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Botulinum toxin

Botulinum toxin A
Ribbon diagram of tertiary structure of BotA (P0DPI1). PDB entry 3BTA.
Clinical data
Trade namesBotox, Myobloc, Jeuveau, others
Other namesBoNT, botox
BiosimilarsabobotulinumtoxinA, daxibotulinumtoxinA, daxibotulinumtoxinA-lanm, evabotulinumtoxinA, incobotulinumtoxinA, letibotulinumtoxinA, letibotulinumtoxinA-wlbg,[1] onabotulinumtoxinA, prabotulinumtoxinA, relabotulinumtoxinA, rimabotulinumtoxinB
AHFS/Drugs.com
MedlinePlusa619021
License data
Pregnancy
category
Routes of
administration		Intramuscular, subcutaneous, intradermal
ATC code
Legal status
Legal status
Identifiers
CAS Number
DrugBank
ChemSpider
  • Botulinum toxin A: none
UNII
KEGG
ECHA InfoCard100.088.372 Edit this at Wikidata
Chemical and physical data
FormulaC6760H10447N1743O2010S32
Molar mass149323.05 g·mol−1
 ☒NcheckY (what is this?)  (verify)
Bontoxilysin
Identifiers
EC no.3.4.24.69
Databases
IntEnzIntEnz view
BRENDABRENDA entry
ExPASyNiceZyme view
KEGGKEGG entry
MetaCycmetabolic pathway
PRIAMprofile
PDB structuresRCSB PDB PDBe PDBsum
Gene OntologyAmiGO / QuickGO
Search
PMCarticles
PubMedarticles
NCBIproteins

Botulinum toxin, or botulinum neurotoxin (commonly called botox), is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species.[24] It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction, thus causing flaccid paralysis.[25] The toxin causes the disease botulism.[26] The toxin is also used commercially for medical and cosmetic purposes.[27][28] Botulinum toxin is an acetylcholine release inhibitor and a neuromuscular blocking agent.[1][23]

The seven main types of botulinum toxin are named types A to G (A, B, C1, C2, D, E, F and G).[27][29] New types are occasionally found.[30][31] Types A and B are capable of causing disease in humans, and are also used commercially and medically.[32][33][34] Types C–G are less common; types E and F can cause disease in humans, while the other types cause disease in other animals.[35]

Botulinum toxins are among the most potent toxins known to science.[36][37] Intoxication can occur naturally as a result of either wound or intestinal infection or by ingesting formed toxin in food. The estimated human median lethal dose of type A toxin is 1.3–2.1 ng/kg intravenously or intramuscularly, 10–13 ng/kg when inhaled, or 1000 ng/kg when taken by mouth.[38]

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  2. ^ a b Cite error: The named reference Letybo APMDS was invoked but never defined (see the help page).
  3. ^ a b "Nuceiva". Therapeutic Goods Administration (TGA). 10 February 2023. Retrieved 8 April 2023.
  4. ^ a b "Relfydess (relabotulinumtoxinA, purified Botulinum toxin type A)". Therapeutic Goods Administration (TGA). 30 July 2024. Retrieved 12 October 2024.
  5. ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.
  6. ^ "Nuceiva (PPD Australia Pty Ltd)". Therapeutic Goods Administration (TGA). 16 February 2023. Archived from the original on 18 March 2023. Retrieved 8 April 2023.
  7. ^ "Nuceiva prabotulinumtoxinA 100 Units Powder for Solution for Injection vial (381094)". Therapeutic Goods Administration (TGA). 26 January 2023. Archived from the original on 8 April 2023. Retrieved 8 April 2023.
  8. ^ "Prescription medicines: registration of new chemical entities in Australia, 2014". Therapeutic Goods Administration (TGA). 21 June 2022. Archived from the original on 10 April 2023. Retrieved 10 April 2023.
  9. ^ "AusPAR: Letybo | Therapeutic Goods Administration (TGA)". Archived from the original on 31 March 2024. Retrieved 31 March 2024.
  10. ^ "Regulatory Decision Summary - Botox". Health Canada. 23 October 2014. Archived from the original on 12 June 2022. Retrieved 12 June 2022.
  11. ^ "Regulatory Decision Summary - Nuceiva". Health Canada. 23 October 2014. Archived from the original on 7 June 2022. Retrieved 11 June 2022.
  12. ^ "Regulatory Decision Summary for Xeomin". Drug and Health Products Portal. 15 March 2022. Retrieved 1 April 2024.
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  15. ^ "Azzalure - Summary of Product Characteristics (SmPC)". (emc). 16 August 2022. Archived from the original on 18 December 2022. Retrieved 18 December 2022.
  16. ^ "Alluzience, 200 Speywood units/ml, solution for injection - Summary of Product Characteristics (SmPC)". (emc). 2 October 2022. Archived from the original on 18 December 2022. Retrieved 18 December 2022.
  17. ^ "Letybo 50 units powder for solution for injection - Summary of Product Characteristics (SmPC)". (emc). 10 May 2022. Archived from the original on 18 December 2022. Retrieved 18 December 2022.
  18. ^ "Xeomin 50 units powder for solution for injection - Summary of Product Characteristics (SmPC)". (emc). 28 July 2022. Archived from the original on 18 December 2022. Retrieved 18 December 2022.
  19. ^ "Botox- onabotulinumtoxina injection, powder, lyophilized, for solution". DailyMed. 30 July 2021. Archived from the original on 2 June 2022. Retrieved 12 June 2022.
  20. ^ "Botox Cosmetic- onabotulinumtoxina injection, powder, lyophilized, for solution". DailyMed. 9 February 2021. Archived from the original on 18 December 2022. Retrieved 18 December 2022.
  21. ^ "Myobloc- rimabotulinumtoxinb injection, solution". DailyMed. 22 March 2021. Archived from the original on 2 June 2022. Retrieved 12 June 2022.
  22. ^ "Dysport- botulinum toxin type a injection, powder, lyophilized, for solution". DailyMed. 28 February 2022. Archived from the original on 2 June 2022. Retrieved 12 June 2022.
  23. ^ a b "Daxxify- botulinum toxin type a injection, powder, lyophilized, for solution". DailyMed. 19 September 2022. Archived from the original on 28 September 2022. Retrieved 27 September 2022.
  24. ^ Montecucco C, Molgó J (June 2005). "Botulinal neurotoxins: revival of an old killer". Current Opinion in Pharmacology. 5 (3): 274–279. doi:10.1016/j.coph.2004.12.006. PMID 15907915.
  25. ^ Figgitt DP, Noble S (2002). "Botulinum toxin B: a review of its therapeutic potential in the management of cervical dystonia". Drugs. 62 (4): 705–722. doi:10.2165/00003495-200262040-00011. PMID 11893235. S2CID 46981635.
  26. ^ Cite error: The named reference Shukla2004 was invoked but never defined (see the help page).
  27. ^ a b Janes LE, Connor LM, Moradi A, Alghoul M (April 2021). "Current Use of Cosmetic Toxins to Improve Facial Aesthetics". Plastic and Reconstructive Surgery. 147 (4): 644e–657e. doi:10.1097/PRS.0000000000007762. PMID 33776040. S2CID 232408799.
  28. ^ Cite error: The named reference Al-Ghamdi was invoked but never defined (see the help page).
  29. ^ Rosales RL, Bigalke H, Dressler D (February 2006). "Pharmacology of botulinum toxin: differences between type A preparations". European Journal of Neurology. 13 (Suppl 1): 2–10. doi:10.1111/j.1468-1331.2006.01438.x. PMID 16417591. S2CID 32387953.
  30. ^ "Botulism toxin X: Time to update the textbooks, thanks to genomic sequencing". Boston Children's Hospital. 7 August 2017. Archived from the original on 14 September 2021. Retrieved 28 October 2019.
  31. ^ "Study: Novel botulinum toxin less dangerous than thought". CIDRAP. University of Minnesota. 17 June 2015. Archived from the original on 28 October 2019. Retrieved 28 October 2019.
  32. ^ Farag SM, Mohammed MO, El-Sobky TA, ElKadery NA, ElZohiery AK (March 2020). "Botulinum Toxin A Injection in Treatment of Upper Limb Spasticity in Children with Cerebral Palsy: A Systematic Review of Randomized Controlled Trials". JBJS Reviews. 8 (3): e0119. doi:10.2106/JBJS.RVW.19.00119. PMC 7161716. PMID 32224633.
  33. ^ Blumetti FC, Belloti JC, Tamaoki MJ, Pinto JA (October 2019). "Botulinum toxin type A in the treatment of lower limb spasticity in children with cerebral palsy". The Cochrane Database of Systematic Reviews. 2019 (10): CD001408. doi:10.1002/14651858.CD001408.pub2. PMC 6779591. PMID 31591703.
  34. ^ American Society of Health-System Pharmacists (27 October 2011). "OnabotulinumtoxinA (Botulinum Toxin Type A) Monograph for Professionals". drugs.com. Archived from the original on 6 September 2015. Retrieved 4 March 2015.
  35. ^ Cite error: The named reference WHO2018 was invoked but never defined (see the help page).
  36. ^ Košenina S, Masuyer G, Zhang S, Dong M, Stenmark P (June 2019). "Crystal structure of the catalytic domain of the Weissella oryzae botulinum-like toxin". FEBS Letters. 593 (12): 1403–1410. doi:10.1002/1873-3468.13446. PMID 31111466.
  37. ^ Dhaked RK, Singh MK, Singh P, Gupta P (November 2010). "Botulinum toxin: Bioweapon & magic drug". Indian Journal of Medical Research. 132 (5): 489–503. PMC 3028942. PMID 21149997.
  38. ^ Arnon SS, Schechter R, Inglesby TV, Henderson DA, Bartlett JG, Ascher MS, et al. (February 2001). "Botulinum toxin as a biological weapon: medical and public health management". JAMA. 285 (8): 1059–1070. doi:10.1001/jama.285.8.1059. PMID 11209178.

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