A potted history of botulinum toxin

On August 29, 2014 By tim In Uncategorized

So, imagine the scenario- you have never heard of botox before but you are troubled by your very obvious frown lines. Your doctor says he has just the solution- “I am just going to give you a little injection with one of the most powerful toxins known to man” he says. Er no thanks. Seems a little unlikely doesn’t it? So how did this wonder drug make it onto the open market?

Botulinum toxin is produced by the bacterium clostridium botulinum- a bug that was responsible for many episodes of food poisoning typically in association with improperly prepared meats (botulus being the latin word for “sausage”). The unfortunate victim would eventually succumb to the condition through paralysis of the muscles of the chest wall and diaphragm. As a junior doctor I recall a case of botulism presenting as a young man who was unable to purse his lips to light his cigarette! Fortunately he made a full recovery.

As is often the case in medicine, some bright spark had a brainwave and thought they might be able to harness the powerful properties of this toxin to use for medical purposes. In this case our pioneer was Alan Scott MD, an American opthalmologist. In the 1960’s and 70’s he developed the botulinum toxin to treat people suffering with eye squints and blepharospasm (uncontrollable blinking- a quite unpleasant condition) without them suffering the unwanted generalised muscle weakness. Here’s the link to the article if you are feeling especially geeky:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1312202/?page=1

Standing on the back of Dr Scott’s excellent work were the Canadian opthalmologist Dr Jean Carruthers and her dermatologist husband Alan. Jean noticed that her patients were having unexpected side effects whilst being treated for blepharospasm. This was of course the smoothing out of unwanted facial wrinkles. At first she was written off as a bit of a crackpot by the medical profession, but her persistence paid off and the FDA approved the use of botox for treating frown lines in 2002. The rest as they say is history…….

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