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从毒药到解药:肉毒杆菌毒素的曲折历史。

From poison to remedy: the chequered history of botulinum toxin.

作者信息

Erbguth F J

机构信息

Department of Neurology, Nuremberg Municipal Academic Hospital, Nuremberg, Germany.

出版信息

J Neural Transm (Vienna). 2008;115(4):559-65. doi: 10.1007/s00702-007-0728-2. Epub 2007 Apr 26.

Abstract

Botulinum toxin poisoning has afflicted mankind through the mists of time. However, the first incident of food-borne botulism was documented as late as the 18th century, when the consumption of meat and blood sausages gave rise to many deaths throughout the kingdom of Württemberg in South Western Germany. The district medical officer Justinus Kerner (1786--1862), who was also a well-known German poet, published the first accurate and complete descriptions of the symptoms of food-borne botulism between 1817 and 1822 and attributed the intoxication to a biological poison. Kerner also postulated that the toxin might be used for treatment purposes. In 1895, an outbreak of botulism in the small Belgian village of Ellezelles led to the discovery of the pathogen "Clostridium botulinum" by Emile Pierre van Ermengem. Modern botulinum toxin treatment was pioneered by Alan B. Scott and Edward J. Schantz in the early 1970s, when the type-A serotype was used in medicine to correct strabismus. Other preparations of the type-A toxin were developed and manufactured in the United Kingdom, Germany, and China, whereas a therapeutic type-B toxin was prepared in the United States. To date, the toxin has been used to treat a wide variety of conditions associated with muscular hyperactivity, glandular hypersecretions and pain.

摘要

肉毒杆菌毒素中毒长期以来一直困扰着人类。然而,食源性肉毒中毒的首例事件直到18世纪才被记录下来,当时在德国西南部的符腾堡王国,食用肉类和血肠导致了许多人死亡。地区医务官贾斯蒂努斯·克纳(1786 - 1862),他也是一位著名的德国诗人,在1817年至1822年间发表了食源性肉毒中毒症状的首批准确而完整的描述,并将中毒归因于一种生物毒素。克纳还推测这种毒素可能用于治疗目的。1895年,比利时小村庄埃勒泽勒爆发肉毒中毒,埃米尔·皮埃尔·范·埃尔姆根发现了病原体“肉毒杆菌”。现代肉毒杆菌毒素治疗由艾伦·B·斯科特和爱德华·J·尚茨在20世纪70年代初开创,当时A型血清型被用于医学上矫正斜视。A型毒素的其他制剂在英国、德国和中国研发生产,而治疗用B型毒素则在美国制备。迄今为止,这种毒素已被用于治疗与肌肉活动亢进、腺体分泌过多和疼痛相关的多种病症。

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