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From the School of Neurosciences and Psychiatry, Department of Neurobiology, Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom
We report here original data on the biological basis of
prolonged neuromuscular paralysis caused by the toxic phospholipase
A2 ß-bungarotoxin. Electron microscopy and
immunocytochemical labeling with anti-synaptophysin and
anti-neurofilament have been used to show that the early onset of
paralysis is associated with the depletion of synaptic vesicles from
the motor nerve terminals of skeletal muscle and that this is followed
by the destruction of the motor nerve terminal and the degeneration of
the cytoskeleton of the intramuscular axons. The postjunctional
architecture of the junctions were unaffected and the binding of
fluorescein-isothiocyanate-conjugated
-bungarotoxin to
achetylcholine receptor was not apparently affected by exposure to
ß-bungarotoxin. The re-innervation of the muscle fiber was associated
by extensive pre- and post-terminal sprouting at 3 to 5 days but was
stable by 7 days. Extensive collateral innervation of adjacent muscle
fibers was a significant feature of the re-innervated neuromuscular
junctions. These findings suggest that the prolonged and severe
paralysis seen in victims of envenoming bites by kraits (elapid snakes
of the genus Bungarus) and other related snakes of the
family Elapidae is caused by the de-pletion of synaptic vesicles
from motor nerve terminals and the degeneration of the motor nerve
terminal and intramuscular axons.
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