RESUMO
Botulinum toxin is a multi-molecular complex comprised of a neuro-active moiety (i.e. botulinum neurotoxin) and several associated non-toxic proteins. The toxin dissociates rapidly at plasmatic pH, thereby releasing neurotoxin. Nerve terminals only take up the neurotoxin. In the peripheral nerve system, the neurotoxin mainly blocks acetylcholine release. When acting at the neuromuscular junctions, this results in paralysis of the muscle fibers. The duration of the neurotoxin action is mainly determined by the life-time of neurotoxin molecules inside the nerve terminals. Inhibition of cholinergic transmission induces rapid atrophy of the muscle fibres, and, sometimes, sprouting from poisoned nerve terminals. These effects, as well as the acetylcholine release blockade are entirely reversible. When injected in the periphery, a direct action of botulinum neurotoxin in the central nervous system remains unlikely despite its retrograde ascent demonstrated in animal models. However, indirect effects are numerous. The constituting proteins of the toxin complex can lead to immunisation against the non-toxic associated proteins and neurotoxin. Only the antibodies directed against neurotoxin are potentially neutralizing.
Assuntos
Toxinas Botulínicas/farmacologia , Neurotoxinas/farmacologia , Animais , Toxinas Botulínicas/química , Toxinas Botulínicas/imunologia , Toxinas Botulínicas/toxicidade , Sistema Nervoso Central/efeitos dos fármacos , Citosol/metabolismo , Humanos , Concentração de Íons de Hidrogênio , Imunização , Neurônios/metabolismo , Neurotoxinas/química , Neurotoxinas/imunologia , Neurotoxinas/toxicidade , Peptídeo Hidrolases/química , Sistema Nervoso Periférico/efeitos dos fármacos , Transporte Proteico , Transmissão Sináptica/efeitos dos fármacosRESUMO
The skeletal neuromuscular junction has been considered as a model of chemical synapses due to its relatively simple organization. It is made up of three cellular partners including the motoneuron nerve terminals, the peri-synaptic Schwann cells and a specialized region of skeletal muscle fibers. It has been extensively studied revealing its ultrastructural complexity involving many molecular actors. The neuromuscular junction is a highly specialized structure, optimized for the rapid transmission of information from the presynaptic nerve terminal to the post-synaptic muscle fiber. This rapid transmission requires a very close apposition of plasmic membranes of pre- and post-synaptic partners, and a strict structural and molecular arrangement on both sides of the narrow synaptic cleft separating nerve terminal and muscle membranes. In this short review, we summarize the knowledge regarding pre- and post-synaptic ultrastructural specializations and give an overview of some functional aspects of neuromuscular transmission, including the quantal acetylcholine release process, which will help to better understand the pharmacological actions of botulinum toxins in esthetic and corrective dermatology.
Assuntos
Músculo Esquelético/anatomia & histologia , Músculo Esquelético/fisiologia , Junção Neuromuscular/anatomia & histologia , Junção Neuromuscular/fisiologia , Transmissão Sináptica/fisiologia , Acetilcolina/metabolismo , Humanos , Placa Motora/anatomia & histologia , Placa Motora/fisiologia , Neurônios Motores/fisiologia , Fibras Musculares Esqueléticas/fisiologia , Neurotransmissores/metabolismo , Terminações Pré-Sinápticas/fisiologia , Receptores Colinérgicos/fisiologia , Sinapses/fisiologiaRESUMO
Several bacteria of the Clostridium genus (C. botulinum) produce 150 kDa di-chainal protein toxins referred as botulinum neurotoxins or BoNTs. They associate with non-toxic companion proteins and form a complex termed botulinum toxin. BoNTs specifically inhibit vesicular neurotransmitter release. The cellular action of BoNTs can be depicted according to a multi-step model : The toxin's heavy chain mediates binding to specific receptors comprised of a ganglioside moiety and a vesicular protein (SV2 for BoNT type A, synaptotagmin for BoNT type B), followed by endocytotic internalisation of the BoNT/receptor complex. Vesicle recycling induces BoNT internalisation. Upon acidification of vesicles, the light chain of the neurotoxin is translocated into the cytosol. Here, this zinc-endopeptidase cleaves one or two among three synaptic proteins (VAMP-synapto-brevin, SNAP25, and syntaxin). As the three protein targets of BoNT play major role in fusion of synaptic vesicles at the release sites, their cleavage is followed by blockade of neurotransmitter exocytosis. Importantly, as the BoNT receptors and intracellular targets are present in all nerve terminals, the BoNTs are not specific for cholinergic transmission. Duration of their inhibitory action is mainly determined by the the life-time of the toxin's light chain in the cytosol. Sprouting of new nerve-endings, which are retracted when the poisoned nerve terminals have recovered full functionality, may lead to anticipated recovery of the poisoned nerve terminals.
Assuntos
Toxinas Botulínicas/farmacologia , Fármacos Dermatológicos/farmacologia , Fármacos Neuromusculares/farmacologia , Toxinas Botulínicas/química , Toxinas Botulínicas/metabolismo , Clostridium botulinum/metabolismo , Fármacos Dermatológicos/química , Fármacos Dermatológicos/metabolismo , Humanos , Metaloendopeptidases/metabolismo , Dados de Sequência Molecular , Proteínas do Tecido Nervoso/metabolismo , Fármacos Neuromusculares/química , Fármacos Neuromusculares/metabolismo , Transmissão Sináptica/efeitos dos fármacosRESUMO
The ability of the cerebellar cortex to learn from experience ensures the accuracy of movements and reflex adaptation, processes which require long-term plasticity at granule cell (GC) to Purkinje neuron (PN) excitatory synapses. PNs also receive GABAergic inhibitory inputs via GCs activation of interneurons; despite the involvement of inhibition in motor learning, its role in long-term plasticity is poorly characterized. Here we reveal a functional coupling between ionotropic GABAA receptors and low threshold CaV3 calcium channels in PNs that sustains calcium influx and promotes long-term potentiation (LTP) at GC to PN synapses. High frequency stimulation induces LTP at GC to PN synapses and CaV3-mediated calcium influx provided that inhibition is intact; LTP is mGluR1, intracellular calcium store and CaV3 dependent. LTP is impaired in CaV3.1 knockout mice but it is nevertheless recovered by strengthening inhibitory transmission onto PNs; promoting a stronger hyperpolarization via GABAA receptor activation leads to an enhanced availability of an alternative Purkinje-expressed CaV3 isoform compensating for the lack of CaV3.1 and restoring LTP. Accordingly, a stronger hyperpolarization also restores CaV3-mediated calcium influx in PNs from CaV3.1 knockout mice. We conclude that by favoring CaV3 channels availability inhibition promotes LTP at cerebellar excitatory synapses.
Assuntos
Cerebelo/fisiologia , Potenciação de Longa Duração/fisiologia , Sinapses/fisiologia , Animais , Cálcio/metabolismo , Canais de Cálcio/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , Modelos Biológicos , Células de Purkinje/fisiologia , Receptores de GABA-A/metabolismoRESUMO
Neurotransmitter release is a highly efficient secretory process exhibiting resistance to fatigue and plasticity attributable to the existence of distinct pools of synaptic vesicles (SVs), namely a readily releasable pool and a reserve pool from which vesicles can be recruited after activity. Synaptic vesicles in the reserve pool are thought to be reversibly tethered to the actin-based cytoskeleton by the synapsins, a family of synaptic vesicle-associated phosphoproteins that have been shown to play a role in the formation, maintenance, and regulation of the reserve pool of synaptic vesicles and to operate during the post-docking step of the release process. In this paper, we have investigated the physiological effects of manipulating synapsin levels in identified cholinergic synapses of Aplysia californica. When endogenous synapsin was neutralized by the injection of specific anti-synapsin antibodies, the amount of neurotransmitter released per impulse was unaffected, but marked changes in the secretory response to high-frequency stimulation were observed, including the disappearance of post-tetanic potentiation (PTP) that was substituted by post-tetanic depression (PTD), and increased rate and extent of synaptic depression. Opposite changes on post-tetanic potentiation were observed when synapsin levels were increased by injecting exogenous synapsin I. Our data demonstrate that the presence of synapsin-dependent reserve vesicles allows the nerve terminal to release neurotransmitter at rates exceeding the synaptic vesicle recycling capacity and to dynamically change the efficiency of release in response to conditioning stimuli (e.g., post-tetanic potentiation). Moreover, synapsin-dependent regulation of the fusion competence of synaptic vesicles appears to be crucial for sustaining neurotransmitter release during short periods at rates faster than the replenishment kinetics and maintaining synchronization of quanta in evoked release.
Assuntos
Plasticidade Neuronal/fisiologia , Neurônios/metabolismo , Sinapsinas/metabolismo , Vesículas Sinápticas/metabolismo , Acetilcolina/metabolismo , Potenciais de Ação/efeitos dos fármacos , Potenciais de Ação/fisiologia , Animais , Anticorpos/farmacologia , Especificidade de Anticorpos , Aplysia , Estimulação Elétrica , Exocitose/fisiologia , Gânglios dos Invertebrados/citologia , Gânglios dos Invertebrados/metabolismo , Técnicas In Vitro , Microinjeções , Inibição Neural/fisiologia , Plasticidade Neuronal/efeitos dos fármacos , Neurônios/efeitos dos fármacos , Técnicas de Patch-Clamp , Ratos , Sinapses/metabolismo , Sinapsinas/antagonistas & inibidores , Sinapsinas/farmacologiaRESUMO
Among bacterial protein toxins with intracellular targets, tetanus and botulinum toxins form a group with unique properties. They are absolutely neurospecific and act in the cytosol of neurons. Recent evidence indicates that they are zinc proteases specific for proteins of the neuroexocytosis apparatus.
Assuntos
Proteínas de Bactérias/farmacologia , Toxinas Bacterianas/farmacologia , Toxinas Botulínicas/farmacologia , Neurotoxinas/farmacologia , Sequência de Aminoácidos , Proteínas de Membrana/metabolismo , Dados de Sequência Molecular , Proteínas do Tecido Nervoso/metabolismo , Proteínas R-SNARERESUMO
The ability of the two-chain form of tetanus toxin (TeTx), its constituent light (LC) or heavy (HC) chains, and papain fragment to block evoked acetylcholine (ACh) release in the buccal ganglia of Aplysia californica was studied electrophysiologically. Extracellularly applied, TeTx or its B fragment (consisting of LC and beta 2, the amino-terminal portion of HC) blocked ACh release, whereas LC, HC, or the beta 2 fragment did not affect it. Toxicity was restored when LC was bath applied together with HC or the beta 2 fragment. When injected into the presynaptic neuron, TeTx, the B fragment or LC, but not HC, induced inhibition of ACh release. These results indicate that the blockade of ACh release by TeTx is mimicked by intracellular action of LC, the internalization of which is mediated by the HC via its amino-terminal moiety.
Assuntos
Acetilcolina/metabolismo , Sinapses/fisiologia , Transmissão Sináptica/efeitos dos fármacos , Toxina Tetânica/farmacologia , Animais , Aplysia , Endocitose , Potenciais Evocados , Técnicas In Vitro , Relação Estrutura-Atividade , Toxina Tetânica/metabolismoRESUMO
Botulinum neurotoxins (BoNT, serotypes A-G) and tetanus neurotoxin (TeNT) are bacterial proteins that comprise a light chain (M(r) approximately 50) disulfide linked to a heavy chain (M(r) approximately 100). By inhibiting neurotransmitter release at distinct synapses, these toxins cause two severe neuroparalytic diseases, tetanus and botulism. The cellular and molecular modes of action of these toxins have almost been deciphered. After binding to specific membrane acceptors, BoNTs and TeNT are internalized via endocytosis into nerve terminals. Subsequently, their light chain (a zinc-dependent endopeptidase) is translocated into the cytosolic compartment where it cleaves one of three essential proteins involved in the exocytotic machinery: vesicle associated membrane protein (also termed synaptobrevin), syntaxin, and synaptosomal associated protein of 25 kDa. The aim of this review is to explain how the proteolytic attack at specific sites of the targets for BoNTs and TeNT induces perturbations of the fusogenic SNARE complex dynamics and how these alterations can account for the inhibition of spontaneous and evoked quantal neurotransmitter release by the neurotoxins.
Assuntos
Toxinas Botulínicas/farmacologia , Neurotransmissores/metabolismo , Transmissão Sináptica/efeitos dos fármacos , Toxina Tetânica/farmacologia , Motivos de Aminoácidos , Sequência de Aminoácidos , Animais , Toxinas Botulínicas/química , Toxinas Botulínicas/metabolismo , Exocitose/efeitos dos fármacos , Humanos , Metaloendopeptidases/metabolismo , Dados de Sequência Molecular , Proteínas do Tecido Nervoso/metabolismo , Toxina Tetânica/química , Toxina Tetânica/metabolismoRESUMO
In order to gain insights into the steps (binding, uptake, intracellular effect) which differ in the inhibitory actions of tetanus toxin and botulinum neurotoxins types A or B, their temperature dependencies were investigated at identified cholinergic and non-cholinergic synapses in Aplysia. Upon lowering the temperature from 22 degrees C to 10 degrees C, extracellularly applied botulinum neurotoxin type A and B appeared unable to inhibit transmitter release whilst tetanus toxin exhibited a residual activity. Binding of each toxin to the neuronal membrane appeared virtually unaltered following this temperature change. By contrast, the intracellular effects of botulinum neurotoxin type B and tetanus toxin were strongly attenuated by temperature reduction whereas the inhibitory action of botulinum neurotoxin type A was only moderately reduced. Importantly, this discrepancy relates to the known proteolytic cleavage of different synaptic proteins by these two toxin groups. Since both the binding and intracellular activity of botulinum neurotoxin type A are minimally affected at 10 degrees C, its inability to inhibit neurotransmission at this low temperature when applied extracellularly indicated attenuation of its uptake. Due to the strict temperature dependence of the intracellular action of tetanus toxin and botulinum neurotoxin type B, but not A, an examination of the effects of changes in temperature on the internalization step was facilitated by the use of heterologous mixtures of the toxins' heavy and light chains. At 10 degrees C, heavy chain from tetanus toxin but not from botulinum neurotoxin type B mediated uptake of botulinum neurotoxin type A light chain. Collectively, these results provide evidence that, at least in Aplysia, the uptake mechanism for botulinum neurotoxin types A and B differs from that of tetanus toxin.
Assuntos
Neurotoxinas/toxicidade , Neurotransmissores/metabolismo , Sinapses/efeitos dos fármacos , Toxina Tetânica/toxicidade , Animais , Aplysia , Fibras Colinérgicas/efeitos dos fármacos , Relação Dose-Resposta a DrogaRESUMO
Tetanus and botulinum neurotoxins bind to nerve cells, penetrate the cytosol, and block neurotransmitter release. Comparison of their amino-acid sequences shows the presence of the highly conserved His-Glu-x-x-His zinc-binding motif of zinc-endopeptidases (HExxH). Atomic absorption measurements of clostridial neurotoxins show the presence of one atom of zinc/toxin molecule bound to the light chain. The toxin-bound zinc ion is essential for the neurotoxins inhibition of neurotransmitter release in Aplysia neurons injected with the toxins. Phosphoramidon, a very specific inhibitor of zinc-endopeptidases, blocks the intracellular activity of the clostridial neurotoxins. Highly purified preparations of the light chain of tetanus and botulinum B and F neurotoxins cleaved specifically VAMP/synaptobrevin, an integral membrane protein of small synaptic vesicles, both in vivo and in vitro. From these studies, it can be concluded that the clostridial neurotoxins responsible for tetanus and botulism block neuroexocytosis via the proteolytic cleavage of specific components of the neuroexocytotic machinery.
Assuntos
Toxinas Botulínicas/toxicidade , Exocitose/efeitos dos fármacos , Metaloendopeptidases/toxicidade , Neurônios/fisiologia , Neurotransmissores/metabolismo , Vesículas Sinápticas/fisiologia , Toxina Tetânica/toxicidade , Zinco/metabolismo , Sequência de Aminoácidos , Animais , Aplysia , Sítios de Ligação , Toxinas Botulínicas/química , Córtex Cerebral/fisiologia , Sequência Conservada , Exocitose/fisiologia , Gânglios/efeitos dos fármacos , Gânglios/fisiologia , Técnicas In Vitro , Metaloendopeptidases/química , Dados de Sequência Molecular , Neurônios/efeitos dos fármacos , Neurotransmissores/antagonistas & inibidores , Ratos , Vesículas Sinápticas/efeitos dos fármacos , Toxina Tetânica/química , Zinco/análiseRESUMO
Tetanus and botulinum neurotoxins are produced by several Clostridia and cause the paralytic syndromes of tetanus and botulism by blocking neurotransmitter release at central and peripheral synapses, respectively. They consist of two disulfide-linked polypeptides: H (100 kDa) is responsible for neurospecific binding and cell penetration of L (50 kDa), a zinc-endopeptidase specific for three protein subunits of the neuroexocytosis apparatus. Tetanus neurotoxin and botulinum neurotoxin serotypes B, D, F and G cleave at single sites, which differ for each neurotoxin, VAMP/synaptobrevin, a membrane protein of the synaptic vesicles. Botulinum A and E neurotoxins cleave SNAP-25, a protein of the presynaptic membrane, at two different carboxyl-terminal peptide bonds. Serotype C cleaves specifically syntaxin, another protein of the nerve plasmalemma. The target specificity of these metallo-proteinases relies on a double recognition of their substrates based on interactions with the cleavage site and with a non-contiguous segment that contains a structural motif common to VAMP, SNAP-25 and syntaxin.
Assuntos
Toxinas Botulínicas/análise , Metaloendopeptidases/metabolismo , Neurotoxinas/análise , Toxina Tetânica/análise , Sequência de Aminoácidos , Animais , Humanos , Metaloendopeptidases/análise , Dados de Sequência MolecularRESUMO
Intraneuronal concentration of serotonin (5-HT) and its changes were measured in live serotonergic metacerebral cells of Aplysia for several hours following neuronal stimulation, after intracellular injection of 5-HT or extracellular application of L-tryptophan, reserpine, or p-chlorophenylalanine. This was achieved by an on-line intracellular differential pulse voltammetric method using a new, needle-tipped and glass-insulated, platinum microelectrode sensitive to 5-HT.
Assuntos
Neurônios/metabolismo , Serotonina/metabolismo , Aplysia , Estimulação Elétrica , Eletroquímica/métodos , Fenclonina/farmacologia , Técnicas In Vitro , Neurônios/efeitos dos fármacos , Neurônios/fisiologia , Reserpina/farmacologia , Serotonina/fisiologia , Estereoisomerismo , Triptofano/metabolismo , Triptofano/farmacologiaRESUMO
The effects of hemicholinium-3 (HC-3) on acetylcholine (ACh) release were studied on central inhibitory or excitatory synapses of Aplysia californica. HC-3 was used at concentrations below 10(-5) M, which did not affect choline uptake by this preparation. Statistical analysis of the synaptic noise evoked by sustained depolarization of the presynaptic neuron allowed us to calculate the amplitude and mean duration of the miniature postsynaptic responses at an inhibitory synapse in the buccal ganglion. Taking into account the modifications of miniature and evoked responses, it was concluded that HC-3 potentiates ACh release. A similar presynaptic effect was observed at an excitatory synapse in the abdominal ganglion. This facilitation of ACh release was prevented by tubocurarine or hexamethonium, pointing to an agonistic action of HC-3 on nicotinic presynaptic receptors implicated in a positive feedback on ACh release. The possible blockage of muscarinic presynaptic receptors by HC-3 was also considered. Hemicholinium-15 was without effect on ACh release but was nevertheless able to prevent the presynaptic action of HC-3.
Assuntos
Acetilcolina/metabolismo , Hemicolínio 3/farmacologia , Receptores Nicotínicos/fisiologia , Sinapses/fisiologia , Animais , Aplysia , Atropina/farmacologia , Curare/farmacologia , Hexametônio , Compostos de Hexametônio/farmacologia , Técnicas In Vitro , Receptores Muscarínicos/efeitos dos fármacos , Receptores Muscarínicos/fisiologia , Receptores Nicotínicos/efeitos dos fármacos , Sinapses/efeitos dos fármacosRESUMO
The respective neuroselective actions of botulinum type A (BoNT) and tetanus (TeTx) neurotoxins on cholinergic and non-cholinergic synapses of Aplysia are mainly due to differences in their extracellular neuronal targetting. Further information was gained on this neuroselectivity by examining the temperature dependencies of binding, internalization and intracellular action of both toxins. After reduction of temperature from 22 degrees C to 10 degrees C, the binding of neither BoNT nor TeTx was significantly altered whereas the neuronal uptake of BoNT, but not of TeTx, was prevented. Although TeTx internalization could be detected at the low temperature, its intracellular activity was greatly attenuated compared to that of BoNT. It is inferred that the uptake mechanisms are different for these two related but distinct toxins.
Assuntos
Aplysia/metabolismo , Toxinas Botulínicas/metabolismo , Neurônios/metabolismo , Toxina Tetânica/metabolismo , Acetilcolina/metabolismo , Animais , Neurônios/fisiologia , TemperaturaRESUMO
Several bacteria of the Clostridium genus (C. botulinum) produce 150 kDa di-chainal protein toxins referred as botulinum neurotoxins or BoNTs. They associate with non-toxic companion proteins and form a complex termed botulinum toxin or BoTx. The latter is used in clinic for therapeutic purpose. BoNTs affect cholinergic nerve terminals in periphery where they block acetylcholine release, thereby causing dysautonomia and motorparalysis (i.e. botulism). The cellular action of BoNTs can be depicted according to a three steps model: binding, internalisation and intraneuronal action. The toxins heavy chain mediates binding to specific receptors followed by endocytotic internalisation of BoNT/receptor complex. BoNT receptors may comprise gangliosides and synaptic vesicle-associated proteins as synaptotagmins. Vesicle recycling induces BoNT internalisation. Upon acidification of vesicles, the light chain of the neurotoxin is translocated into the cytosol. Here, this zinc-endopeptidase cleaves one or two among three synaptic proteins (VAMP-synaptobrevin, SNAP25, and syntaxin). As the three protein targets of BoNT play major role in fusion of synaptic vesicles at the release sites, their cleavage is followed by blockage of neurotransmitter exocytosis. The duration of the paralytic effect of the BoNTs is determined by 1) the turnover of their protein target; 2) the time-life of the toxin light chain in the cytosol, and 3) the sprouting of new nerve-endings that are retracted when the poisoned nerve terminal had recovered its full functionality.
Assuntos
Antidiscinéticos/farmacologia , Toxinas Botulínicas/farmacologia , Antidiscinéticos/farmacocinética , Doenças do Sistema Nervoso Autônomo/tratamento farmacológico , Toxinas Botulínicas/farmacocinética , Clostridium botulinum/patogenicidade , Citosol , Humanos , Estrutura MolecularAssuntos
Toxinas Botulínicas/toxicidade , Células Cromafins/efeitos dos fármacos , Junção Neuromuscular/efeitos dos fármacos , Toxina Tetânica/toxicidade , Animais , Toxinas Botulínicas/farmacologia , Clostridium botulinum/metabolismo , Clostridium tetani/metabolismo , Camundongos , Neurônios/efeitos dos fármacos , Células PC12/efeitos dos fármacos , Ratos , Toxina Tetânica/farmacologiaRESUMO
Clostridium perfringens epsilon toxin (ET) is a potent pore-forming cytotoxin causing fatal enterotoxemia in livestock. ET accumulates in brain and kidney, particularly in the renal distal-collecting ducts. ET binds and oligomerizes in detergent-resistant membranes (DRMs) microdomains and causes cell death. However, the causal linkage between membrane permeabilization and cell death is not clear. Here, we show that ET binds and forms 220-kDa insoluble complexes in plasma membrane DRMs of renal mpkCCD(cl4) collecting duct cells. Phosphatidylinositol-specific phospholipase C did not impair binding or the formation of ET complexes, suggesting that the receptor for ET is not GPI anchored. ET induced a dose-dependent fall in the transepithelial resistance and potential in confluent cells grown on filters, transiently stimulated Na+ absorption, and induced an inward ionic current and a sustained rise in [Ca2+]i. ET also induced rapid depletion of cellular ATP, and stimulated the AMP-activated protein kinase, a metabolic-sensing Ser/Thr kinase. ET also induced mitochondrial membrane permeabilization and mitochondrial-nuclear translocation of apoptosis-inducing factor, a potent caspase-independent cell death effector. Finally, ET induced cell necrosis characterized by a marked reduction in nucleus size without DNA fragmentation. DRM disruption by methyl-beta-cyclodextrin impaired ET oligomerization, and significantly reduced the influx of Na+ and [Ca2+]i, but did not impair ATP depletion and cell death caused by the toxin. These findings indicate that ET causes rapid necrosis of renal collecting duct cells and establish that ATP depletion-mediated cell death is not strictly correlated with the plasma membrane permeabilization and ion diffusion caused by the toxin.