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BOTULINUM TOXIN DAVID WILLIAMS SARAH GOEDDE

Outline History Uses Toxin and Toxic Effects Mechanisms of Action Summary Conclusion References

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Page 1: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

BOTULINUM TOXINDAVID WILLIAMSSARAH GOEDDE

Page 2: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Outline

History Uses Toxin and Toxic Effects Mechanisms of Action Summary Conclusion References

Page 3: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Botulinum Toxin

We chose Botulinum toxin because it is considered the most powerful neurotoxin known to man.

Botulism, or Botulinum intoxication can cause serious effects such as paralysis and respiratory failure.

It is commonly used for a large assortment of cosmetic and medical ailments.

Page 4: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Where Does it Come From?

Botulinum toxin is a protein produced by the anaerobic, spore-forming bacterium Clostridium botulinum

Page 5: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

What is Botulinum Toxin?

The active molecule consists of:Heavy Chain PolypeptideLight Chain Polypeptide

- These Chains are connected via disulfide bond

Page 6: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Historydiscovery

Botulinum was first described in the 18th century, when people were getting food poisoning from eating improperly stored meat and blood sausage resulting in death.

The association between the food poisoning deaths and botulism was first made by Justinus Kerner.

It was later discovered that Botulinum caused paralysis, and the link was soon made that it might be possible to reduce over active muscles with the toxin.

Page 7: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Historyoriginal uses

After the discovery that Botulinum may decrease over-active muscles, testing began by injecting into ocular muscles of monkeys and into the legs of chickens. The results appeared to conclude that injections into the muscular area resulted in decreased muscles spasms or dystonia, with limited toxic effects.

Page 8: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Usescurrent medicinal uses

Initial treatments of Botulinum were used to cure strabismus, or cross eyes

Also used to stop uncontrollable blinking, or blepharospasm

Later discoveries include uses for cerebral palsy, overactive sweating, muscle spasms and chronic migraines

Page 9: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Cosmetic uses

Botulinum Toxin is most currently known to the world as Botox. Its used cosmetically for a temporary decrease in brow lines and frown lines. Botox is injected under the skin in particular areas to remove wrinkles.

Minimal side effects of the injections currently appear to be a decrease in facial or emotional expression.

Page 10: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Exposure Pathway

Botulinum toxin is usually ingested by eating contaminated food.

Once in the stomach, it crosses membrane barriers to enter circulation

In circulation it moves into extracellular space to reach it’s target, neurons.

Page 11: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Mechanism of Action Botulinum toxin utilizes an AB mechanism. There is a Heavy Chain and a Light Chain. The Heavy Chain binds to proteins on the

surface of axon terminals. The toxin is then Endocytosed Heavy Chain forms channel in endosome

which the light chain moves through into the cytoplasm

Light Chain has proteolytic activity, and degrades integral proteins of SNARE complex

SNARE complex is required for the binding of neuro-secretory vesicles to the nerve synapse plasma membrane.

With no binding of neuro-secretory vesicles to plasma membrane, Acetocholine is unable to be released into neuromuscular junction

RESULT: PARALYSIS

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Botulinum Toxin

The non-covalent complex is then connected to auxiliary proteins described as hemaggluttinins and nonhemaggluttinins. These proteins help the complex retain PH resistance allowing it to maintain function in the gut.

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Symptoms

Muscle weakness in the facial region, including the inability to blink, swallow, chew or talk.

Blurred Vision Muscle weakness in

body. Constipation Difficulty breathing

leading to respiratory failure.

Page 14: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Toxic variability

The Botulinum toxin is one the deadliest toxins known, and effects are seen in small doses

90 nanograms of the toxin could be lethal enough to kill a 200lb man

Botulinum consists of seven different serotypes

Serotype A has the lengthiest duration of action and appears to be considered the most toxic form

Page 15: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Prevention of Botulism

Preserving Foods using heat, pressure and low pHSpores can be inactivated at 120 CelsiusHigh pressure kills sporesHigh pH favors spore germination

The toxin can be inactivated be heating at temperatures greater than 85 degrees C for 5 minutes

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Treatment

Antitoxin- inactivates botulinum toxin which has not already attached to neurons. Most effective if given soon after exposure

Gastric Lavage- flush the GI tract of all possible toxin producing bacteria

Respiratory Support

Page 17: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Results

Throughout our research we determined prevention techniques to avoid botulism

We learned that Botulinum is a very powerful neurotoxin

Medicinal uses of Botulinum are very extensive and serve a large facet of conditions

Cosmetic uses also seem to be very valuable and currently seem to show little negative effects

Page 18: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Conclusion

Under strict control Botulinum seems to be very useful in the medical field and should continue to be used when necessary

Possible further studies include long term effects of continual Botulinum injections

Page 19: Outline  History  Uses  Toxin and Toxic Effects  Mechanisms of Action  Summary  Conclusion  References

Literature Cited Erbguth, F. 2008. From poison to remedy: the chequered history of

botulinum toxin. Journal of Neural Transmissions 115:559-565. Oates, A. and J. Jankovic. 1991. Therapeutic uses of Botulinum

Toxin. The New England Journal of Medicine 324: 1186-1194. Simpson, L. 2004. Identification of the major steps in the botulinum

toxin action. Annual Review of Pharmacology and Toxicology 44:167-193.

Simpson, L. 1981. The origin, structure and pharmacological activity of botulinum toxin. The American Society for Pharmacology and Experimental Therapeutics 33: 157-187.