Botulinum and Tetanus Neurotoxins

Annu Rev Biochem. 2019 Jun 20;88:811-837. doi: 10.1146/annurev-biochem-013118-111654. Epub 2018 Nov 2.


Botulinum neurotoxins (BoNTs) and tetanus neurotoxin (TeNT) are the most potent toxins known and cause botulism and tetanus, respectively. BoNTs are also widely utilized as therapeutic toxins. They contain three functional domains responsible for receptor-binding, membrane translocation, and proteolytic cleavage of host proteins required for synaptic vesicle exocytosis. These toxins also have distinct features: BoNTs exist within a progenitor toxin complex (PTC), which protects the toxin and facilitates its absorption in the gastrointestinal tract, whereas TeNT is uniquely transported retrogradely within motor neurons. Our increasing knowledge of these toxins has allowed the development of engineered toxins for medical uses. The discovery of new BoNTs and BoNT-like proteins provides additional tools to understand the evolution of the toxins and to engineer toxin-based therapeutics. This review summarizes the progress on our understanding of BoNTs and TeNT, focusing on the PTC, receptor recognition, new BoNT-like toxins, and therapeutic toxin engineering.

Keywords: bacterial toxin; botulinum neurotoxin; clostridium; protein engineering; tetanus neurotoxin; toxin.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Botulinum Toxins / metabolism
  • Botulinum Toxins / therapeutic use*
  • Botulinum Toxins / toxicity
  • Humans
  • Metalloendopeptidases / metabolism
  • Metalloendopeptidases / therapeutic use*
  • Metalloendopeptidases / toxicity
  • Protein Conformation
  • Protein Engineering
  • Tetanus Toxin / metabolism
  • Tetanus Toxin / therapeutic use*
  • Tetanus Toxin / toxicity


  • Tetanus Toxin
  • tetanospasmin
  • Metalloendopeptidases
  • Botulinum Toxins