Will "botox" be the aspirin of the 21st century?

A prize-winning paper suggests that botulinum toxin might have dozens of new medical uses in treating problems such as restless legs, asthma and even obesity. The journal Medical Hypotheses, an Elsevier publication, has announced the winner of the 2007 David Horrobin Prize for medical theory. Written by Erle CH Lim and Raymond CS Seet of the Yong Loo Lin School of Medicine, National University of Singapore, the article, "Botulinum toxin, Quo Vadis?" was judged to best embody the spirit of the journal.

Botulinum toxin ("botox") is a very powerful and often fatal poison produced by a rare type of food poisoning bacteria. The toxin blocks the activity of 'cholinergic' nerves which control muscles and glands, causing glands to stop secretion and muscles to become paralysed. But in tiny doses and applied to specific structures, "botox" has many medical uses. Lim and Seet's paper describes the early medical use of botulinum toxin in treating eye-squint, then its wider role in treating pain, excess glandular secretion and muscle spasm disorders, and its best-known use as a wrinkle remover in cosmetic surgery.

The authors go on to suggest a wide range of possible uses for "botox" such as calming restless legs, improving breathing in asthma, reducing sweating, and performing a 'chemical liposuction' by removing excessive fat. In theory, botulinum toxin might be used to treat a broad range of pain syndromes, and to reduce activity for all types of glands and muscles that receive their nerve supply from the cholinergic system.

This judge for this year's prize was the internationally famous neuroscientist VS Ramachandran of the University of California at San Diego, USA. Professor Ramachandran described the paper as: "A scholarly overview containing many suggestions for potentially valuable new directions of research"

The £1,000 prize was launched in 2004 and is awarded annually by Elsevier, the publisher of Medical Hypotheses. It is named in honour of Dr. David Horrobin, the renowned researcher, biotechnology expert and founder of Medical Hypotheses, who died in 2003.