Bacillus anthracis, the causative agent of anthrax, is believed to induce disease and death in humans in an endotoxic shock-like manner. A comprehensive study of the effects of anthrax lethal toxin in mice by Stephen Leppla and colleagues at the National Institutes of Health demonstrated that toxin-induced death does not result from septic shock mediated by cytokine release as previously thought, but via hypoxia-induced liver failure. The study strongly suggests that the therapies developed for the treatment of cytokine-mediated septic shock will not be appropriate for the treatment of anthrax.
In an accompanying commentary, Alice Prince from Columbia University College of Physicians and Surgeons in New York states that "this analysis of the pathological effects of the B. anthracis lethal toxin should help focus future studies of optimal therapy for patients exposed to this organism. These results make clear that anthrax patients exhibit a unique pathophysiology and should not be considered to have generic shock analogous to Gram-negative sepsis". Prince continues "exactly how the lethal factor produces such profound tissue hypoxia, what metabolic processes are affected in the liver and elsewhere, and how these effects may be blocked will require further studies".
TITLE: Bacillus anthracis lethal toxin induces TNF-alpha-independent hypoxia-mediated toxicity in mice
National Institutes of Health, Bethesda, Maryland, USA
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The host response to anthrax lethal toxin: unexpected observations
Alice S. Prince
Columbia University College of Physicians and Surgeons, New York, New York, USA