Could Botox's Sweet Tooth be its Downfall?

It seeks out glycans.

Botulinum toxin, including popular brands such as BOTOX®, almost seems like a wonder drug. Although most popular as a wrinkle fighter, doctors have long used botulinum toxins to treat eye disorders, muscle disorders, and now such wide-ranging medical conditions as migraine, incontinence, and excessive sweating. This drug has proven its worth in medicine so well that it is easy to forget the toxin's humble beginnings as a deadly disease.

Botulism Disease

Especially before the days of modern food safety, but even today, botulism has remained a potentially deadly health threat. Although rare these days, botulism can be fatal because of the botulinum toxin's high toxicity. The Clostridium botulinum bacterium thrives without oxygen, multiplying within food or in the guts of infants, pumping out its toxin. This toxin begins to affect the patient's muscles as it blocks the release of acetylcholine, the neurotransmitter responsible for communicating between motor neurons and muscle cells. Usually muscles on the face become paralyzed first, with droopy eyes and other symptoms, and the effects of botulism gradually spread to the limbs and other areas of the body. Eventually, the disease can spread to the muscles responsible for respiration, preventing the patient's ability to breathe and resulting in their death.

Botulinum Toxin for Medical Uses

Although potentially deadly in high doses, doctors use much smaller doses of botulinum toxin in medical procedures. By using just enough of the toxin to target a particular muscle, doctors can correct a wrinkle or prevent muscle spasms for months at a time. When used correctly, BOTOX® can have a variety of positive effects on the body. When used incorrectly, BOTOX® can cause a droopy look on the face or its effects can spread to produce symptoms of botulism.

How Does Sugar Fit Into the Botulinum Toxin Story?

Researchers know how BOTOX® works, but they are always learning more details about how the toxin affects the body. University of California, Irvine scientists looked into what attracts the pathogen to the neuromuscular system in particular. When the botulinum toxin leaves the bacterium, it searches out glycans, which are chains of sugars that cells synthesize for growth, development, functioning, and survival. The toxin is able to adapt to glycans at motor neuron receptors and interfere with their function. It seems that the toxin's sweet tooth is what helps it seek out its target and have such a specific effect on the human body.

The Key to Blocking BOTOX®'s Effects

Knowing the structure of the botulinum toxin and its glycan targets, the researchers identified particular amino acids that the toxin needs to bind to the glycans. When the researchers mutated just one of the amino acids, they reduced the toxin's toxicity by more than a million fold. They believe this could be the key to blocking the effects of botulinum toxin. Usually when doctors use BOTOX® they want the toxin to paralyze a particular muscle, but when someone injects too much or the effects spread, there can be unwanted side effects. Researchers could find a way to change just one of the amino acids in the toxin, blocking its ability to bind to motor neurons, reversing the effects of paralysis. This would be like making a change to a lock and key, disrupting their fit to keep the invader out. In the rare case that a patient has botulism, this discovery could be a life saver, stopping the toxin from paralyzing essential muscles in the respiratory system. When the botulinum toxin seeks to satisfy its sugar craving, it will find the door to the kitchen locked and the sugars out of reach.

Although doctors can counteract the effects of a hyaluronic acid injection with products like HYALASE®, options for counteracting BOTOX® are limited. If a patient experiences unwanted facial drooping or is simply unhappy with the way their treatment results look, about the only solution is to wait it out and let the effects gradually wear off in the following weeks. The new discovery by researchers about the botulinum toxin sweet tooth offers hope that one day cosmetic surgeons will have an effective tool to counteract the effects of BOTOX®. To buy BOTOX® for medical or cosmetic uses, or to learn more about this helpful toxin, visit


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