Toxin Detection

The only standard method for the detection of BoNT is the mouse bioassay. Two mice are injected intraperitoneally with a sample elution, and, in the case of a positive sample, the mice die with symptoms typical of botulism. The toxin type is determined by seroneutralization of the toxic samples with specific antitoxins. The immunoassay formats reported for the detection of BoNT include radioimmunoassay (RIA), gel diffusion assay, and passive hemagglutination assay (PHA). However, many of these assays provide poor sensitivity or specificity, which decreases the diagnostic value of the methods. An exception is enzyme-linked immunosorbent assay (ELISA), which may reach sensitivity similar to the mouse bioassay. A recently published ELISA format has been validated in the United States.[18] Another method with sensitivity and specificity similar to the mouse assay is the endopeptidase assay, which is based on the specific zinc endopeptidase activity of BoNTs in nerve terminals.[19] Synthetic pep-tides resembling the soluble N-ethylmaleimide-sensitive fusion protein attachment receptor (SNARE) complex proteins involved with neurotransmitter release in peripheral nerve endings serve as substrates for the toxin.

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Peripheral Neuropathy Natural Treatment Options

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