1. Local Tetanus Begins with a Neuromuscular Junction Paralysis around the Site of Tetanus Neurotoxin Release due to Cleavage of the Vesicle-Associated Membrane Protein.
- Author
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Fabris F, Megighian A, Rossetto O, Simonato M, Schiavo G, Pirazzini M, and Montecucco C
- Subjects
- Animals, Mice, Motor Neurons metabolism, Motor Neurons pathology, Interneurons metabolism, Mice, Inbred C57BL, Disease Models, Animal, Female, Tetanus metabolism, Tetanus complications, Tetanus Toxin metabolism, Neuromuscular Junction metabolism, Neuromuscular Junction pathology, Neuromuscular Junction drug effects, Paralysis metabolism
- Abstract
Local tetanus develops when limited amounts of tetanus neurotoxin (TeNT) are released by Clostridium tetani generated from spores inside a necrotic wound. Within days, a spastic paralysis restricted to the muscles of the affected anatomical area develops. This paralysis follows the retrograde transport of TeNT inside the axons of motoneurons and its uptake by inhibitory interneurons with cleavage of a vesicle-associated membrane protein required for neurotransmitter release. Consequently, incontrollable excitation of motoneurons causes contractures of innervated muscles and leads to local spastic paralysis. Here, the initial events occurring close to the site of TeNT release were investigated in a mouse model of local tetanus. A peripheral flaccid paralysis was found to occur, before or concurrent to the spastic paralysis. At variance from the confined TeNT proteolytic activity taking place within motor neuron terminals, central protein cleavage was detected within inhibitory interneurons controlling motor neuron efferents innervating muscle groups distant from the site of TeNT release. These results indicate peripheral activity of TeNT in tetanus and explains why the spastic paralysis observed in local tetanus, although confined to single limbs, generally affects multiple muscles. The initial TeNT neuroparalytic activity can be detected by measuring the compound muscle action potential, providing a very early diagnosis and therapy, thus preventing the ensuing life-threatening generalized tetanus., (Copyright © 2024 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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