Botulinum toxin intoxication requires retrograde transport and membrane translocation at the ER

Reviewer #1 (Public Review):

Summary:
During the last decades, extensive studies (mostly neglected by the authors), using in vitro and in vivo models, have elucidated the five-step mechanism of intoxication of botulinum neurotoxins (BoNTs). The binding domain (H chain) of all serotypes of BoNTs binds polysialogangliosides and the luminal domain of a synaptic vesicle protein (which varies among serotypes). When bound to the synaptic membrane of neurons, BoNTs are rapidly internalized by synaptic vesicles (SVs) via endocytosis. Subsequently, the catalytic domain (L chain) translocates, a process triggered by the acidification of these organelles. Following translocation, the disulfide bridge connecting the H chain with the L chain is reduced by the thioredoxin reductase/thioredoxin system, and it is refolded by the chaperone Hsp90 on SV's surface. Once released into the cytosol, the L chains of different serotypes cleave distinct peptide bonds of specific SNARE proteins, thereby disrupting neurotransmission.

In this study, Yeo et al. extensively revise the neuronal intoxication model, suggesting that BoNT/A follows a more complex intracellular route than previously thought. The authors propose that upon internalization, BoNT/A-containing endosomes are retro-axonally trafficked to the soma. At the level of the neuronal soma, this serotype then traffics to the endoplasmic reticulum (ER) via the Golgi apparatus. The ER SEC61 translocon complex facilitates the translocation of BoNT/A's LC from the ER lumen into the cytosol, where the thioredoxin reductase/thioredoxin system and HSP complexes release and refold the catalytic L chain. Subsequently, the L chain diffuses and cleaves SNAP25 first in the soma before reaching neurites and synapses.

Strengths:
I appreciate the authors' efforts to confirm that the newly established methods somehow recapitulate aspects of the BoNTs mechanism of action, such as toxin binding and uptake occurring at the level of active synapses. Furthermore, even though I consider the SNAPR approach inadequate, the genome-wide RNAi screen has been well executed and thoroughly analyzed. It includes well-established positive and negative controls, making it a comprehensive resource not only for scientists working in the field of botulinum neurotoxins but also for cell biologists studying endocytosis more broadly.

Weaknesses:
I have several concerns about the authors' main conclusions, primarily due to the lack of essential controls and validation for the newly developed methods used to assess toxin cleavage and trafficking into neurons. Furthermore, there is a significant discrepancy between the proposed intoxication model and existing studies conducted in more physiological settings. In my opinion, the authors have omitted over 20 years of work done in several labs worldwide (Montecucco, Montal, Schiavo, Rummel, Binz, etc.). I want to emphasize that I support changes in biological dogma only when these changes are supported by compelling experimental evidence, which I could not find in the present manuscript.

Reviewer #2 (Public Review):

Summary:
The study by Yeo and co-authors addresses a long-lasting issue about botulinum neurotoxin (BoNT) intoxication. The current view is that the toxin binds to its receptors at the axon terminus by its HCc domain and is internalized in recycled neuromediator vesicles just after the release of the neuromediators. Then, the HCn domain assists the translocation of the catalytic light chain (LC) of the toxin through the membrane of these endocytic vesicles into the cytosol of the axon terminus. There, the LC cleaves its SNARE substrate and blocks neurosecretion. However, other views involving kinetic aspects of intoxication suggest that the toxin follows the retrograde axonal transport up to the nerve cell body and then back to the nerve terminus before cleaving its substrate.

In the current study, the authors claim that the BoNT/A (isotype A of BoNT) not only progresses to the cell body but once there, follows the retrograde transport trafficking pathway in a retromer-dependent fashion, through the Golgi apparatus, until reaching the endoplasmic reticulum. Next, the LC dissociates from the HC (a process not studied here) and uses the translocon Sec61 machinery to retro-translocate into the cytosol. Only then, does the LC traffic back to the nerve terminus following the anterograde axonal transport. Once there, LC cleaves its SNARE substrate (SNAP25 in the case of BoTN/A) and blocks neurosecretion.

To reach their conclusion, Yeo and co-authors use a combination of engineered tools: a cell line able to differentiate into neurons (ReNcell VN), a reporter dual fluorescent protein derived from SNAP25, the substrate of BoNT/A (called SNAPR), the use of either native BoNT/A or a toxin to which three fragment 11 of the reporter fluorescent protein Neon Green (mNG) are fused to the N-terminus of the LC (BoNT/A-mNG11x3), and finally ReNcell VN transfected with mNG1-10 (a protein consisting of the first 10 beta strands of the mNG).

SNAPR is stably expressed all over in the ReNcell VN. SNAPR is yellow (red and green) when intact and becomes red only when cleaved by BoNT/A LC, the green tip being degraded by the cell. When the LC of BoNT/A-mNG11x3 reaches the cytosol in ReNcell VN transfected by mNG1-10, the complete mNG is reconstituted and emits a green fluorescence.

In the first experiment, the authors show that the catalytic activity of the LC appears first in the cell body of neurons where SNAPR is cleaved first. This phenomenon starts 24 hours after intoxication and progresses along the axon towards the nerve terminus during an additional 24 hours. In a second experiment, the authors intoxicate the ReNcell VN transfected by mNG1-10 using the BoNT/A-mNG11x3. The fluorescence appears also first in the soma of neurons, then diffuses in the neurites in 48 hours. The conclusion of these two experiments is that translocation occurs first in the cell body and that the LC diffuses in the cytosol of the axon in an anterograde fashion.

In the second part of the study, the authors perform a siRNA screen to identify regulators of BoNT/A intoxication. Their aim is to identify genes involved in intracellular trafficking of the toxin and translocation of the LC. Interestingly, they found positive and negative regulators of intoxication. Regulators could be regrouped according to the sequential events of intoxication. Genes affecting binding to the cell-surface receptor (SV2) and internalization. Genes involved in intracellular trafficking. Genes involved in translocation such as reduction of the disulfide bond linking the LC to the HC and refolding in the cytosol. Genes involved in signaling such as tyrosine kinases and phosphatases. All these groups of genes may be consistent with the current view of BoNT intoxication within the nerve terminus. However, two sets of genes were particularly significant to reach the main conclusion of the work and definitely constitute an original finding important to the field. One set of genes consists of those of the retromer, and the other relates to the Sec61 translocon. This should indicate that once endocytosed, the BoNT traffics from the endosomes to the Golgi apparatus, and then to the ER. Ultimately, the LC should translocate from the ER lumen to the cytosol using the Sec61 translocon. The authors further control that the SV2 receptor for the BoNT/A traffics along the axon in a retromer-dependent fashion and that BoNT/A-mNG11x3 traverses the Golgi apparatus by fusing the mNG1-10 to a Golgi resident protein.

Strengths:
The findings in this work are convincing. The experiments are carefully done and are properly controlled. In the first part of the study, both the activity of the LC is monitored together with the physical presence of the toxin. In the second part of the work, the most relevant genes that came out of the siRNA screen are checked individually in the ReNcell VN / BoNT/A reporter system to confirm their role in BoNT/A trafficking and retro-translocation.

These findings are important to the fields of toxinology and medical treatment of neuromuscular diseases by BoNTs. They may explain some aspects of intoxication such as slow symptom onset, aggravation, and appearance of central effects.

Weaknesses:
The findings antagonize the current view of the intoxication pathway that is sustained by a vast amount of observations. The findings are certainly valid, but their generalization as the sole mechanism of BoNT intoxication should be tempered. These observations are restricted to one particular neuronal model and engineered protein tools. Other models such as isolated nerve/muscle preparations display nerve terminus paralysis within minutes rather than days. Also, the tetanus neurotoxin (TeNT), whose mechanism of action involving axonal transport to the posterior ganglia in the spinal cord is well described, takes between 5 and 15 days. It is thus possible that different intoxication mechanisms co-exist for BoNTs or even vary depending on the type of neurons.

Although the siRNA experiments are convincing, it would be nice to reach the same observations with drugs affecting the endocytic to Golgi to ER transport (such as Retro-2, golgicide or brefeldin A) and the Sec61 retrotranslocation (such as mycolactone). Then, it would be nice to check other neuronal systems for the same observations.

Reviewer #3 (Public Review):

Summary:
The manuscript by Yao et al. investigates the intracellular trafficking of Botulinum neurotoxin A (BoNT/A), a potent toxin used in clinical and cosmetic applications. Contrary to the prevailing understanding of BoNT/A translocation into the cytosol, the study suggests a retrograde migration from the synapse to the soma-localized Golgi in neurons. Using a genome-wide siRNA screen in genetically engineered neurons, the researchers identified over three hundred genes involved in this process. The study employs organelle-specific split-mNG complementation, revealing that BoNT/A traffics through the Golgi in a retromer-dependent manner before moving to the endoplasmic reticulum (ER). The Sec61 complex is implicated in the retro-translocation of BoNT/A from the ER to the cytosol. Overall, the research challenges the conventional model of BoNT/A translocation, uncovering a complex route from synapse to cytosol for efficient intoxication. The findings are based on a comprehensive approach, including the introduction of a fluorescent reporter for BoNT/A catalytic activity and genetic manipulations in neuronal cell lines. The conclusions highlight the importance of retrograde trafficking and the involvement of specific genes and cellular processes in BoNT/A intoxication.

Strengths:
The major part of the experiments are convincing. They are well-controlled and the interpretation of their results is balanced and sensitive.

Weaknesses:
To my opinion, the main weakness of the paper is in the interpretation of the data equating loss of tGFP signal (when using the Red SNAPR assay) with proteolytic cleavage by the toxin. Indeed, the first step for loss of tGFP signal by degradation of the cleaved part is the actual cleavage. However, this needs to be degraded (by the proteasome, I presume), a process that could in principle be affected (in speed or extent) by the toxin.