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Mechanism of action of botulinum toxins

Synaptobrevin on the synaptic vesicle must interact with syntaxin and SNAP (synaptosomal-associated protein)-25 on the neuronal membrane for fusion to occur, which allows the nerve impulse to be delivered across the synaptic junction. The botulinum neurotoxin serotypes cleave the peptide bonds at specific sites on the three cellular proteins, as indicated. Cleavage of any one of these cellular proteins prevents vesicle membrane docking and nerve impulse transmission. (Source: Barr JR, Moura H, Boyer AE, et al. Botulinum neurotoxin detection and differentiation by mass spectrometry. Emerg Infect Dis 2005;11[10]:1578-83. Public domain.)