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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Main Authors:	Coggeshall, Kenneth Mark, Lupu, Florea, Ballard, Jimmy, Metcalf, Jordan P, James, Judith A, Farris, Darise, Kurosawa, Shinichiro
Format:	Online
Language:	English
Published:	Blackwell Publishing Ltd 2013
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3729634/

id	pubmed-3729634
recordtype	oai_dc
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 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.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Coggeshall, Kenneth Mark Lupu, Florea Ballard, Jimmy Metcalf, Jordan P James, Judith A Farris, Darise Kurosawa, Shinichiro
spellingShingle	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
author_facet	Coggeshall, Kenneth Mark Lupu, Florea Ballard, Jimmy Metcalf, Jordan P James, Judith A Farris, Darise Kurosawa, Shinichiro
author_sort	Coggeshall, Kenneth Mark
title	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_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_sort	sepsis model: an emerging hypothesis for the lethality of inhalation anthrax
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.
publisher	Blackwell Publishing Ltd
publishDate	2013
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3729634/
_version_	1611999588534714368

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

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