Neuromuscular DiseasesNeuromuscular DiseasesНервно-мышечные болезни2222-87212413-0443Publishing House ABV Press4410.17650/2222-8721-2013-0-2-6-19LECTURES AND REVIEWSЛЕКЦИИ И ОБЗОРЫBotulinum toxin: yesterday, today, tomorrowБотулинический токсин: вчера, сегодня, завтраArtemenkoA. R.АртеменкоА. Р.
Russian Federation
aartemenko@gmail.comKurenkovA. L.КуренковА. Л.
Russian Federation
I.M. Sechenov First Moscow State Medical UniversityГБОУ ВПО Первый МГМУ им. И.М. СеченоваResearch Center of Child Health, Russian Academy of Medical Sciences, MoscowФГБУ «Научный центр здоровья детей» РАМН, Москва20062013326191902201519022015Copyright ©; 2013, Artemenko A.R., Kurenkov A.L.Copyright ©; 2013, Артеменко А.Р., Куренков А.Л.2013Artemenko A.R., Kurenkov A.L.Артеменко А.Р., Куренков А.Л.https://creativecommons.org/licenses/by/4.0https://nmb.abvpress.ru/jour/article/view/44

Botulinum toxin (BoNT) is a bacterial neurotoxin presented with seven serotypes that inhibit neurotransmitter release from nerve endings. The serotypes of BoNT are antigenically dissimilar, act via different, but interconnected mechanisms, and are not interchangeable. The activity of BoNT is associated with impaired neuroexocytosis occurring in several steps: from the binding of BoNT to its specific receptor on the axon terminal membrane to the proteolytic enzymatic cleavage of SNARE substrate. The effect of BoNT is considered to be restricted to the peripheral nervous system, but when given in particularly high doses, it has been recently shown to affect individual brain structures. In addition, by modulating peripheral afferentation, BoNT may influence the excitability of central neuronal structures at both spinal and cortical levels. Only BoNT serotypes A and B are used in clinical practice and aesthetic medicine. The type A has gained the widest acceptance as a therapeutic agent for more than 100 abnormalities manifesting themselves as muscular hyperactivity, hyperfunction of endocrine gland, and chronic pain. The effect of BoNT preparations shows itself 2-5 days after injection, lasts 3 months or more, and gradually decreases with as a result of pharmacokinetic and intracellular reparative processes. Biotechnology advances and potentialities allow purposefully modification of the protein molecular structure of BoNT, which expands the use and efficiency of performed therapy with neurotoxins. Recombinant technologies provide a combination of major therapeutic properties of each used BoNT serotype and expand indications for recombinant chimeric toxins.

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