БОТУЛОТОКСИН. МЕХАНИЗМ ТОКСИЧЕСКОГО ВОЗДЕЙСТВИЯ. ПРИНЦИП ДЕЙСТВИЯ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ НА ОСНОВЕ РАЗНЫХ СЕРОТИПОВ БОТУЛОТОКСИНА. ПРИМЕНЕНИЕ В МЕДИЦИНЕ

Abstract

The paper discusses the most recent understanding of the mechanisms of action of naturally occurring botulinum toxins in the context of chemical analysis, the types of botulism, the conditions of their origin, causes of development, as well as the methods of prevention of the toxic process, according to the type of lesion. The structural and pathogenic mechanisms of these toxins (A, B, C, D, E, F, G) are very similar (due to the property of inhibiting the exocytosis of neurotransmitter and causing muscle paralysis). However, because each type of toxin has a unique receptor, they have different affinities for the three transporter proteins found in SNAR (VAMP, SNAP, and syntaxin). If in the process of pathogenesis BTA (botulotoxin A) cleaves the protein in the synaptose, BTB cleaves synaptobrevin, while the intracellular target of BTC (which is still in the research stage) are two proteins of the transporter complex (synaptotagmin and syntaxin) at the same time, which has a positive effect on some pharmacological features. The existence of the A1 and A2 subtypes of BTA is discussed, and a chemical justification is provided for why even a minor alteration in the amino acid sequence results in a difference in the biological and immunological characteristics of these subtypes. Furthermore, evidence supports the idea that reducing the amount of complexing proteins is a strategy to lessen toxicity, reduce immune-resistance, assure a long-lasting myorelaxant impact, and thereby increase the potential of botulinum toxin therapy. And this can be achieved by reducing the inactive toxins in the mixture, the ways of which are presented. Meanwhile, on the basis of that same mechanism, one of the unique manifestations of A and B botulinum toxins acting as active drugs, the phenomenon of botulinum toxin therapy, is explained, if of course they are completely free of toxic substances and act in minimal amounts. In the meantime, the phenomena of botulinum toxin therapy, one of the distinctive manifestations of A and B botulinum toxins operating as active medications, is explained on the basis of that same mechanism, assuming, of course, that they are completely free of toxic components and act in minimal levels. This is when they are converted from poison to medicine as “wonderful forces of nature that are meant to help people with diseases that were previously thought to be incurable”. The uniqueness of their mechanism of action, the availability of the drug in any zone of injection, the long duration of the pharmacological effect and, most importantly, the absence of systematic and side effects already justify the demand for drugs, based on botulinum toxins, in neurology, surgery, traumatology, nephrology, dentistry, ophthalmology, aesthetic medicine and later also prospective possibilities of their application in other clinical fields.