Is botulinum toxin a killer or an antidote

Toxins are molecules produced by organisms that act as poisons to other organisms. Millions of toxins are known, and their side effects on humans have been recorded for centuries. Chemists working in the pharmaceutical industry often study toxins because it allows them to produce antidotes for poisoning events, and because some toxins can also be used for treatment. Determining their structure is not an easy task and requires techniques such as X-ray crystallography. This botulinum toxin is a protein commonly known by the commercial name botulinum toxin. Just a few nanograms (1 ng = 1×10-9 grams) of the toxin is enough to kill a person. This toxin poisoning is known as botulism and is usually the result of botulism infection or eating food contaminated with the toxin.  

The seven serotypes of botulinum toxin (BTX) produced by Clostridium botulinum exert paralyzing effects by inhibiting acetylcholine release at the neuromuscular junction. Each of these zinc endopeptidases cleaves one or more proteins involved in vesicle transport and membrane fusion. The degree of paralysis depends on the dose and volume; The duration of paralysis further depends on the serotype used. Neuromuscular function is restored after sprouting at the end of the axon. The two main commercial formulations of BTX-A appear to differ in their relative efficacy, despite a common unit labeling system. Adverse reactions are the result of the mechanism of action of the drug and can usually be tolerated or mitigated by changing the dose. Patients who are pregnant or breastfeeding, or those with neuromuscular disease, may not be suitable candidates for BTX treatment. The development of resistance to BTX-A therapy is an important clinical problem, characterized by muscle atrophy after injection without any beneficial effect. The incidence of antibody-mediated resistance has been reported to be between 3% and 10% by the lethality assay in mice. Using the smallest possible effective dose and longer treatment intervals can reduce the likelihood of antibody production. Other serotypes may benefit those who develop antibody resistance.