Background Tetrodotoxin (TTX) is a natural weak alkaline toxin with unique structure and strong toxicity. It causes nerve palsy and produces a strong central analgesic effect by specifically blocking voltage-gated sodium channels. Because of its significant pharmacological value, it has become a hot spot in natural product research. Although its potential is huge, its practical application is still restricted by the complex preparation process and narrow safety window.

Objective This paper aims to systematically clarify the relationship among TTX extraction, purification, medical pharmacological activities and safety from the perspective of translational medicine, and provide a strategic reference for breaking through the bottleneck of TTX research in the field of fisheries. Progress In this paper, the key progress of TTX in extraction, purification and functional activity research. TTX extraction has developed from traditional constant temperature water bath method to ultrasonic assisted extraction, and purification technology has evolved from column chromatography and membrane separation to high resolution high-performance liquid chromatography-mass spectrometry (HPLC-MS) and immunomagnetic bead system, which has significantly improved purity and recovery rate of TTX. Functional activity studies have shown that TTX has potential application value in analgesia, anti-arrhythmia, inhibition of tumor metastasis and local anesthesia by blocking sodium ion channels. In recent years, drug delivery systems such as liposomes and nanoparticles have been used for the encapsulation and controlled release of TTX, which can effectively reduce toxicity and prolong efficacy, providing a new idea for its safe medicinal use.

Conclusion TTX has great medicinal potential, but the difficulty of extraction and purification makes it 'difficult to produce', and the narrow safety window makes it 'difficult to apply'. In the future, it is necessary to explore low-cost, industrialized extraction and purification processes, and develop targeted drug delivery systems, so as to gradually realize the high-value application of TTX and the interdisciplinary combination of 'fishery resources-clinical application'.