botulinumi

Botulinum refers to botulinum neurotoxins produced by the anaerobic bacterium Clostridium botulinum and related species. There are seven toxin types, labeled A through G. In humans, types A, B and E are most commonly associated with botulism, while other types primarily affect animals or are rare in humans. Botulism is a severe paralytic illness that can result from ingestion of preformed toxin in contaminated food (foodborne botulism), colonization of the infant gut (infant botulism), or wound infection (wound botulism).

Mechanism: botulinum neurotoxins are zinc-dependent endopeptidases that cleave SNARE proteins required for acetylcholine release at peripheral nerve terminals, thereby causing flaccid paralysis.

Clinical features: the illness typically begins with cranial nerve dysfunction—double vision, drooping eyelids, difficulty speaking or swallowing—followed by descending weakness and potential respiratory failure if untreated.

Diagnosis and treatment: diagnosis relies on clinical suspicion supported by laboratory detection of toxin in serum, stool, or implicated foods. Treatment involves prompt supportive care, especially respiratory support, and administration of botulinum antitoxin when indicated to limit progression. Wound botulism requires source control and appropriate antibiotics.

Prevention and use: preventing foodborne botulism centers on proper food preservation and preparation; infants under one year should not be given honey to reduce infant botulism risk. In medicine, purified botulinum neurotoxin is used therapeutically and cosmetically under various brand names (for example onabotulinumtoxinA, abobotulinumtoxinA, incobotulinumtoxinA) to treat focal dystonias, spasticity, chronic migraine, hyperhidrosis, and cosmetic wrinkles. Safety depends on appropriate dosing and professional administration.