Abstract
Botulinum neurotoxins (BoNTs) show increasing therapeutic applications ranging from treatment of locally paralyzed muscles to cosmetic benefits. At first, in the 1970s, BoNT was used for the treatment of strabismus, however, nowadays, BoNT has multiple medical applications including the treatment of muscle hyperactivity such as strabismus, dystonia, movement disorders, hemifacial spasm, essential tremor, tics, cervical dystonia, cerebral palsy, as well as secretory disorders (hyperhidrosis, sialorrhea) and pain syndromes such as chronic migraine. This review summarizes current knowledge related to engineering of botulinum toxins, with particular emphasis on their potential therapeutic applications for pain management and for retargeting to non-neuronal tissues. Advances in molecular biology have resulted in generating modified BoNTs with the potential to act in a variety of disorders, however, in addition to the modifications of well characterized toxinotypes, the diversity of the wild type BoNT toxinotypes or subtypes, provides the basis for innovative BoNT-based therapeutics and research tools. This expanding BoNT superfamily forms the foundation for new toxins candidates in a wider range of therapeutic options.
Highlights
Botulinum neurotoxins (BoNTs) show increasing therapeutic applications ranging from treatment of locally paralyzed muscles to cosmetic benefits
We summarize the current understanding of Botulinum neurotoxin (BoNT) therapeutic applications together with a special focus on engineering opportunities leading to enhanced therapeutic potential
BoNT intoxication resulting from ingestion of preformed toxin in food or from C. botulinum toxi-infection leads to a disease called botulism
Summary
We summarize the current understanding of Botulinum neurotoxin (BoNT) therapeutic applications together with a special focus on engineering opportunities leading to enhanced therapeutic potential. BoNT intoxication resulting from ingestion of preformed toxin in food or from C. botulinum toxi-infection leads to a disease called botulism. C-terminal domain (HCC), which is comprised of two subdomains (HCCn and HCCc) is responsible for specific binding of the toxin to presynaptic membrane of neurons prior to endocytosis [5,6,7,8]. BoNTs are produced as botulinum complexes, called progenitor toxin complexes (PTCs), by non-covalently binding to multiple non-toxic proteins [9]. The toxinotype H ( termed H/A or F/A) was identified, in 2014, from a clinical isolate [12] This toxinotype is composed of a mosaic structure including regions of similarity to toxinotypes A and F with the LC most similar to BoNT/F5 subtype and an HC similar to BoNT/A1-HC [13,14]. The clinical implication or impact of the BoNT-like toxins or sequences are not yet elucidated
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