Poison as cure: a clinical review of botulinum toxin as an invaluable drug

Abstract

Botulinum toxin is the most potent toxin known. It is readily absorbed from mucosal surfaces. If dispersed as an aerosol or mixed in the food or water it can lead to a large outbreak of botulism. The disease presents as a symmetric descending paralysis in an afebrile patient. Cranial nerve involvement with diplopia, dysarthria, dysphonia, dysphagia and respiratory paralysis is seen after a variable incubation period. The treatment is mainly supportive. The source of the toxin is Clostridium botulinum, an anaerobic gram-positive spore-forming organism. Some other species of Clostridium like C. butyricum and C. baratii also produce the toxin.The toxin is heat labile and can be inactivated by heating at 100°C for 10 minutes.The toxin acts at the peripheral cholinergic nerve terminals at the neuromuscular junctions, postganglionic parasympathetic ganglia, etc, and affects neurotransmitter release by inhibiting exocytosis. Clinical uses in various medical fields were found for it.

Marine-Derived Compounds Applied in Cardiovascular Diseases: Submerged Medicinal Industry

“…Botulinum toxin is obtained from the marine source Clostridium botulinum . Clostridium botulinum is a Gram-positive anaerobic spore-forming bacterium found in marine environments [ 126 ]. The botulinum toxin (BoNT/A1)–chitosan nanoparticles (BTN) formulation inhibits arrhythmia caused by sodium, calcium, and potassium channel activation [ 89 ].…”

Therapeutic Application of Botulinum Toxin in Clinical Practice

“…The toxin inhibits the aggregation and complex formation of SNARE proteins. The SNARE complex consists of synaptosomal associated protein (SNAP25), Synaptobrevin or vesicle Associated Membrane Protein (V Amp) and Syntaxin [3]. They bind to the presynaptic membrane by heavy chain and is internalized to the cytosol of the membrane, where the light chain is catalytic and translocated to the external surface of the synaptic vesicle, deactivates the SNARE proteins that are needed for ducking and fusion of the synaptic vesicle with the terminal membrane [4].…”