Xeomin acts selectively on peripheral cholinergic nerve endings, inhibiting the release of acetylcholine. The introduction into cholinergic nerve endings occurs in three stages: binding of the molecule to the external components of the membrane, internalization of the toxin by endocytosis, and translocation of the endopeptidase domain of the toxin from the endosome into the cytosol. In the cytosol, the endopeptidase domain of the toxin molecule selectively cleaves SNAP-25, an important protein component of the mechanism that controls the membrane movement of exovesicles, thus stopping the release of acetylcholine. The final effect is relaxation of the injected muscle. The effect of the drug begins within four to seven days after injection. The effect of each procedure lasts, as a rule, three to four months, although it can last significantly longer or less.
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