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The sepsis model: an emerging hypothesis for the lethality of inhalation anthrax

Inhalation anthrax is often described as a toxin-mediated disease. However, the toxaemia model does not account for the high mortality of inhalation anthrax relative to other forms of the disease or for the pathology present in inhalation anthrax. Patients with inhalation anthrax consistently show e...

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Autores principales: Coggeshall, Kenneth Mark, Lupu, Florea, Ballard, Jimmy, Metcalf, Jordan P, James, Judith A, Farris, Darise, Kurosawa, Shinichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3729634/
https://www.ncbi.nlm.nih.gov/pubmed/23742651
http://dx.doi.org/10.1111/jcmm.12075
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author Coggeshall, Kenneth Mark
Lupu, Florea
Ballard, Jimmy
Metcalf, Jordan P
James, Judith A
Farris, Darise
Kurosawa, Shinichiro
author_facet Coggeshall, Kenneth Mark
Lupu, Florea
Ballard, Jimmy
Metcalf, Jordan P
James, Judith A
Farris, Darise
Kurosawa, Shinichiro
author_sort Coggeshall, Kenneth Mark
collection PubMed
description Inhalation anthrax is often described as a toxin-mediated disease. However, the toxaemia model does not account for the high mortality of inhalation anthrax relative to other forms of the disease or for the pathology present in inhalation anthrax. Patients with inhalation anthrax consistently show extreme bacteraemia and, in contrast to animals challenged with toxin, signs of sepsis. Rather than toxaemia, we propose that death in inhalation anthrax results from an overwhelming bacteraemia that leads to severe sepsis. According to our model, the central role of anthrax toxin is to permit the vegetative bacteria to escape immune detection. Other forms of B. anthracis infection have lower mortality because their overt symptoms early in the course of disease cause patients to seek medical care at a time when the infection and its sequelae can still be reversed by antibiotics. Thus, the sepsis model explains key features of inhalation anthrax and may offer a more complete understanding of disease pathology for researchers as well as those involved in the care of patients.
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spelling pubmed-37296342014-07-01 The sepsis model: an emerging hypothesis for the lethality of inhalation anthrax Coggeshall, Kenneth Mark Lupu, Florea Ballard, Jimmy Metcalf, Jordan P James, Judith A Farris, Darise Kurosawa, Shinichiro J Cell Mol Med Point of View Inhalation anthrax is often described as a toxin-mediated disease. However, the toxaemia model does not account for the high mortality of inhalation anthrax relative to other forms of the disease or for the pathology present in inhalation anthrax. Patients with inhalation anthrax consistently show extreme bacteraemia and, in contrast to animals challenged with toxin, signs of sepsis. Rather than toxaemia, we propose that death in inhalation anthrax results from an overwhelming bacteraemia that leads to severe sepsis. According to our model, the central role of anthrax toxin is to permit the vegetative bacteria to escape immune detection. Other forms of B. anthracis infection have lower mortality because their overt symptoms early in the course of disease cause patients to seek medical care at a time when the infection and its sequelae can still be reversed by antibiotics. Thus, the sepsis model explains key features of inhalation anthrax and may offer a more complete understanding of disease pathology for researchers as well as those involved in the care of patients. Blackwell Publishing Ltd 2013-07 2013-06-07 /pmc/articles/PMC3729634/ /pubmed/23742651 http://dx.doi.org/10.1111/jcmm.12075 Text en Copyright © 2013 Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd. http://creativecommons.org/licenses/by/2.5/ Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.
spellingShingle Point of View
Coggeshall, Kenneth Mark
Lupu, Florea
Ballard, Jimmy
Metcalf, Jordan P
James, Judith A
Farris, Darise
Kurosawa, Shinichiro
The sepsis model: an emerging hypothesis for the lethality of inhalation anthrax
title The sepsis model: an emerging hypothesis for the lethality of inhalation anthrax
title_full The sepsis model: an emerging hypothesis for the lethality of inhalation anthrax
title_fullStr The sepsis model: an emerging hypothesis for the lethality of inhalation anthrax
title_full_unstemmed The sepsis model: an emerging hypothesis for the lethality of inhalation anthrax
title_short The sepsis model: an emerging hypothesis for the lethality of inhalation anthrax
title_sort sepsis model: an emerging hypothesis for the lethality of inhalation anthrax
topic Point of View
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3729634/
https://www.ncbi.nlm.nih.gov/pubmed/23742651
http://dx.doi.org/10.1111/jcmm.12075
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