Association with HLA DQ of early onset myasthenia gravis in Southeast Texas region of the United States.

Forty-four Caucasian American myasthenia gravis (MG) patients from Southeast Texas underwent high resolution HLA DQ analysis. For the majority of patients who were late onset or male, no significant associations with DQ were observed. However, associations with DQ increased in female patients and early onset patients. At the allele level, DQB1 *0503, *0604, *0502 and *0402 collectively contributed to a positive association of the DQ locus with early onset MG (EOMG), while individually failing to show significant association. At DQ level, the novel haplotype DQA1*0401:DQB1*0201 was the primary factor in the association of combined DQ loci with early onset. In addition, *0104:*0503, *0102:*0604, *0102:*0502 and *0303:*0402 collectively contributed to the positive association of the haplotype loci. DR3-DQ2.5cis, a well known risk factor for MG in Western Eurasia, was not found associated with disease in any group. For typical EOMG [early onset, no thymoma, anti-acetylcholine receptor (AChR) antibody (Ab) positive] no association with DQA1 locus was found, however DQB1*0604 demonstrated an 'uncorrected' positive association. A few DQ haplotype (DQA1:DQB1) were positively associated with typical EOMG; a positive individual association for *0401:*0201 was complimented by the contributions of *0102:*0604 and *0303:*0402 haplotypes. A small minority of patients that were atypical and EOMG had a strong genetic association with DQA1*0104:DQB1*0503, the group included an anti-MuSK Ab positive and an anti-AChR negative patient. This report finds common ground with European studies regarding MuSK association; however similarities in association for typical early onset disease resembled HLA risk factors in East Asia and Southern Europe.

T cell clones reactive with sperm whale myoglobin. Isolation of clones with specificity for individual determinants on myoglobin.

We have been able to isolate clones of sperm whale muscle myoglobin (Mb)-reactive T cells from (C57BL/6 x A/J)F1 [(B6A)F1] mice. Four types of clones were isolated, distinguished by their patterns of recognition of Mb cyanogen bromide (CNBr) fragments and antigen presenting cell (APC) requirements. Individual T cell clones proliferated in response to one of three CNBr fragments of Mb. Dose-response curves of all clones were identical for native Mb and the appropriate fragment. T cell clones reactive to fragment 1-55 did not proliferate in response to peptide 15-22 (a peptide that binds to serum antibody directed against 1-55). These data support previous findings suggesting differences between antigen recognition by T and B cells, i.e., T cells may not recognize antigen in its native conformation and/or T and B cells may recognize distinct epitopes on the same antigen. Using T cell clones to analyze genetic control of responsiveness to Mb, we found that certain (B6A)F1 T cells recognize Mb presented by low responder strain APC. Thus, genetically determined low responsiveness in this case is probably not due to failure of APC function. We also found that responsiveness to certain Mb epitopes mapped to the I-A subregion whereas others mapped, via gene complementation, to the I-A and I-E subregions. We found no examples of responsiveness mapping to the I-C subregion and suggest an alternative explanation for previous reports mapping genetic control of responsiveness to certain Mb determinants to I-C.

Immune recognition of serum albumin.15. Localization by synthesis of antigenic site 4 of bovine serum albumin to the region around the disulfide bond 166-175.

Recently, we have localized and confirmed by synthesis the regions within which reside five major antigenic sites of bovine serum albumin and proposed that the remaining sixth major antigenic site (antigenic site 4) was localized within subdomain 3 (fragment 115-184) of albumin. In the present work, antigenic site 4 was localized to fall around the disulfide bond 166-175 by synthesis and immunochemical reactivity of the region 162-179. The synthetic 18-residue peptide was shown to bind substantial amounts of antibodies from early (38-day) and late (398-day) anti-albumin antisera from two rabbits. As much as half the total anti-albumin antibodies could be bound by the peptide from the late antisera. It was concluded that antigenic site 4 resides within, but may not include all of, the region 162-179 of albumin.

Antibodies to synthetic antibody-combining sites. Antibodies against a surface-simulation peptide with antibody-combining activity toward lysozyme antigenic site 3 react with lysozyme antibodies.

Recently, we reported the synthesis and immunochemistry of two peptides designed, by complementarity and surface-simulation synthesis, to mimic antibody-combining sites against two antigenic sites of lysozyme. In the present work antibodies were raised against one of these peptides, which is complementary to antigenic site 3 of lysozyme, to determine whether these antibodies will react with anti-lysozyme antibodies. Radioiodinated antipeptide antibodies were bound by immunoadsorbents of the immune IgG from two goats anti-lysozyme antisera but not by adsorbents of myoglobin, non-immune goat IgG or immune IgG of antisera against cytochrome c. The binding of anti-peptide antibodies to adsorbents of anti-lysozyme antibodies was fully inhibited by free lysozyme but not by bovine serum albumin, human hemoglobin A, horse cytochrome c or bovine ribonuclease A. Thus, antisera against an antibody-combining site can be raised by immunizing with a peptide which probably does not exist in the antibody but is designed by surface-simulation synthesis to mimic an antibody-combining site.

Antibodies against protein antigenic sites that are identical in the homologous protein of the immunized animal. Autoreactivity in rabbits of antibodies to sperm-whale myoglobin.

Sequence comparisons between the antigenic sites of sperm-whale myoglobin and the corresponding regions in rabbit myoglobin indicate that rabbits make antibodies to regions of the sperm-whale myoglobin molecule which are identical to the corresponding regions in rabbit myoglobin. Rabbit myoglobin did not precipitate with antisera to sperm-whale myoglobin. However, it exhibited an extensive cross-reaction as demonstrated by its ability to inhibit the precipitin reaction of sperm-whale myoglobin, and on an immunoadsorbent, bound a large amount of antibodies to sperm-whale myoglobin.

Conformational studies on modified proteins and peptides. IX. Conformation and immunochemistry of hemoglobin reduced at some carboxyl groups by diborane.

A derivative of apohemoglobin was prepared by reduction with diborane at -10 degrees C for 2 h. Four aspartate and two glutamate side chains were reduced per half molecule to their corresponding alcohols. The modifications were identified as: alpha asp 64, alpha-asp 74, alpha-asp 75 and alpha asp 85;beta-glu 121 and beta-glu 6 (or beta-glu 7). Recombination of reduced apohemoglobin with unmodified ferriheme yielded the corresponding reduced hemoglobin derivative which was electrophoretically homogeneous. Hemoglobin and reduced hemoglobin had different electrophoretic mobilities and showed slight spectral differences. Titration with ferriheme revealed that reduced globin possessed an anomalous heme-binding behavior. The s 20,w of reduced hemoglobin was slightly higher than that of hemoglobin. Agregation of the derivative was also apparent from its behavior in gel filtration. ORD and CD measurements indicated substantial conformational differences between hemoglobin and its derivative. Immunochemical studies showed that the derivative reacted poorly with antisera to hemoglobin and, conversely, hemoglobin showed little reaction with antisera to the derivative. The results are discussed in terms of the three-dimensional structure of hemoglobin in the crystalline state and its relationship to the structure in solution.

2,3-Dioxo-5-indolinesulfonic acid, a new highly specific reagent for modification of tryptophan in peptides and proteins.

A new reagent, 2,3-dioxo-5-indolinesulfonic acid (DISA), has been investigated for its specificity to react with tryptophan and tryptophan residues in peptides and proteins. On reaction of 19 amino acids with 1 M excess of DISA in 0.1 M acetic acid (pH 2.9), considerable (50%) modification of tryptophan was obtained within 50 min and no other amino acid was modified. After reaction for 5 h, only proline showed very slight (7%) modification. On reaction in the presence of 5 M excess of DISA, tryptophan was very rapidly modified. Modification of proline became appreciable in the presence of this molar excess of reagent and cysteine modification, although much smaller, became detectable (12 h, 7%). However, proline modification was completely prevented when this amino acid was engaged in a peptide linkage, even after reaction for 45 h in the presence of 5 or 10 M excess of DISA per proline residue. Reaction of egg albumin with 50 M excess of DISA was entirely specific for tryptophan and showed no modification of proline or cysteine residues. The reagent offers the advantages of stability, easy handling, high water solubility and high specificity. It affords protein and peptide derivatives that are completely water soluble because of the polar nature of the added group. The yellow color (lambda max, 367 nm) of the derivatives offers advantages of easy determination of the extent and location of the modification.

Enzymic and immunochemical properties of lysozyme. XI. Conformation and immunochemistry of the two-disulfide peptide and the tryptophan and lysine residues in its antigenic reactivity.

The previously described peptide 62-68 (Cys 64-Cys 80) 74-96 (Cys 76-Cys 94) (Atassi, M.Z., Suliman, A.M. and Habeeb, A.F.S.A. (1975) Biochim. Biophys. Acta 405, 452-463), which accounted for about one-third of the total antigenic reactivity of native lysozyme, was isolated here with lysine 97 attached to it. The peptide was subjected to specific modification reactions in order to determine some of the residues which formed part of its antigenic reactive site. ORD measurements showed that the peptide was greatly unfolded in solution relative to its expected mode of folding within the intact lysozyme molecule. Modification of the two tryptophan residues in the peptide by reaction with 2,3-dioxo-5-indolinesulfonic acid provided a derivative which possessed similar conformational parameters to those of the unmodified peptide. However, the derivative retained only about half the immunochemical reactivity of the peptide. Succinylation of the amino groups afforded a derivative whose conformational parameters were identical to those of the unmodified peptide but in which half of the immunochemical reactivity was lost. Modification of the two tryptophan residues followed by succinylation of the amino groups resulted in almost complete loss of the antigenic reactivity, and the loss was not due to conformational differences. The antigenic reactivity of the peptide was also destroyed on removal of tryptophans 62 and 63, of sequence 84-93 from the loop 74-79 and of sequence 74-75 by chymotryptic digestion. From these and previous results it was concluded that the antigenic reactive site in this part of the lysozyme molecule incorporates one or both of tryptophans 62 and 63 as well as one or both lysines 96 and 97. The two disulfides 64-80 and 76-94 bring these two parts of the lysozyme molecule into a single reactive site. The intactness of the disulfides is essential for maintenance and reactivity of the site.

Immune recognition of serum albumin. 11. Mouse antibodies against bovine serum albumin recognize the same antigenic sites that are recognized by rabbit antibodies.

In recent studies, we have localized and confirmed by synthetic peptides five major antigenic sites in each of bovine and human serum albumins which are recognized by rabbit antibodies against the respective protein. In order to determine whether the antigenic sites of albumin are peculiar to the protein or are dependent on the species of the immunized host, we have studied here the specificity of the antibody response in outbred mice against bovine serum albumin. By immunoadsorbent titration studies, the synthetic antigenic sites, previously localized with rabbit antisera against bovine serum albumin, were shown to bind considerable amounts of specific mouse 125I-labelled antibodies against bovine serum albumin. The amounts of mouse anti-bovine serum albumin antibodies bound by the adsorbents of the synthetic sites were comparable to the amounts of rabbit anti-bovine serum albumin antibodies that could be bound. It was concluded that recognition of the antigenic sites of serum albumin is independent of the immunized species and is inherent in their structural and conformational uniqueness.

Immunochemistry of serum albumin. VI. A dynamic approach to the immunochemical cross reactions of proteins using serum albumins from various species as models.

Antisera against bovine serum albumin were raised in two rabbits. Serial bleedings were obtained at different times after the first immunization, and antisera from these serial bleedings were not mixed but were kept and studied separately. The immunochemical cross-reactions of these antisera with serum albumins from bovine, goat, sheep, porcine, horse, human and chicken were determined by immunoadsorbent studies. These were done by titration so that the values of maximum (plateau) binding by each albumin of radioiodinated antibodies were determined. In each rabbit, the immunochemical cross-reactivity was not static but increased progressievly with time after the first immunization. In the interval 7 days to 398 days the increases in cross-reaction were extremely large. pH dissociation studies revealed that, together with the increase in cross-reactivity of a given albumin with time after immunization, there was a restriction in the antibody heterogeneity towards populations possessing higher affinity. These results provide a rational explanation for the different values of cross-reactivities for a given albumin from different laboratories. The findings are analyzed in relation to the antigenic structure of albumin and their significance in evolutionary studies discussed.

Differentiation of the contribution of the two subunits of lutropin to its in vivo activity.

Porcine and ovine lutropins were acetimidated at amino groups to various degrees and the effects of the modification on the induction of ovarian ornithine decarboxylase activity were examined. A drastic (84%) loss of biological activity was observed upon modification of two amino groups in porcine lutropin. The results with ovine lutropin derivatives were quite similar. Circular dichroism measurements showed no conformational changes and dissociation into subunits was not observed in the derivatives. Accordingly, the loss of biological activity was not a by-product of conformational changes. It was concluded that lutropin carries a single binding site which is constructed by surface residues or regions located on both the alpha- and beta-subunits of the hormone.

Human haptoglobin binds to human myoglobin.

Human myoglobin, obtained from human heart, was purified to homogeneity by salt precipitation, crystallization and ion-exchange chromatography. Trace contamination by haemoglobin, if any, was removed by repeated adsorption on an immunoadsorbent of anti-haemoglobin antibodies. The interaction between human haptoglobin and human myoglobin was investigated by a solid-phase radioimmunoassay. Myoglobin adsorbents bound 125I-labelled haptoglobin in a specific manner. Linear Scatchard plots of the data indicate that human myoglobin has only one binding site for haptoglobin in terms of the binding affinity (Ka = 8.5 X 10(6) M-1). These results suggest that haptoglobin not only binds haemoglobin but also binds human myoglobin, although with an affinity that is much lower than that of haemoglobin. The physiological significance of this interaction is discussed.

Enzymic and immunochemical properties of lysozyme. XIII. Accurate delineation of the reactive site around the disulfide 6-127 by immunochemical study of beta-propiolactone lysozyme derivative and of synthetic disulfide peptides.

In previous reports from this laboratory it was shown that an antigenic reactive site resides around the sequences 6-13 and 126-128 linked by the disulfide 6-127. The present work provides a strong support for the location of the reactive site by an independent approach. It also determines accurately the boundaries of the reactive site. 1. The two methionine residues in lysozyme were carboxyethylated by reaction with beta-propiolactone. The electrophoretically homogeneous derivative had no other modified amino acids and showed no conformational changes, relative to native lysozyme, as determined by ORD and CD measurements. However, it exhibited a slight increase in disulfide reducibility relative to native lysozyme and its lytic activity was about half that of native lysozyme, probably as a result of the slight conformational change. On the other hand, the antigenic reactivity of the derivative was equal to that of native lysozyme with several goat and rabbit antisera to lysozyem. It was therefore concluded that methionines 12 and 105 were not parts of antigenic reactive sites in native lysozyme. 2. Eleven peptides, corresponding to various sequences on the two sides of the disulfide 6-127 (i.e. two groups of peptides) were synthesized, purified and characterized. One group (A) of peptides comprised sequences 3-14, 5-14, 6-14, 5-13, 5-12 and an analog of sequence 5-14 in which methionine 12 is replaced by glycine. The second group (B) of peptides comprised sequences 125-129, 125-128, 126-128, 127-128, and 125-127. From groups A and B, nine disulfide-containing peptides (see Fig. 2) were synthesized, purified, characterized and their immunochemical interactions with antisera to native lysozyme studied. Towards each of the antisera studied here, Phe-3, Gly-4, Arg-5, Arg-125 and Leu-129 were not essential parts of the reactive site. On the other hand, Arg-14, Lys-13, Gly-126 and with some antisera Arg-128 were each critical for the reactivity of the site. Peptides from group A alone or group B alone did not inhibit the reaction of lysozyme with its antisera, confirming our previous findings that the integrity of the disulfide bond is essential for bringing the two distant (in sequence) parts of the site together. Finally, replacement of Met-12 by glycine did not influence the immunochemical reactivity of the site, confirming the above conclusion that neither of the two methionine residues takes part in interaction of lysozyme with its antibodies. An accurate delineation of the antigenic reactive site is, therefore derived here and its shape in the three-dimensional structure of native lysozyme is described.

High yield coupling of peptides to protein carriers.

Coupling of peptides to protein carriers has been achieved at a high level of peptide incorporation. Bovine serum albumin was used as the model carrier protein and several peptides were tested in the coupling reaction. The peptides were coupled to succinylated bovine serum albumin after conversion of its carboxyl side chains to the reactive p-nitrophenyl ester group by reaction with p-nitrophenol/N,N'-dicyclohexylcarbodiimide in anhydrous dimethylformamide. The reaction afforded succinyl-albumin-peptide conjugates that had high level of peptide incorporation (18-35 mol peptide/mol albumin). In addition to the high level of peptide coupling, the reaction avoids the production of polymeric forms of peptide, protein or conjugate.

Enzymic and immunochemical properties of lysozyme. XVI. A novel synthetic approach to an antigenic reactive site by direct linkage of the relevant conformationally adjacent residues constituting the site.

Previous studies from this laboratory on the immunochemistry of specific chemical derivatives of native lysozyme and of the two disulfide peptide 62-68 (Cys 64-Cys 80) 74-97 (Cys 76-Cys 94) (i.e. (SS)2-peptide), have established an antigenic reactive site to comprise the spatially contiguous surface residues: Trp 72, Lys 97, Lys 96, Asn 93, Thr 89 and Asp 87. In the present work, the identity of the site was verified by an entirely different and novel approach. The aforementioned amino acids were linked directly into a single linear peptide with an intervening spacer where appropriate and substituting phenylalanine for tryptophan (i.e. Phe-Gly-Lys-Asn-Thr-Asp). This peptide (which does not exist in native lysozyme but simulates a surface region of the protein) possessed a remarkable inhibitory activity towards the reaction of lysozyme with its antisera. The immunochemical reactivity of the peptide was equal to the maximum expected reactivity of the site (i.e. a third of the total antigenic reactivity of lysozyme). These findings define quite conclusively and accurately the reactive site which is clearly composed of spatially adjacent residues that are distant in sequence reacting as if in direct linear linkage. The unequivocal establishment of this concept indicates that antigenic sites need not always be composed of residues in direct peptide linkage in the sequence. The nature of the site may depend on the protein. This unorthodox attack at the problem provides a novel and powerful approach for final delineation of the antigenic reactive sites (and perhaps other types of binding sites) in native proteins, following the completion of accurate narrowing down by chemical methods.

Enzymic and immunochemical properties of lysozyme. X. Conformation, enzymic activity and immunochemistry of lysozyme reduced at two carboxyl groups.

Reduction of lysozyme by diborane, followed by air oxidation of the reduced disulfides and chromatography on CM-cellulose, yielded a homogeneous derivative. In the derivative, the carboxyl groups of aspartic acid 119 and the end-chain leucine residue were reduced to their corresponding alcohols. Correct re-forming of the disulfide bonds was demonstrated by peptide mapping of the tryptic hydrolysates of the derivative and lysozyme without breaking the disulfide bonds, followed by identification of the disulfide-containing peptides. Correct disulfide pairing in the two-disulfide peptide in the tryptic hydrolysate was established from its immunochemical behavior. Preparations of the two-disulfide fragment from lysozyme and derivative had equal inhibitory activities (26 or 32%) of the reaction of lysozyme with two homologous antisera. In ORD measurements, lysozyme and the derivative had equal rotatory powers at neutral pH. However, the bo value for the derivative decreased by about 10%. Below pH 6.4 and above pH 8.0, the derivative was less rotatory than native lysozyme. In CD measurements at neutral pH, the negative ellipticity bands at 220 and 208 nm showed little or no decrease in the derivative relative to the native protein. Although conformational differences between the derivative and its parent protein were almost undetectable by ORD and CD measurements, they were readily detected by chemical monitoring of the conformation. In the derivative, both accessibility to tryptic hydrolysis and reducibility of the disulfide bonds increased markedly. The enzymic activity of the derivative was decreased but retained the same pH optimum. With antisera to lysozyme or antisera to the derivative, lysozyme and its derivative possessed equal antigenic reactivities. The immunochemical findings further confirm the correct refolding of the disulfides. Also, they indicate that aspartic acid 119 and the C-terminal leucine residue are not part of an antigenic reactive region in lysozyme.

Enzymic and immunochemical properties of lysozyme. IX. Conformation and immunochemistry of derivatives succinylated at certain lysine residues.

Succinylation of lysozyme in the presence of 7 molar excess of [1,4-14C2]-succinic anhydride gave a reaction product which showed at least six components by disc electrophoresis. Chromatography on CM-cellulose enabled the isolation of six homogeneous derivatives. The derivatives were succinylated at the following locations: derivative I, lysines-1 (alpha- and epsilon-NH2), -13, -97 and -116 and the OH group at position 43 (or 36 or 40); derivative II, lysines-1 (alpha- and epsilon-NH2), -13, -96, -116; derivative III, lysines-1 (alpha-and epsilon-NH2), -13, -97, -116; derivative IV, lysines-1 (alpha-NH2), -33, -96 and -116; derivative V, lysines-1 (alpha-NH2), -33 and -96; derivative VI, lysines-33 and -116. Conformational changes were detectable in derivative I by ORD and CD measurements and by accessibility of the disulfide bonds to reduction. On the other hand, the other five succinyl derivatives showed no conformational changes by ORD and CD measurements. However, their disulfide bonds were slightly more accessible to reduction than lysozyme, with the increase being somewhat higher in derivatives I, II and III. Enzymic activity measurements showed that only derivative VI possessed some (10%) enzymic activity. Immunochemical studies with antisera to lysozyme showed that the reactivity of each of the derivatives was lower than the homologous reaction. Correlation of the extent of decrease in immunochemical reaction with the locations of modification and with the results of conformational analysis, led to the conclusion that lysines 33, 96 and 116 are part of antigenic reactive regions in lysozyme. The modification results are also discussed in relation to the three-dimensional structure of lysozyme in solution.

Discovery and implications of the immunogenicity of free small synthetic peptides: powerful tools for manipulating the immune system and for production of antibodies and T cells of preselected submolecular specificities.

Recent studies from this laboratory have found, contrary to a long-held belief, that synthetic peptides of a protein, as small as six residues, when immunized in their free form (i.e., without coupling to any carrier), elicit the formation of antibodies with submolecular binding specificities to preselected protein regions. These peptides could represent either the antigenic sites of the protein or surface regions that are not immunogenic when the intact protein is the antigen. In either case, the antibodies bind specifically to the intact protein, exclusively at the region used in immunization. Monoclonal antibodies with preselected specificities can also be produced by hybridoma technology from the spleens of the immunized animals. Furthermore, free synthetic peptides have been employed to generate T-cell lines and T-cell clones with specificities to preselected immunogenic locations and also to induce tolerance to such preselected locations. These fascinating breakthroughs indicate that free synthetic peptides may be used in the future as powerful tools in basic investigations and in therapeutic and diagnostic applications.

Autoimmune responses against acetylcholine receptor: T and B cell collaboration and manipulation by synthetic peptides.

Myasthenia gravis (MG) and experimental autoimmune MG (EAMG) are induced by antibodies (Abs) against self acetylcholine receptor (AChR). We have mapped the T and B cell epitopes on AChR alpha subunit in human MG and in EAMG-susceptible (C57BL/6, B6) and nonsusceptible mouse strains. A T-cell epitope within residues alpha 146-162 (P14) of Torpedo californica (t)AChR plays an important role in EAMG pathogenesis of the auto Ab-induced disease. P14-specific T cell (P14Th) lines from tAChR-primed B6 mice activated, in vivo and in vitro, tAChR-primed B cells that secreted anti-AChR Abs directed against four other regions on the tAChR alpha-chain, but not against P14 itself. P14Th cells are pathogenic because they help B cells that make Abs against a conserved tAChR region (t alpha 122-150) involved in ACh binding. These Abs cross-react with region alpha 122-150 of mouse (m)AChR, thereby disrupting its normal physiological function. Thus, a T cell epitope not recognized by Abs plays an active role in B cell responses against other epitopes on the protein. We have found that in B6, the MHC region 62-76 of I-A beta(b) is involved in the presentation of P14 to T cells. Anti-peptide Abs, prepared in BALB/c, were found to inhibit in vitro the proliferation of P14-specific T-cells. Furthermore, this MHC peptide elicited Abs in B6 mice and we are investigating whether immunization of B6 with this peptide, before priming with tAChR, would suppress in vivo the T-cell response to the epitope in P14. Thus, these preliminary results would suggest that immunization with the MHC peptide might be employed for control of the autoimmune disease.

Structure, activity, and immune (T and B cell) recognition of botulinum neurotoxins.

Botulism, which was first reported over a century ago, is caused by botulinum neurotoxins produced by Clostridium botulinum in seven immunological serotypes (A through G). The primary structures of a number of these BoNTs have been determined and are reviewed here, together with their gene structure and synthesis. The biological actions of BoNTs, which result in their ability to block neurotransmitter release have been the subject of intensive study, and in this review we discuss the binding of BoNTs to the cell surface as well as the mechanism of their intercellular action. The ability of BoNTs to block neurotransmitter release has been exploited in therapeutic applications to reduce muscle hyperactivity for the treatment of a variety of clinical conditions associated with involuntary muscle spasm and contractions. The advantages, limitations, and risks of these applications are discussed. Certain compounds provide some limited protection against BoNT. However, more effective protection has been obtained immunologically either by passive immunity (i.e., by administration of anti-BoNT Abs) or by immunization with inactivated toxin. More recently, excellent protection has been obtained by immunization with the receptor-binding region comprising the C-terminal (residues 860 to 1296) fragment (Hc) of the heavy chain of BoNT/A. Here we review the mapping of the epitopes on the Hc region of BoNT/A that are recognized by anti-BoNT/A Abs raised in horse, human, and mouse. The epitopes on the Hc that are recognized by anti-Hc Abs and by Hc-primed T lymphocytes were mapped in two mouse strains [BALB/c (H-2d) and SJL (H-2s)]. The peptides, which contain Ab or T cell epitopes (or both) on the Hc, were used as immunogens in BALB/c and SJL mice and we identified those peptides whose Ab and/or T-cell response cross-react with Hc. Identification of these peptides is an important first step in the intricate requirements for the design of a synthetic vaccine.