Botox and the prostate: A new wrinkle

It earned notoriety as the cause of a deadly form of food poisoning, and it's considered a potential weapon of bioterrorists. But recently, botulinum toxin (Botox) has also achieved respectability as a cosmetic treatment for wrinkles and as a therapy for a broad range of medical problems. And a 2005 study suggests that benign prostatic hyperplasia (BPH) may someday join the list of conditions that can benefit from it.

The toxin

Botox is a protein produced by a bacterium called Clostridium botulinum. It binds to nerve fibers, preventing them from releasing acetylcholine, a chemical that allows nerves to communicate with muscles and other nerves. Without this chemical messenger, muscles cannot contract properly.

Muscular paralysis makes the toxin dangerous, causing the disease called botulism. The clostridial bacteria normally live in soil and in the intestinal tracts of humans and animals. In the soil or feces, the bacteria are harmless, but they form spores that can contaminate food. Because the spores are inert, they are not dangerous, and pressure cooking can destroy them — which is why botulism is now rarely spread by commercially canned foods. But if contaminated food is not handled properly, the spores come to life, turning into the bacterial forms that multiply, grow, and produce the hazardous toxin. The toxin can be destroyed by heating food to 176˚F for 30 minutes or boiling for 10 minutes; otherwise, toxin that is consumed is absorbed into the bloodstream, which carries it to the nervous system, where it goes to work. In mild cases, symptoms include dry mouth, blurred vision, decreased sweating, constipation, and urinary retention. If enough toxin is swallowed, however, the patient becomes weak, then paralyzed. Even with the best modern treatment, 25% of victims die from respiratory paralysis. But if treatment is difficult, prevention is easy. Be sure to cook your food thoroughly, refrigerate leftovers promptly, and reheat them before eating.

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