Medical Applications of Clostridia and Clostridial Toxins

The bacterial genus Clostridium produces a diverse array of protein toxins, many of which have played an important role in disease and medicine. Although initially known for their ability to do harm, many clostridial toxins have been shown to have therapeutic value for a diverse array of diseases. The articles included in this special issue provide insight into some of that diversity and show that bacterial toxins remain a valuable storehouse for development of new therapeutic measures. Perhaps the most known toxin therapeutics derived from the clostridial species are neurotoxins secreted by Clostridium botulinum. Treatment using BTX is remarkable in that the amount of toxin required is small and the beneficial effects are dramatic, particularly considering the fact that many of the conditions, such as dystonias and muscle spasms, do not respond to other pharmacological treatments. Over the last few decades, BTX has also become cosmetically important and has created significant markets for the drug. Most commercial BTX products are not the pure toxin, but a combination of the toxin and toxin-associated proteins. While these progenitor toxins are safe, a purified form of the toxin would eliminate extraneous proteins and offer a safer drug. Clinical investigations conducted by Y. Matsuka and coworkers (J. Toxicol., 12, 2012) show that BTX purified over a lactose column was an effective treatment for urinary incontinence and prostatic hyperplasia. Their studies provide further data confirming that purified BTX can be used in lieu of progenitor toxins for treatment of many spasmodic conditions. Although the focus of most BTX treatment has centered upon using the toxin as a local paralytic to relieve spasm-related illness, new studies show also that BTX aids in the treatment of other difficult-to-treat conditions. D. Intiso (J. Toxicol., 12, 2012) provides an excellent review showing the positive effects of BTX as a supplement in treatment strategies in which the patient requires neurorehabilitative intervention. In treating conditions such as cerebral palsy, stroke, sialorrhea, and other neuromuscular diseases, BTX permits the individual to benefit from physical therapy which is often extremely difficult without some muscle relaxation. New uses of BTX are not limited to rehabilitative intervention, but as suggested by F. j. Lebeda and colleagues (J. Toxicol., 12, 2012), BTX treatment may enhance the processes of wound healing. By performing a systematic search of the literature, the authors developed a qualitative model that shows the possibility of using BTX therapy in wound healing. BTX …