach)?
2. How is the olfactory quality: (7 point-scale reaching from -3=very unpleasant, over 0=neutral
up to +3=very pleasant)?
3. How would you describe the odour (positive or negative adjectives were given for choice, e.g.
bloomy versus purulent, fruity versus rancid, etc.)?
4. How do you feel while perceiving this odour (9 points of valency)?
5. Can you imagine having a partner with this odour?
6. What falls into your mind concerning this odour?
Analysis: The pair-wise comparisons were calculated by means of the McNemar x2 -test for
repeated measurements of nominal data points.
The odour of the side which was botulinus toxin-treated was high significantly sensed as more
pleasant (p Positive adjectives were high significantly used more often for the botulinus toxin-treated samples.
The women felt high significantly "securer" and "happier" in the case of the perception of the
botulinus toxin-treated samples and they could also high significantly imagine more often to have
a partner with the odour of a botulinus toxin-treated armpit than with the odour of an untreated
one (each p BIBLIOGRAPHICAL REFERENCES:
1) Huang W, Foster JA, Rogachefsky AS (2000): Pharmacology of botulinum toxin. J Am Acad
Dermatol 43: 249-59
2) Munchau A, Bhatia KP (2000): Uses of botulinum toxin injection in medicine today. BMJ 320:
3) Naumann M, Hofrnann U, Bergmann I, Hamm H, Toyka KV, Reiners K (1998): Focal
hyperhidrosis: effective treatment with intracutaneous botulinum toxin [see comments]. Arch
Dermatol 134. 301-4
4) Sato K, Kang WH, Saga K, Sato KT (1989): Biology of sweat glands and their disorders. II.
Disorders of sweat gland function. J Am Acad Dermatol 20: 713-726
1. A pharmaceutical composition for the prophylaxis and/or therapy
of bromhidrosis and improvement of general body odour,
comprising the botulinus toxins of the kind as herein described or
derivatives or fragments thereof, wherein the said toxins are
present in a range of 12.5U to 100U/ml, along with
pharmaceutically acceptable excipients of the kind as herein
2. A pharmaceutical composition, wherein said botulinus toxins are
selected from botulinus toxin type A, B, C, D, E, F and G.
A pharmaceutical composition for the prophylaxis and/or therapy of
bromhidrosis and improvement of general body odour, comprising the
botulinus toxins of the kind as herein described or derivatives or
fragments thereof, wherein the said toxins are present in a range of a
therapeutically effective amount, along with pharmaceutically acceptable
excipients of the kind as herein described.
351-kolnp-2004-granted-reply to examination report.pdf
351-kolnp-2004-granted-translated copy of priority document.pdf
|Indian Patent Application Number||351/KOLNP/2004|
|PG Journal Number||49/2007|
|Date of Filing||16-Mar-2004|
|Name of Patentee||ALLERGAN INC.|
|Applicant Address||2525 DUPONT DRIVE, IRVINE, CALIFORNIA 92612|
|PCT International Classification Number||A 61 K 8/64|
|PCT International Application Number||PCT/DE 02/03561|
|PCT International Filing date||2002-09-23|