Inhalational Poisoning by Botulinum Toxin and Inhalation Vaccination with Its Heavy-Chain Component

Abstract

Botulinum toxin is the etiologic agent responsible for the disease botulism, which is characterized by peripheral neuromuscular blockade. Botulism is ordinarily encountered as a form of oral poisoning. The toxin is absorbed from the lumen of the gut to reach the general circulation and is then distributed to peripheral cholinergic nerve endings. However, there is a widespread presumption that botulinum toxin can also act as an inhalation poison, which would require that it be absorbed from the airway. Experiments have been done to show that both pure toxin and progenitor toxin (a complex with auxiliary proteins) are inhalation poisons. Interestingly, the data indicate that auxiliary proteins are not necessary to protect the toxin or to facilitate its absorption. When studied on rat primary alveolar epithelial cells or on immortalized human pulmonary adenocarcinoma (Calu-3) cells, botulinum toxin displayed both specific binding and transcytosis. The rate of transport was greater in the apical-to-basolateral direction than in the basolateral-to-apical direction. Transcytosis was energy dependent, and it was blocked by serotype-specific antibody. The results demonstrated that the holotoxin was not essential for the process of binding and transcytosis. Both in vivo and in vitro experiments showed that the heavy-chain component of the toxin was transported across epithelial monolayers, which indicates that the structural determinants governing binding and transcytosis are found in this fragment. The heavy chain was not toxic, and therefore it was tested for utility as an inhalation vaccine against the parent molecule. This fragment was shown to evoke complete protection against toxin doses of at least 10 4 times the 50% lethal dose.

A Novel Neurotoxoid Vaccine Prevents Mucosal Botulism

“…Although these reports showed successful induction of BoNT-specific Ab responses, they limited themselves to an examination of the IgG Ab isotype and did not investigate a role for S-IgA Ab responses in BoNT intoxication (39,40). In contrast, our study has shown that BoNT/A-specific S-IgA Ab responses were induced in various mucosal secretions when mice were given a nasal BoNT/A vaccine.…”

In Vivo Molecular Imaging Analysis of a Nasal Vaccine That Induces Protective Immunity against Botulism in Nonhuman Primates

“…In this study, we attempted to develop a PET imaging system that uses a protein tracer for evaluating nasal vaccine candidates in multiple species. For this approach, we chose to evaluate a recombinant form of the nontoxic fragment of the C-terminal half of the H chain of Clostridium botulinum type A neurotoxin (BoHc/A) as a subunit vaccine candidate against botulism (12). It has been shown that systemic immunization of primates with a similar preparation of type B (BoHc/B) resulted in the generation of neutralizing Ab response (13).…”

Botulism

“…Cuando es ingerida, la neurotoxina se absorbe fundamentalmente en la parte más craneal del intestino delgado 10,94 , y alcanza los nervios colinérgicos a través de la circulación sanguínea y linfática 61 . También puede absorberse por el estómago 61 o atravesar otras células epiteliales como la mucosa respiratoria, lo que explica la posible contaminación por inhalación 71 . La inducción de la parálisis neuromuscular mediada por la neurotoxina requiere 3 pasos bioquímicos.…”