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Panditrao MV, Chung CH, Khouri JM, Barash JR, Motter RN, Dover N, Arnon SS. Dual-Toxin ("Bivalent") Infant Botulism in California, 1976-2020: Epidemiologic, Clinical, and Laboratory Aspects. J Pediatr 2023; 253:8-13. [PMID: 35977619 DOI: 10.1016/j.jpeds.2022.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/05/2022] [Accepted: 08/11/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the consequences of infant botulism that result from Clostridium botulinum strains that produce 2 botulinum toxin serotypes, termed "bivalent." STUDY DESIGN Epidemiologic investigations used a standard questionnaire. Clostridium botulinum strains were isolated by standard methods. Botulinum neurotoxin (BoNT) serotypes and the relative amounts of toxins produced were identified using the standard mouse bioassay. BoNT subtypes and genomic locations were identified by DNA nucleotide sequencing. RESULTS Thirty bivalent cases of infant botulism occurred in the 45 years (1976-2020), representing 2.0% of all California infant botulism cases, in the 3 geographic regions of southern California, the southern Central Valley, and mid-northern California. Toxin serotype combinations were Ba (n = 22), Bf (n = 7), and Ab (n = 1). More patients with illness caused by bivalent C botulinum Ba and Bf strains needed endotracheal intubation at hospital admission, 60.0% (18/30), than did patients with illness caused by monovalent BoNT/B strains, 34.3% (152/443). The Cbotulinum Ba and Bf strains produced BoNT/B5 and either BoNT/A4 or /F2. The Ab strain produced BoNT/A2 and /B1. All toxin gene clusters were on plasmids. CONCLUSIONS Infant botulism caused by bivalent Cbotulinum strains occurs sporadically and in diverse locations in California. Affected patients with bivalent Ba and Bf strains lacked distinguishing epidemiological features but appeared to be more severely paralyzed at hospital presentation than patients with illness caused by only BoNT/B. These bivalent strains produced BoNT subtypes A2, A4, B1, B5, and F2, and all toxin gene clusters were on plasmids.
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Affiliation(s)
- Mayuri V Panditrao
- Epidemiology, Surveillance, and Modeling Branch, COVID-19 Response California Department of Public Health, Richmond, CA
| | - Connie H Chung
- Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA
| | - Jessica M Khouri
- Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA.
| | - Jason R Barash
- Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA
| | - Ruth N Motter
- Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA
| | - Nir Dover
- Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA
| | - Stephen S Arnon
- Infant Botulism Treatment and Prevention Program, Infectious Diseases Laboratory Branch, Center for Infectious Diseases, California Department of Public Health, Richmond, CA
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A Comprehensive Structural Analysis of Clostridium botulinum Neurotoxin A Cell-Binding Domain from Different Subtypes. Toxins (Basel) 2023; 15:toxins15020092. [PMID: 36828407 PMCID: PMC9966434 DOI: 10.3390/toxins15020092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Botulinum neurotoxins (BoNTs) cause flaccid neuromuscular paralysis by cleaving one of the SNARE (soluble N-ethylmaleimide-sensitive factor attachment protein receptor) complex proteins. BoNTs display high affinity and specificity for neuromuscular junctions, making them one of the most potent neurotoxins known to date. There are seven serologically distinct BoNTs (serotypes BoNT/A to BoNT/G) which can be further divided into subtypes (e.g., BoNT/A1, BoNT/A2…) based on small changes in their amino acid sequence. Of these, BoNT/A1 and BoNT/B1 have been utilised to treat various diseases associated with spasticity and hypersecretion. There are potentially many more BoNT variants with differing toxicological profiles that may display other therapeutic benefits. This review is focused on the structural analysis of the cell-binding domain from BoNT/A1 to BoNT/A6 subtypes (HC/A1 to HC/A6), including features such as a ganglioside binding site (GBS), a dynamic loop, a synaptic vesicle glycoprotein 2 (SV2) binding site, a possible Lys-Cys/Cys-Cys bridge, and a hinge motion between the HCN and HCC subdomains. Characterising structural features across subtypes provides a better understanding of how the cell-binding domain functions and may aid the development of novel therapeutics.
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Gregory KS, Mahadeva TB, Liu SM, Acharya KR. Structural Features of Clostridium botulinum Neurotoxin Subtype A2 Cell Binding Domain. Toxins (Basel) 2022; 14:toxins14050356. [PMID: 35622602 PMCID: PMC9146395 DOI: 10.3390/toxins14050356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/14/2022] Open
Abstract
Botulinum neurotoxins (BoNT) are a group of clostridial toxins that cause the potentially fatal neuroparalytic disease botulism. Although highly toxic, BoNTs are utilized as therapeutics to treat a range of neuromuscular conditions. Several serotypes (BoNT/A-/G, /X) have been identified with vastly differing toxicological profiles. Each serotype can be further sub-categorised into subtypes due to subtle variations in their protein sequence. These minor changes have been attributed to differences in both the duration of action and potency for BoNT/A subtypes. BoNTs are composed of three domains—a cell-binding domain, a translocation domain, and a catalytic domain. In this paper, we present the crystal structures of the botulinum neurotoxin A2 cell binding domain, both alone and in complex with its receptor ganglioside GD1a at 1.63 and 2.10 Å, respectively. The analysis of these structures reveals a potential redox-dependent Lys-O-Cys bridge close to the ganglioside binding site and a hinge motion between the HCN and HCC subdomains. Furthermore, we make a detailed comparison with the previously reported HC/A2:SV2C structure for a comprehensive structural analysis of HC/A2 receptor binding.
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Affiliation(s)
- Kyle S. Gregory
- Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath BA2 7AY, UK; (K.S.G.); (T.B.M.)
| | - Tejaswini B. Mahadeva
- Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath BA2 7AY, UK; (K.S.G.); (T.B.M.)
| | - Sai Man Liu
- Protein Sciences Department, Ipsen Bioinnovation Limited, 102 Park Drive, Milton Park, Abingdon OX14 4RY, UK;
| | - K. Ravi Acharya
- Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath BA2 7AY, UK; (K.S.G.); (T.B.M.)
- Correspondence: ; Tel.: +44-(0)1225-386238
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Barreto RR, Veras PJL, de Oliveira Leite G, Vieira Neto AE, Zogheib LV, Sessle BJ, Campos AR. Botulinum toxin promotes orofacial antinociception by modulating TRPV1 and NMDA receptors in adult zebrafish. Toxicon 2022; 210:158-166. [DOI: 10.1016/j.toxicon.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/12/2022] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
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Descriptive Epidemiology of Infant Botulism in California: The First 40 Years. J Pediatr 2020; 227:247-257.e3. [PMID: 32800814 DOI: 10.1016/j.jpeds.2020.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/11/2020] [Accepted: 08/06/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To ascertain the descriptive epidemiology of infant botulism, the flaccid paralysis that results when neurotoxigenic Clostridium species produce botulinum toxin (BoNT) in the infant colon, in its first 40 years following initial recognition in California in 1976. STUDY DESIGN Cases were defined by laboratory identification of BoNT and/or neurotoxigenic Clostridium species in patients' feces. Parents were interviewed using a structured questionnaire. Descriptive epidemiologic characteristics were compared between 1976-1996 and 1997-2016. RESULTS From 1976-2016, 1345 cases of infant botulism occurred in 45 of 58 California counties (6.5 cases/100 000 live-births/year) caused by BoNT types A, B, Ba, Bf, and F; 88% of cases were ≤6 months of age and 51% were female. Cases were white (84.2%), Asian (8.9%), other races (3.8%), and African American (2.8%); 29.4% of cases were Hispanic. More than 99% of cases were hospitalized. Case occurrence peaked in summer-fall. Of 8 designated geographic regions, the Central Coast counties had 3 times the statewide incidence in both 20-year time periods. Breast-fed patients (83%) were more than twice as old at onset as formula-fed patients (median, 4.4 vs 1.7 months, respectively; P < .001). BoNT/A cases were older at onset than BoNT/B cases (median, 3.8 vs 2.9 months, respectively; P < .001). CONCLUSIONS Comprehensive continuous surveillance of infant botulism for 40 years in a large, diversely populated state identified fundamental epidemiologic characteristics of this uncommon illness. Unusual features included greater than 99% case hospitalization, absence of male preponderance, and a distinctive age distribution.
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Davies JR, Britton A, Liu SM, Acharya KR. High-resolution crystal structures of the botulinum neurotoxin binding domains from subtypes A5 and A6. FEBS Open Bio 2020; 10:1474-1481. [PMID: 32654405 PMCID: PMC7396429 DOI: 10.1002/2211-5463.12931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 11/10/2022] Open
Abstract
Clostridium botulinum neurotoxins (BoNTs) cause flaccid paralysis through inhibition of acetylcholine release from motor neurons; however, at tiny doses, this property is exploited for use as a therapeutic. Each member of the BoNT family of proteins consists of three distinct domains: a binding domain that targets neuronal cell membranes (HC ), a translocation domain (HN ) and a catalytic domain (LC). Here, we present high-resolution crystal structures of the binding domains of BoNT subtypes/A5 (HC /A5) and/A6 (HC /A6). These structures show that the core fold identified in other subtypes is maintained, but with subtle differences at the expected receptor-binding sites.
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Affiliation(s)
- Jonathan R Davies
- Department of Biology and Biochemistry, Claverton Down, University of Bath, Bath, UK.,Department of Biochemistry and Biophysics, Stockholm University, Sweden
| | - Amy Britton
- Department of Biology and Biochemistry, Claverton Down, University of Bath, Bath, UK
| | - Sai Man Liu
- Ipsen Bioinnovation Limited, Milton Park, Abingdon, UK
| | - K Ravi Acharya
- Department of Biology and Biochemistry, Claverton Down, University of Bath, Bath, UK
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Pellett S, Tepp WH, Johnson EA. Botulinum neurotoxins A, B, C, E, and F preferentially enter cultured human motor neurons compared to other cultured human neuronal populations. FEBS Lett 2019; 593:2675-2685. [PMID: 31240706 PMCID: PMC7751886 DOI: 10.1002/1873-3468.13508] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/06/2019] [Accepted: 06/07/2019] [Indexed: 12/11/2022]
Abstract
Human-induced pluripotent stem cell (hiPSC)-derived neurons can be exquisitely sensitive to botulinum neurotoxins (BoNTs), exceeding sensitivity of the traditionally used mouse bioassay. In this report, four defined hiPSC-derived neuronal populations including primarily GABAergic, glutamatergic, dopaminergic, and motor neurons were examined for BoNT/A, B, C, D, E, and F sensitivity. The data indicate that sensitivity varies markedly for the BoNTs tested. Motor neurons are significantly more sensitive than other neuron types for all BoNTs except BoNT/D. Examination of SNARE protein levels and BoNT-specific cell surface protein receptors reveals few differences between the cell types except greater expression levels of the receptor protein SV2C and synapsin-IIa in motor neurons. This indicates that differential toxicity of BoNTs for motor neurons compared to other neuronal cell types involves multiple mechanisms.
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Affiliation(s)
- Sabine Pellett
- Department of Bacteriology, University of Wisconsin-Madison, WI, USA
| | - William H Tepp
- Department of Bacteriology, University of Wisconsin-Madison, WI, USA
| | - Eric A Johnson
- Department of Bacteriology, University of Wisconsin-Madison, WI, USA
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Davies JR, Liu SM, Acharya KR. Variations in the Botulinum Neurotoxin Binding Domain and the Potential for Novel Therapeutics. Toxins (Basel) 2018; 10:toxins10100421. [PMID: 30347838 PMCID: PMC6215321 DOI: 10.3390/toxins10100421] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/11/2018] [Accepted: 10/18/2018] [Indexed: 01/23/2023] Open
Abstract
Botulinum neurotoxins (BoNTs) are categorised into immunologically distinct serotypes BoNT/A to /G). Each serotype can also be further divided into subtypes based on differences in amino acid sequence. BoNTs are ~150 kDa proteins comprised of three major functional domains: an N-terminal zinc metalloprotease light chain (LC), a translocation domain (HN), and a binding domain (HC). The HC is responsible for targeting the BoNT to the neuronal cell membrane, and each serotype has evolved to bind via different mechanisms to different target receptors. Most structural characterisations to date have focussed on the first identified subtype within each serotype (e.g., BoNT/A1). Subtype differences within BoNT serotypes can affect intoxication, displaying different botulism symptoms in vivo, and less emphasis has been placed on investigating these variants. This review outlines the receptors for each BoNT serotype and describes the basis for the highly specific targeting of neuronal cell membranes. Understanding receptor binding is of vital importance, not only for the generation of novel therapeutics but also for understanding how best to protect from intoxication.
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Affiliation(s)
- Jonathan R Davies
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, UK.
| | - Sai Man Liu
- Ipsen Bioinnovation Limited, Abingdon OX14 4RY, UK.
| | - K Ravi Acharya
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, UK.
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Hackett G, Moore K, Burgin D, Hornby F, Gray B, Elliott M, Mir I, Beard M. Purification and Characterization of Recombinant Botulinum Neurotoxin Serotype FA, Also Known as Serotype H. Toxins (Basel) 2018; 10:E195. [PMID: 29751611 PMCID: PMC5983251 DOI: 10.3390/toxins10050195] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/04/2018] [Accepted: 05/08/2018] [Indexed: 11/17/2022] Open
Abstract
We have purified and characterized recombinant botulinum neurotoxin serotype FA (BoNT/FA). This protein has also been named as a new serotype (serotype H), but the classification has been controversial. A lack of well-characterized, highly pure material has been a roadblock to study. Here we report purification and characterization of enzymatically active, and of inactive nontoxic, recombinant forms of BoNT/FA as tractable alternatives to purifying this neurotoxin from native Clostridium botulinum. BoNT/FA cleaves the same intracellular target proteins as BoNT/F1 and other F serotype BoNTs; the intracellular targets are vesicle associated membrane proteins (VAMP) 1, 2 and 3. BoNT/FA cleaves the same site in VAMP-2 as BoNT/F5, which is different from the cleavage site of other F serotype BoNTs. BoNT/FA has slower enzyme kinetics than BoNT/F1 in a cell-free protease assay and is less potent at inhibiting ex vivo nerve-stimulated skeletal muscle contraction. In contrast, BoNT/FA is more potent at inhibiting neurotransmitter release from cultured neurons.
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Affiliation(s)
- Gavin Hackett
- Ipsen Bioinnovation Ltd., 102 Park Drive, Milton Park, Abingdon OX14 4RY, UK.
| | - Kevin Moore
- Ipsen Bioinnovation Ltd., 102 Park Drive, Milton Park, Abingdon OX14 4RY, UK.
| | - David Burgin
- Ipsen Bioinnovation Ltd., 102 Park Drive, Milton Park, Abingdon OX14 4RY, UK.
| | - Fraser Hornby
- Ipsen Bioinnovation Ltd., 102 Park Drive, Milton Park, Abingdon OX14 4RY, UK.
| | - Bryony Gray
- Ipsen Bioinnovation Ltd., 102 Park Drive, Milton Park, Abingdon OX14 4RY, UK.
| | - Mark Elliott
- Ipsen Bioinnovation Ltd., 102 Park Drive, Milton Park, Abingdon OX14 4RY, UK.
| | - Imran Mir
- Ipsen Bioinnovation Ltd., 102 Park Drive, Milton Park, Abingdon OX14 4RY, UK.
| | - Matthew Beard
- Ipsen Bioinnovation Ltd., 102 Park Drive, Milton Park, Abingdon OX14 4RY, UK.
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