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Significance Botulism is induced byClostridium botulinum neurotoxins (BoNTs). At neuromuscular junctions, BoNT/B binds to dual receptors: a plasma membrane resident polysialoganglioside and synaptotagmin, a synaptic vesicle protein transiently inserted in neuronal membranes upon exocytosis. It is widely thought that BoNT binds initially to gangliosides and that this binary complex then diffuses to interact with synaptotagmin. Here, we show that the true BoNT/B receptor is the preassembled GT1b–SYT complex and that the α-helical structure of the BoNT/B binding domain of synaptotagmin found in previous structural studies is induced by the ganglioside before it ever meets the toxin. BoNT/B thus exploits a preexisting protein–glycolipid complex of yet unknown physiological function.

Gangliosides interact with synaptotagmin to form the high-affinity receptor complex for botulinum neurotoxin B