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  • Chapter 3 - Pharmacology of Botulinum Toxin Therapy

  • Edited by Daniel Truong, University of California, Riverside, Dirk Dressler, Hannover Medical School, Mark Hallett, National Institutes of Health (NIH), Christopher Zachary, University of California, Irvine, Mayank Pathak, Truong Neuroscience Institute
  • Book:
    Manual of Botulinum Toxin Therapy
    Published online:
    02 November 2023
    Print publication:
    23 November 2023, pp 13-17

  • Summary

    Botulinum neurotoxins (BoNTs) are protins derived from the bacterium Clostridium botulinum. Nine serotypes are known; seroptypes A and B have been formulated for clinical use. BoNTs cleave one of the three soluble N-ethylmaleimide-sensitive factor attachment protein receptors (SNARE) proteins: vesicle-associated membrane protein (VAMP), synaptosomal-associated protein 25 (SNAP-25), or syntaxin. Upon entry into the synaptic terminal, BoNT inhibits the exocytosis of neurotransmitter containing synaptic vesicles. Cliical effects begin developing within a week after injection into skeletal muscle, then wear off after 2–4 months, requiring repeat injection. Neutralizing antibodies may develop, reducing clinical effects. Newer toxin preparations under development are listed in a table.