• binding to the MHC class II receptor and triggering the release of cytokines - superantigens

• binding to the neuromuscular junction and prevention of ACh release - botulinum toxin

• blockage of a GTP-binding protein resulting gin the accumulation of cAMP - pertussis toxin

• blockage of presynaptic inhibition of spinal motor reflexes - tetanus toxin

• prevention of protein synthesis by blocking elongation of the polypeptide chain - diphtheria toxin, Pseudomonas aeruginosa exotoxin A

Patient present to the clinic with classical symptoms of tetanus. Tetanus toxin work via inhibition of GABA/glycine release from Renshaw inhibitory cells. Without these inhibitory signals on the postsynaptic neuron, they are continuously activated causing muscle tetany.