Reveiw of the Disruptive Potential of Botulinum Neurotoxins as Chemical Warfare Agents

摘要

The botulinum neurotoxins (BoNTs) act with high specificity and high potency to prevent neurotransmitter release at the neuromuscular junction, causing sustained paralysis, and at sufficiently high doses death by asphyxiation. The seven BoNT serotypes are the most potent substance known to man and are the only toxins designated Tier 1 select agents. Modeling of toxin distribution, mortality rates and first response limitations suggests that deployment of small amounts by terrorists could rapidly incapacitate the critical care infrastructure. Since BoNT is both a unique and valuable therapeutic drug as well as a highly potent weapon, the toxin is currently the only true dual-use select agent. The same characteristics that render the toxin a dangerous chemical weapon (persistence in vivo, exceedingly high potency, ease of distribution and ease of production) also make it highly effective for a broad range of clinical applications. The expansion in therapeutic BoNT uses is contributing to the increasing number of black market BoNT producers, which in turn raises the risk that technologies for synthesis, purification and distribution could be utilized to support political or economic terrorism. Below, we present a short review of the disruptive potential of the BONTs, emphasizing the nature of the security risk.