Botox Can Precipitate Neurological Complications

Botox – widely used as a cosmetic modality to reduce the appearance of skin wrinkles, is derived from the neurotoxin––Botulinum. Botox can have beneficial effects when injected in small doses despite being a toxin. 

Apart from its cosmetic applications, the United States Food and Drug Administration (FDA) has approved Botox as a treatment for various health conditions, including eyelid spasms, excessive sweating, certain bladder disorders, and migraines.

A recent study by Professor Frederic Meunier and Dr. Merja Joensuu at the Queensland Brain Institute of the University of Queensland has shed light on how Botox enters brain cells, leading to paralysis or even death. Utilizing super-resolution microscopy, the researchers discovered that a receptor called Synaptotagmin 1 forms a complex with two other known clostridial neurotoxin receptors on the neuronal surface. Botox then targets this complex, allowing the toxin to enter the synaptic vesicles where neurotransmitters, critical for neuron communication, are stored. By interrupting nerve-to-muscle cell communication, Botox induces paralysis.

These new findings of this study published in the EMBO Journal pave the way for identifying new therapeutic targets to treat botulism effectively. Dr. Joensuu emphasized that clostridial neurotoxins are incredibly potent protein toxins, and now there is a comprehensive understanding of how these toxins are internalized to intoxicate neurons at therapeutically relevant concentrations.