ABSTRACT
This chapter begins by briefly looking at the mechanism of action of botulinum toxins, before examining the process of manufacturing products containing them. It then examines complexes and complexing proteins and concludes that molecular weight or protein complex size do not affect biological activity and pharmacological properties. The chapter next ponders whether there is a benefit to complexing proteins, as it is argued that they influence the spread or diffusion of the neurotoxin out of the injected muscle and into others not intended for treatment, although this can be influenced by numerous factors. It eventually concludes blame of migration of neurotoxin on complexing proteins is harsh, as the neurotoxin is already dissociated from the complexing proteins when it is injected into patients. The chapter then discusses the potency and clinical efficacy of botulinum products, before looking at the immunological properties the body might respond to the admittance of botulinum with. The chapter concludes that botulinum therapies are biological products and their clinical pharmacology depends on a number of factors, including the bacterial strain used in production, methods of isolation and purification, and the presence or absence of complexing proteins, and how these vary from each commercially available product.
