While the growth of mold on fruits and vegetables forgotten in the fridge is not an atypical occurrence, lethal spores slowly sprouting in improperly preserved or fermented foods lead to more than a smelly fridge. The Clostridium botulinum bacterium produces deadly botulinum toxins (BoNT) that destroy proteins critical for the release of acetylcholine, the neurotransmitter primarily responsible for muscular function, into the neuromuscular synapse. The simple bacterium may be microscopic, but its ability to inhibit signals in the muscular network are potent and can induce irreversible paralysis.
Exocytosis, the release of neurotransmitters into the synapse via vesicle-membrane fusion, primarily requires the complete assembly of three proteins: SNAP-25, syntaxin, and synaptobrevin. The bridging of these proteins between the vesicle and the plasma membrane are crucial for neurotransmitter release. Once the vesicles bind to the plasma membrane, neurotransmitters are released into the synapse and the action potential signals from the presynaptic neurons are sent to the postsynaptic muscle fibers. When these signals are blocked, however, muscle contractions are inhibited — initiating paralysis.
The structure of BoNT allows it to penetrate neurons and cleave the proteins that transfer the signals for movement. The toxins have 2 subunits, a light and heavy chain, which work together to penetrate the neuron and wreak havoc. The heavy chain dictates which neurons are affected by the toxins by strongly binding to the external membrane. They facilitate the entry of the light chain into the cytoplasm of synaptic terminals, which then disrupts exocytosis by snipping the critical proteins for vesicle-membrane fusion. The structure of the light chain determines which proteins are cleaved. The toxins ultimately causes a paralytic effect by inhibiting membrane fusion of vesicles and acetylcholine release at neuromuscular junctions.
The extreme potency and lethality of botulinum toxins makes them potentially fatal bioweapons. Small amounts of BoNT can be deadly, where “a single gram of crystalline toxin, evenly dispersed and inhaled, can kill more than one million people.” The lethal dose for humans orally is estimated to be 30 ng and by inhalation 0.80 to 0.90 µg. An estimate of only 39.2 g of pure BoNT could eradicate humankind. While the inhibition of neurotransmitter release is irreversible, the paralytic effects are felt in full force by four to seven days after exposure. The long latency of effects can delay alarm and medical treatment. While some paralytic effects may be mediated by the growth of new nerve terminals and synaptic connections, these recovery processes can take up to months.
The lethality of these toxins have been harnessed for a range of purposes, from cosmetic procedures to treatments for movement disorders. BoNT is colloquially well-known as Botox, the drug commonly used to smooth facial wrinkles and enhance a youthful appearance. Beyond the surface, Botox has also been FDA-approved to treat chronic migraines, excessive sweating, and several other medical conditions. Other applications are under investigation, but the botulinum toxins have been found to reduce tremors, tics, muscle spasms, and other movement disorders that derive from debilitating neurological diseases.
The potential uses of these toxins may enhance the quality of life for many people. While the use of deadly botulinum toxins for medical treatments may seem unorthodox, these compounds have proven to be incredibly versatile in their application.