0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

The Myriad Uses of Botulinum Toxin

Seth L. Pullman, MD
[+] Article and Author Information

From Columbia University Medical Center, New York, NY 10032.


Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Seth L. Pullman, MD, The Neurological Institute, 710 West 168th Street, New York, NY 10032; e-mail, sp31@columbia.edu.


Ann Intern Med. 2005;143(11):838-839. doi:10.7326/0003-4819-143-11-200512060-00014
Text Size: A A A

Botulinum toxin (BTx) is an important therapeutic agent with widespread applications in neurologic and non-neurologic disease. One of the most potent neurotoxins known, BTx derives its name from the Latin word for sausage, botulus— referring to poisoning from badly prepared meat in the early 19th century. The toxin is a 150-kDa protein produced by Clostridium botulinum and composed of a heavy and light chain linked by a disulfide bond. When activated, the toxin targets peripheral cholinergic systems and prevents the release of acetylcholine. The heavy chain mediates binding to presynaptic cholinergic nerve terminals and internalization of the toxin into the cell. The light chain is a zinc endopeptidase responsible for its toxic effects and cleaves specific proteins needed for synaptic transmission (1). The first therapeutic use of BTx, purified and highly diluted, was as a treatment for strabismus in the 1970s (2). Seven serotypes of BTx have been identified, each with a specific mode of action at the molecular level. Currently, serotypes A (Botox [Allergan, Inc., Irvine, California]; Dysport [Ipsen, Ltd., Berkshire, England]) and B (Myobloc [Solstice Neurosciences, Inc., South San Francisco, California]) are available for clinical use. Over the past 25 years, BTx has proved to be remarkably successful in relieving spasms, unwanted movements, abnormal postures, and pain associated with many disorders (1).

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)