Effects of pH on the binding of Clostridium botulinum type E derivative toxin to gangliosides and phospholipids

Abstract Clostridium botulinum type E derivative toxin directly bound to gangliosides G_T1b, G_D1a, and G_Q1b but not to G_M1 or G_D1b at pH 5.0 or above, At the same pH values, it bound to negatively charged phospholipids but not to noncharged ones. At pH 4.0, it bound to any of gangliosides and phospholipids including G_M1, G_D1a, and non-charged phospholipids. It bound to ceramide, a hydrophobic component of ganglioside and also to sphingomyelin, a phospholipid containing a ceramide moiety, only at pH 4.0. It bound to ceramide and sphingomyelin less firmly than to other phospholipids at pH 4.0. We assume that botulinum toxin adheres to the neural cell surface mainly by sialic acid-specific and charge-dependent binding possibly aided by nonspecific hydrophobic(toxin)-hydrophobic(lipids, mainly phospholipids) interaction.     

Differential entry of botulinum neurotoxin A into neuronal and intestinal cells

Botulinum neurotoxins (BoNTs) are often acquired from the digestive tract and specifically target neuromuscular junctions where they cause an inhibition of acetylcholine release. A transcytotic mechanism has been evidenced in epithelial intestinal cells, which delivers whole BoNTs across the intestinal barrier, whereas BoNTs enter motoneurons through a pathway that permits the translocation of light chain into the cytosol. We used fluorescent BoNT/A C-terminal part of H chain (Hc) that mediates toxin binding to cell receptors to monitor toxin entry into NG108-15 neuronal cells as well as into Caco-2 and m-IC_cl2 intestinal cells. BoNT/A Hc receptors were found to be distributed in membrane structures closely associated to cholesterol-enriched microdomains, but distinct from detergent-resistant microdomains in both cell types. BoNT/A Hc was trapped into endocytic vesicles, which progressively migrated to a perinuclear area in NG108-15 cells, and in a more scattered manner in intestinal cells. In both cell types, BoNT/A Hc entered through a dynamin- and intersectin-dependent pathway, reached an early endosomal compartment labelled with early endosome antigen 1. In neuronal cells, BoNT/A Hc entered mainly via a clathrin-dependent pathway, in contrast to intestinal cells where it followed a Cdc42-dependent pathway, supporting a differential toxin routing in both cell types.     

Cellular localization of gangliosides in the developing mouse cerebellum: analysis using the weaver mutant

Abstract: The distribution of gangliosides was studied in the weaver ( wv/wv ) mutant mouse, where the vast majority of postmitotic granule cell neurons die prior to their differentiation. The wv mutation also shows a dosage effect, as granule cell migration is slowed or retarded in the + /wv heterozygotes. By correlating changes in ganglioside composition with the well-documented histological events that occur during cerebellar development in the normal (+/+), heterozygous ( +/wv ), and weaver ( wv/ wv ) mutant mice, information was obtained on the cellular localization and function of gangliosides. Ganglioside G_M1 may be enriched in granule cell growth cones and play an important role in neurite outgrowth. A striking accumulation of G_M1, which may result from altered metabolism, occurred in the adult wvlwv mice. G_D3 was heavily concentrated in undifferentiated granule cells, but was rapidly displaced by the more complex gangliosides during differentiation. G_D1a became enriched in granule cells during formation of synaptic and dendritic membranes, whereas G_T1a appeared enriched in Purkinje cell synaptic spines. A possible fucose-containing ganglioside was quantitated only in the wvlwv mice. Ganglioside G_T1b became enriched in granule cells during synaptogenesis, whereas G_Q1b became enriched in these cells after synaptogenesis. The concentrations of G_T1b and especially G_Q1b increased continuously with age. Our results provide further evidence for a differential cellular enrichment of gangliosides in the mouse cerebellum and also suggest that certain gangliosides may be differentially distributed within the membranes of these cells at various stages of development.     

Phospholipid and Ganglioside Composition in Rat Brain After Chronic Intake of Ethanol

Abstract: A total of 18 60-day-old male Wistar rats were divided into three groups of six animals each. One group was fed a basal diet containing high levels of protein, fat, carbohydrate, vitamins, and minerals and separately a solution of 25% sucrose-32% ethyl alcohol (wt/vol). A second group was offered water as the only drinking fluid and a similar solid diet, except that carbohydrate replaced ethanol isocalorically. A third group was maintained on the basal diet ad libitum . All groups of animals were killed in a sober state after 6 months of chronic ethanol treatment and lipid analyses were performed on brain homog-enates. Chronic treatment of the animals with ethanol produces statistically significant modification of the phospholipid and ganglioside patterns in rat brain. A statistically significant decrease of the total phospholipid content and of some of the investigated fractions, i.e., phos-phatidylcholine and phosphatidylserine, as well as an increase of phosphatidylinositol were observed. Chronic alcohol consumption was associated with a statistically significant increase in the total amount of ganglioside in rat brain. An increase in most of the investigated ganglioside fractions was indicated but the difference was statistically significant only for trisialoganglioside GT_1b. The amount of disialoganglioside GD_1a in these brains was decreased after chronic intake of ethanol.     

Myelin Gangliosides in Developing Rats: The Influence of Maternal Ethanol Consumption

Abstract: The present study examined myelin gangliosides in the developing offspring of rats that were pair-fed control or ethanol liquid diets prior to and during gestation. Between 17 and 31 days of age, we observed an increase in the proportion of G_M1 in myelin (from 15% to 38% of ganglioside sialic acid) and a decrease in the proportion of G_T1b (from 26% to 4%). G_M4 was detected at all ages examined. Between 17 and 31 days of age, there was an increase in the proportion of N -acetylman-nosamine-derived radioactivity associated with G_M1 (from 16% to 22%) and G_M4 (from 5% to 13%), and a decrease in that associated with G_T1b (from 24% to 4%). Small, but sygnificant (p < 0.05), developmentally related differences were found in G_D2 and G_D3. Detection of G_M4 in myelin of young rats in the present study appears to depend on the use of nonpartitioning methods of ganglioside extraction. Although the distribution of myelin gangliosides and radioactivity was near-normal in ethanol-treated pups, there was a consistent decrease in the proportion and radioactivity associated with the major myelin ganglioside, G_M1.     

Glycosylated SV2A and SV2B mediate the entry of botulinum neurotoxin E into neurons

Botulinum neurotoxin E (BoNT/E) can cause paralysis in humans and animals by blocking neurotransmitter release from presynaptic nerve terminals. How this toxin targets and enters neurons is not known. Here we identified two isoforms of the synaptic vesicle protein SV2, SV2A and SV2B, as the protein receptors for BoNT/E. BoNT/E failed to enter neurons cultured from SV2A/B knockout mice; entry was restored by expressing SV2A or SV2B, but not SV2C. Mice lacking SV2B displayed reduced sensitivity to BoNT/E. The fourth luminal domain of SV2A or SV2B alone, expressed in chimeric receptors by replacing the extracellular domain of the low-density lipoprotein receptor, can restore the binding and entry of BoNT/E into neurons lacking SV2A/B. Furthermore, we found disruption of a N-glycosylation site (N573Q) within the fourth luminal domain of SV2A rendered the mutant unable to mediate the entry of BoNT/E and also reduced the entry of BoNT/A. Finally, we demonstrate that BoNT/E failed to bind and enter ganglioside-deficient neurons; entry was rescued by loading exogenous gangliosides into neuronal membranes. Together, the data reported here demonstrate that glycosylated SV2A and SV2B act in conjunction with gangliosides to mediate the entry of BoNT/E into neurons.     

Botulinum neurotoxins C, E and F bind gangliosides via a conserved binding site prior to stimulation-dependent uptake with botulinum neurotoxin F utilising the three isoforms of SV2 as second receptor

The high toxicity of clostridial neurotoxins primarily results from their specific binding and uptake into neurons. At motor neurons, the seven botulinum neurotoxin serotypes A–G (BoNT/A–G) inhibit acetylcholine release, leading to flaccid paralysis, while tetanus neurotoxin blocks neurotransmitter release in inhibitory neurons, resulting in spastic paralysis. Uptake of BoNT/A, B, E and G requires a dual interaction with gangliosides and the synaptic vesicle (SV) proteins synaptotagmin or SV2, whereas little is known about the entry mechanisms of the remaining serotypes. Here, we demonstrate that BoNT/F as wells depends on the presence of gangliosides, by employing phrenic nerve hemidiaphragm preparations derived from mice expressing GM3, GM2, GM1 and GD1a or only GM3. Subsequent site-directed mutagenesis based on homology models identified the ganglioside binding site at a conserved location in BoNT/E and F. Using the mice phrenic nerve hemidiaphragm assay as a physiological model system, cross-competition of full-length neurotoxin binding by recombinant binding fragments, plus accelerated neurotoxin uptake upon increased electrical stimulation, indicate that BoNT/F employs SV2 as protein receptor, whereas BoNT/C and D utilise different SV receptor structures. The co-precipitation of SV2A, B and C from Triton-solubilised SVs by BoNT/F underlines this conclusion.     

THE GAUCHER MOUSE: ADDITIONAL BIOCHEMICAL ALTERATIONS

Abstract— Additional biochemical alterations were observed in the Gaucher mouse. The activity of β-xylosidase in brain, spleen and liver was considerably decreased in this animal model and acid phosphatase in plasma was increased about 4-fold. The levels of the splenic hexosylceramides, glucosyl-ceramide, lactosylceramide, trihexosylceramide, globoside and hematoside were all increased in comparison with controls. Brain ganglioside content was examined and very few differences were noted; however, there was a tendency towards slight elevations for the monosialogangliosides and GD_1a and lower values for GD_1b and GT.     

Glycosphingolipids—Sweets for botulinum neurotoxin

A number of viruses, bacteria, and bacterial toxins can only act on cells that express the appropriate glycosphingolipids (GSLs) on the outer surface of their plasma membranes. An example of this dependency is provided by botulinum neurotoxin (BoNT) which is synthesized by Clostridium botulinum and inhibits neurotransmission at the neuromuscular junction by catalyzing hydrolysis of a SNARE protein, thereby inducing a flaccid paralysis. Haemagglutinin components of progenitor forms of BoNT mediate its adherence to glycosphingolipids (GSLs) on intestinal epithelial cells while the cellular activity of most isolated serotypes requires the presence of certain gangliosides, especially those of the Gg1b family. This review discusses available information about the identity and the roles of GSLs in the activity of BoNT. Observations that serotypes A-F of BoNT require gangliosides for optimum activity (serotype G apparently does not), permits the hypothesis that it should be possible to develop an antagonist of this interaction thereby inhibiting/reducing its effect.     

Botulinum Neurotoxin Serotype C Associates with Dual Ganglioside Receptors to Facilitate Cell Entry

Botulinum neurotoxins (BoNTs) cleave SNARE proteins in motor neurons that inhibits synaptic vesicle (SV) exocytosis, resulting in flaccid paralysis. There are seven BoNT serotypes (A–G). In current models, BoNTs initially bind gangliosides on resting neurons and upon SV exocytosis associate with the luminal domains of SV-associated proteins as a second receptor. The entry of BoNT/C is less clear. Characterizing the heavy chain receptor binding domain (HCR), BoNT/C was shown to utilize gangliosides as dual host receptors. Crystallographic and biochemical studies showed that the two ganglioside binding sites, termed GBP2 and Sia-1, were independent and utilized unique mechanisms to bind complex gangliosides. The GBP2 binding site recognized gangliosides that contained a sia5 sialic acid, whereas the Sia-1 binding site recognized gangliosides that contained a sia7 sialic acid and sugars within the backbone of the ganglioside. Utilizing gangliosides that uniquely recognized the GBP2 and Sia-1 binding sites, HCR/C entry into Neuro-2A cells required both functional ganglioside binding sites. HCR/C entered cells differently than the HCR of tetanus toxin, which also utilizes dual gangliosides as host receptors. A point-mutated HCR/C that lacked GBP2 binding potential retained the ability to bind and enter Neuro-2A cells. This showed that ganglioside binding at the Sia-1 site was accessible on the plasma membrane, suggesting that SV exocytosis may not be required to expose BoNT/C receptors. These studies highlight the utility of BoNT HCRs as probes to study the role of gangliosides in neurotransmission.     

Enhancement by Gangliosides of the Binding of Serotonin to Serotonin Binding Protein

Abstract: Several gangliosides, especially G_D3 (disialosyllactosyl ceramide) in the presence of another lipid (lecithin) were found to enhance the binding of serotonin to serotonin binding protein (SBP) severalfold. In our conditions, this enhancement was linear to a concentration of 2.7 × 10⁻⁶I G_D3 and a three- to fivefold increase in binding capacity of SBP was obtained with 8.8 × 10⁻⁶ M. The addition of this ganglioside led to an increase of serotonin binding sites, but not to an increase in the affinity of SBP to serotonin. Optimal binding capacity was found with a ratio of lecithin to ganglioside of 6: 1 (w/w). No binding was found in the absence of either SBP or Fe²⁺ (binding of serotonin to SBP is dependent on Fe²⁺). Other glycosphingolipids (sulfatide, G_D1a, G_D1b, G_M1) showed lesser effects at low concentration, whereas asialo-G_M1, cytolipin H, galactocerebroside and G_M3 had insignificant effects. Since earlier studies suggested a storage role for serotonin binding protein, the interaction of gangliosides with this protein may regulate the concentration of the biogenic amine in the synapse.     

Synthesis of Retinal Gangliosides During Chick Embryonic Development

Abstract: Embryonic retina cells incorporated radioactivity from D-[6-³H]glucosamine into gangliosides in vitro. The incorporation was higher in retinas from younger embryos. The pattern of labeling of individual gangliosides of the retina changed gradually from a predominant labeling of gangliosides running chromatographically as GD₃ (nomenclature of Svennerholm) and GM₃ in retinas from 8-day-old embryos to a predominant labeling of those running as GD_Ia and GT, in retinas from 13–18-day-old embryos and newly hatched chicks. The shift in the pattern of labeling correlated with a temporary increase of about sixfold of the activity of UDP-N-acetyl-galactosamine:GM₃ N-acetylgalactosaminyltransferase occurring between days 8 and 14 of embryonic development and with a regular increase of the activity of the UDP-galactose:GM₂ galactosyltransferase occurring from day 8 until hatching. The activities of the CMP-NeuAc:lactosylceramide-, CMP-NeuAc:GM_3-, and CMP-NeuAc:GM₁-sialosyltransferases in the retinas of newly hatched chicks were 40, 20, and 40%(in comparison with the corresponding activities determined in retinas of the 8-day-old embryo.     

Neurites and Somata of Sensory and Sympathetic Neurons in Culture Contain Multiple Species of Ganglio sides

Abstract: We have used tissue culture methods to study the capacity of sensory and sympathetic neurons to synthesize gangliosides. Under appropriate culture conditions, explants of dorsal root or superior cervical ganglia generate an extensive halo of ncurites, which is substantially free of contaminating cells. The cultures incorporate enough [³H]glucosamine into glycolipids to allow biochemical characterization. Gangliosides synthesized by the cells are extracted and freed of radioactive precursors and other lipids by column chromatography. Synthesized material comigrates on (thin-layer chromatograms with the gangliosides, G_Q, G_T, G_D1a, G^D1b, and G_M1, In addition, a substantial amount of unidentified labeled material migrates in a region between the mono- and disialo bands. The ganglioside profiles show that a similar spectrum of gangliosides is found on the neurites and somata of a particular class of neuron. Furthermore, the ganglioside compositions of the two types of neuron studied appear to be similar. We conclude that both sensory and adrenergic autonomic neurons synthesize gangliosides of each of the major classes and that representatives of each class are found in both somata and neurites. Dispersed cell cultures of the superior cervical ganglion synthesize a repertoire of gangliosides similar or identical to that of explant cultures.     

Botulinum neurotoxin D uses synaptic vesicle protein SV2 and gangliosides as receptors

Botulinum neurotoxins (BoNTs) include seven bacterial toxins (BoNT/A-G) that target presynaptic terminals and act as proteases cleaving proteins required for synaptic vesicle exocytosis. Here we identified synaptic vesicle protein SV2 as the protein receptor for BoNT/D. BoNT/D enters cultured hippocampal neurons via synaptic vesicle recycling and can bind SV2 in brain detergent extracts. BoNT/D failed to bind and enter neurons lacking SV2, which can be rescued by expressing one of the three SV2 isoforms (SV2A/B/C). Localization of SV2 on plasma membranes mediated BoNT/D binding in both neurons and HEK293 cells. Furthermore, chimeric receptors containing the binding sites for BoNT/A and E, two other BoNTs that use SV2 as receptors, failed to mediate the entry of BoNT/D suggesting that BoNT/D binds SV2 via a mechanism distinct from BoNT/A and E. Finally, we demonstrated that gangliosides are essential for the binding and entry of BoNT/D into neurons and for its toxicity in vivo, supporting a double-receptor model for this toxin.     

STUDIES ON THE BIOSYNTHESIS OF GLYCO-SPHINGOLIPIDS IN CULTURED MOUSE NEUROBLASTOMA CELLS: CHARACTERIZATION AND ACCEPTOR SPECIFICITIES OF N-ACETYLNEURAMINYL- AND N-ACETYLGALACTOSAMINYLTRANSFERASES

Abstract— The pathway of biosynthesis of N -acetylgalactosamine-containing gangliosides in mouse neuroblastoma has been studied using NB41A cells grown in monolayer tissue culture. Cell-free enzyme preparations catalyzed the transfer of NeuNAc from CMP-NeuNAc to lactosylceramide (GL-2a), to form G_M3. Asialo-G_M2 was neither an acceptor nor a competitive inhibitor of the sialyltransferase (CMP-NeuNAc: GL-2a N-acetylneuraminyltransferase, EC 2.4.99.-) under a variety of experimental conditions. Enzyme preparations also contained an N -acetylgalactosaminyltransferase (UDP-GalNAc. G_M3 N -acetylgalactosaminyltransferase, EC 2.4.1.-) which catalyzed the conversion of G_M3 to G_M2. No significant transfer of N -acetylgalactosamine to GL-2a could be demonstrated. The results of the glycosyltransferase assays support the concept that the first NeuNAc of brain gangliosides is introduced into GL-2a. The present data suggests that the occurrence of asialo-G_M2 in NB41A cells under some culture conditions is a consequence of the catabolism of higher gangliosides.     

CaMKII associates with CaV1.2 L-type calcium channels via selected β subunits to enhance regulatory phosphorylation

Calcium/calmodulin-dependent kinase II (CaMKII) facilitates L-type calcium channel (LTCC) activity physiologically, but may exacerbate LTCC-dependent pathophysiology. We previously showed that CaMKII forms stable complexes with voltage-gated calcium channel (VGCC) β_1b or β_2a subunits, but not with the β₃ or β₄ subunits ( Grueter et al. 2008 ). CaMKII-dependent facilitation of Ca_V1.2 LTCCs requires Thr498 phosphorylation in the β_2a subunit ( Grueter et al. 2006 ), but the relationship of this modulation to CaMKII interactions with LTCC subunits is unknown. Here we show that CaMKII co-immunoprecipitates with forebrain LTCCs that contain Ca_V1.2α₁ and β₁ or β₂ subunits, but is not detected in LTCC complexes containing β₄ subunits. CaMKIIα can be specifically tethered to the I/II linker of Ca_V1.2 α₁ subunits in vitro by the β_1b or β_2a subunits. Efficient targeting of CaMKIIα to the full-length Ca_V1.2α₁ subunit in transfected HEK293 cells requires CaMKII binding to the β_2a subunit. Moreover, disruption of CaMKII binding substantially reduced phosphorylation of β_2a at Thr498 within the LTCC complex, without altering overall phosphorylation of Ca_V1.2α₁ and β subunits. These findings demonstrate a biochemical mechanism underlying LTCC facilitation by CaMKII.     

The association of metabotropic glutamate receptor type 5 with the neuronal Ca2+-binding protein 2 modulates receptor function

Metabotropic glutamate (mGlu) receptors mediate in part the CNS effects of glutamate. These receptors interact with a large array of intracellular proteins in which the final role is to regulate receptor function. Here, using co-immunoprecipitation and pull-down experiments we showed a close and specific interaction between mGlu₅ receptor and NECAB2 in both transfected human embryonic kidney cells and rat hippocampus. Interestingly, in pull-down experiments increasing concentrations of calcium drastically reduced the ability of these two proteins to interact, suggesting that NECAB2 binds to mGlu₅ receptor in a calcium-regulated manner. Immunoelectron microscopy detection of NECAB2 and mGlu₅ receptor in the rat hippocampal formation indicated that both proteins are codistributed in the same subcellular compartment of pyramidal cells. In addition, the NECAB2/mGlu₅ receptor interaction regulated mGlu_5b-mediated activation of both inositol phosphate accumulation and the extracellular signal-regulated kinase/mitogen-activated protein kinase pathway. Overall, these findings indicate that NECAB2 by its physical interaction with mGlu_5b receptor modulates receptor function.     

Inhibition by Botulinum Toxin of Acetylcholine Release from Synaptosomes: Latency of Action and the Role of Gangliosides

Abstract: Crude and crystalline botulinum toxin type A have been compared for their ability to inhibit [¹⁴C]ACh release from synaptosomes preloaded with [¹⁴C]choline. The toxin preparations exhibited similar dose-response curves, with maximal inhibition at 10⁵ mouse LD₅₀/ml after 60 min preincubation. The time course for the inhibitory action of the toxin showed that inhibition develops almost linearly over this time period. However, free toxin could be removed from the synaptosome suspension after 15 min without altering the subsequent development of inhibition of [¹⁴C]ACh release, which suggests that the toxin is rapidly fixed by synaptosomes and that fixation alone cannot account for the latency of its action. Incorporation of gangliosides into synaptosomes by prior preincubation failed to increase the potency of the toxin, which implies that gangliosides do not serve as the membrane receptor for the toxin. Treatment of botulinum toxin with dithiothreitol greatly diminished its ability to inhibit [¹⁴C]ACh release and it is suggested that botulinum toxin may be analogous to other bacterial toxins in its structure and mode of action.     

Botulinum neurotoxin type B uses a distinct entry pathway mediated by CDC42 into intestinal cells versus neuronal cells

Botulinum neurotoxins (BoNTs) are responsible for severe flaccid paralysis by inhibiting the release of acetylcholine at the neuromuscular junctions. BoNT type B (BoNT/B) most often induces mild forms of botulism with predominant dysautonomic symptoms. In food borne botulism and botulism by intestinal colonisation such as infant botulism, which are the most frequent naturally acquired forms of botulism, the digestive tract is the main entry route of BoNTs into the organism. We previously showed that BoNT/B translocates through mouse intestinal barrier by an endocytosis‐dependent mechanism and subsequently targets neuronal cells, mainly cholinergic neurons, in the intestinal mucosa and musculosa. Here, we investigated the entry pathway of BoNT/B using fluorescent C‐terminal domain of the heavy chain (HcB), which is involved in the binding to specific receptor(s) and entry process into target cells. While the combination of gangliosides GD_1a/GD_1b/GT_1b and synaptotagmin I and to a greater extent synaptotagmin II constitutes the functional HcB receptor on NG108‐15 neuronal cells, HcB only uses the gangliosides GD_1a/GD_1b/GT_1b to efficiently bind to m‐IC_cl2 intestinal cells. HcB enters both cell types by a dynamin‐dependent endocytosis, which is efficiently prevented by Dynasore, a dynamin inhibitor, and reaches a common early endosomal compartment labeled by early endosome antigen (EEA1). In contrast to neuronal cells, HcB uses a Cdc42‐dependent pathway to enter intestinal cells. Then, HcB is transported to late endosomes in neuronal cells, whereas it exploits a nonacidified pathway from apical to basal lateral side of m‐IC_cl2 cells supporting a transcytotic route in epithelial intestinal cells.     

Preferential Entry of Botulinum Neurotoxin A Hc Domain through Intestinal Crypt Cells and Targeting to Cholinergic Neurons of the Mouse Intestine

Botulism, characterized by flaccid paralysis, commonly results from botulinum neurotoxin (BoNT) absorption across the epithelial barrier from the digestive tract and then dissemination through the blood circulation to target autonomic and motor nerve terminals. The trafficking pathway of BoNT/A passage through the intestinal barrier is not yet fully understood. We report that intralumenal administration of purified BoNT/A into mouse ileum segment impaired spontaneous muscle contractions and abolished the smooth muscle contractions evoked by electric field stimulation. Entry of BoNT/A into the mouse upper small intestine was monitored with fluorescent HcA (half C-terminal domain of heavy chain) which interacts with cell surface receptor(s). We show that HcA preferentially recognizes a subset of neuroendocrine intestinal crypt cells, which probably represent the entry site of the toxin through the intestinal barrier, then targets specific neurons in the submucosa and later (90–120 min) in the musculosa. HcA mainly binds to certain cholinergic neurons of both submucosal and myenteric plexuses, but also recognizes, although to a lower extent, other neuronal cells including glutamatergic and serotoninergic neurons in the submucosa. Intestinal cholinergic neuron targeting by HcA could account for the inhibition of intestinal peristaltism and secretion observed in botulism, but the consequences of the targeting to non-cholinergic neurons remains to be determined.