We finally know how Botox gets into the neurons. The discovery could help develop an antidote for the molecule’s neurotoxic effects, which can lead to paralysis or even death.

Botox uses a type of botulinum neurotoxin, a highly toxic substance produced by bacteria. The toxin disrupts communication between neurons, resulting in muscle paralysis. In small therapeutic doses, it can ease muscle spasms, cure migraines, or more commonly, reduce wrinkles. However, in high doses, this molecule causes botulism, a potentially fatal disease that does not require large amounts of treatment.

Frederic Meunier from the University of Queensland in Australia and colleagues analyzed how botulinum neurotoxin type A enters neurons using a technique called single molecule imaging. This allowed them to capture the movement of molecules labeled with a fluorescent dye.

The researchers placed the toxin in a dish of rat neurons. They tuned one camera to a neurotoxin and the other to receptors in neuronal membranes, also labeled with different colors of dyes.

Previously, only two receptors, called polysialoganglioside (PSG) and synaptic vesicle glycoprotein 2 (SV2), were thought to be key for toxin entry into cells. But when they tracked SV2’s response to the toxin, they saw that it moved in tandem with another receptor known as synaptotagmin 1 (Syt1).

“Basically we started thinking, ‘Oh, this is weird,'” Meunier says. The researchers genetically modified rat neurons to prevent Syt1 from binding to SV2 and repeated the experiment. If you suppress the binding between these two receptors, the toxin can no longer enter the cell, Meunier says.

The same was true when they genetically modified neurons to lack PSG, indicating that all three receptors are required for botulinum neurotoxin type A to enter cells. Future drugs that block the binding of the three receptors could prevent neurons from being infected by the toxin, Meunier said.

“By understanding more about the mechanism of cell entry, we are one step closer to preventing cell entry and preventing botulism,” says Sabine Pellett at the University of Wisconsin-Madison.

In a letter to Veterans Administration Secretary Denis McDonough following news of proposed layoffs at Mann-Grandstaff Medical Center, Virginia, Rep. Katie McMorris Rogers, R-Washington State, said hiring was restricted and further staff cuts will be required to address the issue. $35 million budget shortfall caused by Oracle Cerner Electronic Health Records Modernization Program.

WHY IS IT IMPORTANT

McMorris Rogers said on Thursday that she “demanded” the VA secretary to commit to prevent cuts in staff or services at the medical centers where Oracle Cerner EHR operates by redirecting funding earmarked for a rollout now on hold, specifically at two medical centers. VA in Washington.

“Under no circumstances should a VA medical center experience budgetary shortfalls and reductions in staff or services as a result of an EHR failure,” McMorris Rogers said in her report. letter.

Dr. Robert Fischer, medical director of Mann-Grandstaff, sent an email to executives on May 9, reportedly stating that the hospital would need to cut its approved workforce by more than 15% due to a projected budget shortfall, equivalent to losing 146 full states. temporary positions, according to report earlier this week from Press secretary overview.

Overburdened medical centers said they relied on the private sector to make up for limited specialized care, although Fisher’s email cited wages as a contributing factor.

Sheriff Elnahal, Virginia’s chief health officer, indicated during a press conference last week that the department had already provided funding to account for the system’s impact, the report said.

McMorris insists that the EHR has undermined treatment and is now threatening facilities, and has asked the secretary to ensure adequate resources are provided for affected medical centers.

“Mr. Secretary, would you please make a commitment to me and to every veteran in Eastern Washington that your department will use every available EHR dollar to prevent staff or service cuts at Mann-Grandstaff and Jonathan Medical Centers. M. Wainwright, Virginia. ?”

BIG TREND

Due to system outages, slowdowns, and patient-harming errors, the beleaguered EHR impacted the five institutions that were the first to migrate from VistA.

VA recently extended its contract to upgrade Oracle Cerner EHR with revised terms, including a number of performance metrics, failure to meet which will result in a cash loan to the agency and five one-year terms instead of one five-year.

“Overall, this is a much stronger contract, and I hope it helps VA ensure that Oracle Cerner makes this EHR program work for Washington State suppliers and veterans.” — U.S. Senator Patty Murray, WA, Chair of the Senate Appropriations Committee and Veterans Affairs Subcommittee, as well as a senior member of the Senate Veterans Affairs Committee, the statement said.

IN RECORDING

“There will be no further system deployments during the VA-announced EHR reset,” McMorris Rogers said.

“Therefore, those funds that were originally intended for further development should be redirected to those medical centers that are experiencing budget deficits, facing staff reductions and experiencing difficulties in operation due to EHR.”

Andrea Fox is a senior editor at Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a publication of HIMSS Media.