Botulinum toxin and its clinical applications

Abstract

Botulin, exotoxin produced by C. botulinum, is one of the most potent toxins known to the mankind. For nearly 40 years it has been successfully used in various fields of medicine, despite the word botox is still mainly associated with aesthetic medicine and more or less successful beauty treatments. The review of the literature and description of the current knowledge about botulinum toxin and its clinical applications was the aim of the study. Botulinum toxin is protein composed of two chains linked together by a disulfide bridge. Seven serotypes were distinguish and label from A to G. The botulinum toxin mechanism of action involves proteolysis of specific neuronal proteins which resulting in blockade of acetylcholine release from presynaptic vesicles at the neuromuscular junction. For the first time botulin was used by A. Scott in treatment of strabismus. Since then botulinum neurotoxin has found its application in such areas as ophthalmology, neurology and urology. Botulinum proved to be a safe drug with few adverse effects, among which dysphagia is the most dangerous. Although the effect of botulinum toxin is unstable and reversible, there is a possibility of appearance of antibodies and clinical resistance, particularly in patients undergoing long-term therapy. Since the discovery, botulinum neurotoxin, has undergone a transformation from the deadly poison to the drug used in many areas of medicine. Numerous studies confirm that botulin, when used responsibly with the smallest effective dose and required intervals, is safe for the organism. Botulin can be for physicians a therapeutic tool, which can bring relief from the symptoms and suffering and significantly improving patients quality of life.