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Botulinum neurotoxin serotype D – a potential treatment alternative for BoNT/A and B non-responding patients

Kutschenko, A;Weisemann, J;Kollewe, K;Fiedler, T;Alvermann, S;Bselt, S;Escher, C;Garde, N;Gingele, S;Kaehler, S;Karatschai, R;Krger, T;Sikorra, S;Tacik, P;Wegner, F;Wollmann, J;Bigalke, H;Wohlfarth, K;Rummel, A;

Botulinum neurotoxin serotypes A and B (BoNT/A & B) are highly effective medicines to treat hyperactive cholinergic neurons. Due to neutralizing antibody formation, some patients may become non-responders. In these cases, the serotypes BoNT/C-G might become treatment alternatives. BoNT/D is genetically least related to BoNT/A & B and thereby circumventing neutralisation in A/B non-responders. We produced BoNT/D and compared its pharmacology with BoNT/A _ex vivo_ in mice tissue and _in vivo_ in human volunteers.