Botulinski nevrotoksin: odkritje in uporaba v dermatologiji
DOI:
https://doi.org/10.6016/ZdravVestn.3241Ključne besede:
Clostridium botulinum, botulizem, dermatologija, estetska medicina, zgodovina medicinePovzetek
Botulinski nevrotoksin je izredno strupena beljakovina, ki jo tvori anaerobna po Gramu pozitivna bakterija Clostridium botulinum. Zgodba o odkritju botulinskega nevrotoksina se je pričela s pojavljanjem nepojasnjenih zastrupitev s klobasami, iz česar tudi izvira njegovo ime. Latinska beseda za klobaso je namreč botulus. Zgodba o tem se je nadaljevala s stoletji raziskav in še poteka z njegovo vedno širšo uporabo v medicini. Botulinski nevrotoksin v aktivni obliki postane proteolitični encim, izključno specifičen za fuzijske beljakovine kompleksa SNARE v presinaptičnih živčnih končičih. Prek kemodenervacije začasno zavre delovanje tarčnega tkiva, na skeletnih in gladkih mišicah povzroči npr. začasno ohlapno paralizo mišic. Botulinski nevrotoksin se uporablja v nevrologiji, za zdravljenje čezmerne aktivnosti sečnega mehurja in tudi v dermatologiji, kjer njegovo uporabo še vedno mnogi povezujejo zgolj z estetiko. Novejša dognanja pa razkrivajo, da botulinski nevrotoksin zmanjšuje bolečino in srbež ter vpliva tudi na nekatere nenevronske celice, kot npr. epidermalne keratinocite, dermalne fibroblaste, vnetne celice, lojnice, žilne endotelne celice in mezenhimske matične celice v podkožnem maščevju. Odkritja napovedujejo tudi možno razširitev nabora indikacij v dermatologiji. Članek predstavi zgodovino razvoja botulinskega nevrotoksina, njegovo sestavo, mehanizem delovanja in trenutne ter obetavne indikacije za uporabo v dermatologiji.
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