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Archana CA, Sekar YS, Suresh KP, Subramaniam S, Sagar N, Rani S, Anandakumar J, Pandey RK, Barman NN, Patil SS. Investigating the Influence of ANTXR2 Gene Mutations on Protective Antigen Binding for Heightened Anthrax Resistance. Genes (Basel) 2024; 15:426. [PMID: 38674361 PMCID: PMC11049084 DOI: 10.3390/genes15040426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024] Open
Abstract
Bacillus anthracis is the bacterium responsible for causing the zoonotic disease called anthrax. The disease presents itself in different forms like gastrointestinal, inhalation, and cutaneous. Bacterial spores are tremendously adaptable, can persist for extended periods and occasionally endanger human health. The Anthrax Toxin Receptor-2 (ANTXR2) gene acts as membrane receptor and facilitates the entry of the anthrax toxin into host cells. Additionally, mutations in the ANTXR2 gene have been linked to various autoimmune diseases, including Hyaline Fibromatosis Syndrome (HFS), Ankylosing Spondylitis (AS), Juvenile Hyaline Fibromatosis (JHF), and Infantile Systemic Hyalinosis (ISH). This study delves into the genetic landscape of ANTXR2, aiming to comprehend its associations with diverse disorders, elucidate the impacts of its mutations, and pinpoint minimal non-pathogenic mutations capable of reducing the binding affinity of the ANTXR2 gene with the protective antigen. Recognizing the pivotal role of single-nucleotide polymorphisms (SNPs) in shaping genetic diversity, we conducted computational analyses to discern highly deleterious and tolerated non-synonymous SNPs (nsSNPs) in the ANTXR2 gene. The Mutpred2 server determined that the Arg465Trp alteration in the ANTXR2 gene leads to altered DNA binding (p = 0.22) with a probability of a deleterious mutation of 0.808; notably, among the identified deleterious SNPs, rs368288611 (Arg465Trp) stands out due to its significant impact on altering the DNA-binding ability of ANTXR2. We propose these SNPs as potential candidates for hypertension linked to the ANTXR2 gene, which is implicated in blood pressure regulation. Noteworthy among the tolerated substitutions is rs200536829 (Ala33Ser), recognized as less pathogenic; this highlights its potential as a valuable biomarker, potentially reducing side effects on the host while also reducing binding with the protective antigen protein. Investigating these SNPs holds the potential to correlate with several autoimmune disorders and mitigate the impact of anthrax disease in humans.
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Affiliation(s)
- Chamalapura Ashwathama Archana
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru 560064, India; (C.A.A.); (Y.S.S.); (N.S.); (S.R.); (J.A.); (S.S.P.)
| | - Yamini Sri Sekar
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru 560064, India; (C.A.A.); (Y.S.S.); (N.S.); (S.R.); (J.A.); (S.S.P.)
| | - Kuralayanapalya Puttahonnappa Suresh
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru 560064, India; (C.A.A.); (Y.S.S.); (N.S.); (S.R.); (J.A.); (S.S.P.)
| | | | - Ningegowda Sagar
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru 560064, India; (C.A.A.); (Y.S.S.); (N.S.); (S.R.); (J.A.); (S.S.P.)
| | - Swati Rani
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru 560064, India; (C.A.A.); (Y.S.S.); (N.S.); (S.R.); (J.A.); (S.S.P.)
| | - Jayashree Anandakumar
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru 560064, India; (C.A.A.); (Y.S.S.); (N.S.); (S.R.); (J.A.); (S.S.P.)
| | - Rajan Kumar Pandey
- Department of Medical Biochemistry and Biophysics, Karolinska Institute, 17177 Solna, Sweden;
| | - Nagendra Nath Barman
- College of Veterinary Science, Assam Agricultural University (AAU), Guwahati 781022, India;
| | - Sharanagouda S. Patil
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bengaluru 560064, India; (C.A.A.); (Y.S.S.); (N.S.); (S.R.); (J.A.); (S.S.P.)
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2
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Georgopoulos AP, James LM. Anthrax Vaccines in the 21st Century. Vaccines (Basel) 2024; 12:159. [PMID: 38400142 PMCID: PMC10892718 DOI: 10.3390/vaccines12020159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
Vaccination against Bacillus anthracis is the best preventive measure against the development of deadly anthrax disease in the event of exposure to anthrax either as a bioweapon or in its naturally occurring form. Anthrax vaccines, however, have historically been plagued with controversy, particularly related to their safety. Fortunately, recent improvements in anthrax vaccines have been shown to confer protection with reduced short-term safety concerns, although questions about long-term safety remain. Here, we (a) review recent and ongoing advances in anthrax vaccine development, (b) emphasize the need for thorough characterization of current (and future) vaccines, (c) bring to focus the importance of host immunogenetics as the ultimate determinant of successful antibody production and protection, and (d) discuss the need for the systematic, active, and targeted monitoring of vaccine recipients for possible Chronic Multisymptom Illness (CMI).
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Affiliation(s)
- Apostolos P. Georgopoulos
- The Gulf War Illness Working Group, Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, MN 55417, USA;
- Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN 55455, USA
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55455, USA
- Department of Neurology, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Lisa M. James
- The Gulf War Illness Working Group, Brain Sciences Center, Department of Veterans Affairs Health Care System, Minneapolis, MN 55417, USA;
- Department of Neuroscience, University of Minnesota Medical School, Minneapolis, MN 55455, USA
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55455, USA
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Luong T, Nguyen TD, Lu VT, Metrailer MC, Pham VK, Hoang TTH, Hung Tran TM, Pham TH, Pham TL, Pham QT, Blackburn JK. Spatial epidemiology of human anthrax in Son La province, Vietnam, 2003-2022. Zoonoses Public Health 2024. [PMID: 38282103 DOI: 10.1111/zph.13112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 01/30/2024]
Abstract
AIMS Anthrax is reported with frequency but poorly understood in Southeast Asian countries including Vietnam. In Vietnam, anthrax surveillance is national. However, case detection, prevention, and control are implemented locally at the provincial level. Here, we describe the epidemiological characteristics, identify spatial clusters of human anthrax, and compare the variation in livestock anthrax vaccine coverage to disease incidence in humans and livestock using historical data in Son La province, Vietnam (2003-2020). METHODS AND RESULTS Most human cases occurred between April and September. Most of the patients were male, aged 15-54 years old. The human cases were mainly reported by public district hospitals. There was a delay between disease onset and hospitalization of ~5 days. We identified spatial clusters of high-high incidence communes in the northern communes of the province using the local Moran's I statistic. The vaccine coverage sharply decreased across the study period. The province reported sporadic human anthrax outbreaks, while animal cases were only reported in 2005 and 2022. CONCLUSIONS These results suggest underreporting for human and livestock anthrax in the province. Intersectoral information sharing is needed to aid livestock vaccination planning, which currently relies on reported livestock cases. The spatial clusters identify areas for targeted surveillance and livestock vaccination, while the seasonal case data suggest prioritizing vaccination campaigns for February or early March ahead of the April peak. A regional approach for studying the role of livestock trading between Son La and neighbouring provinces in anthrax occurrence is recommended.
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Affiliation(s)
- Tan Luong
- Spatial Epidemiology and Ecology Research Laboratory (SEER Lab), Department of Geography, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tien Dung Nguyen
- Son La Provincial Center for Disease Control, Son La City, Son La Province, Vietnam
| | - Van Truong Lu
- Son La Provincial Sub-Department of Animal Husbandry, Animal Health and Fisheries, Son La City, Son La Province, Vietnam
| | - Morgan C Metrailer
- Spatial Epidemiology and Ecology Research Laboratory (SEER Lab), Department of Geography, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | - Van Khang Pham
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | | | - Thanh Hai Pham
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Thanh Long Pham
- Department of Animal Health, Ministry of Agriculture and Rural Development, Hanoi, Vietnam
| | - Quang Thai Pham
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Jason K Blackburn
- Spatial Epidemiology and Ecology Research Laboratory (SEER Lab), Department of Geography, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
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Goossens PL. Bacillus anthracis, "la maladie du charbon", Toxins, and Institut Pasteur. Toxins (Basel) 2024; 16:66. [PMID: 38393144 PMCID: PMC10891547 DOI: 10.3390/toxins16020066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/25/2023] [Accepted: 12/30/2023] [Indexed: 02/25/2024] Open
Abstract
Institut Pasteur and Bacillus anthracis have enjoyed a relationship lasting almost 120 years, starting from its foundation and the pioneering work of Louis Pasteur in the nascent fields of microbiology and vaccination, and blooming after 1986 following the molecular biology/genetic revolution. This contribution will give a historical overview of these two research eras, taking advantage of the archives conserved at Institut Pasteur. The first era mainly focused on the production, characterisation, surveillance and improvement of veterinary anthrax vaccines; the concepts and technologies with which to reach a deep understanding of this research field were not yet available. The second period saw a new era of B. anthracis research at Institut Pasteur, with the anthrax laboratory developing a multi-disciplinary approach, ranging from structural analysis, biochemistry, genetic expression, and regulation to bacterial-host cell interactions, in vivo pathogenicity, and therapy development; this led to the comprehensive unravelling of many facets of this toxi-infection. B. anthracis may exemplify some general points on how science is performed in a given society at a given time and how a scientific research domain evolves. A striking illustration can be seen in the additive layers of regulations that were implemented from the beginning of the 21st century and their impact on B. anthracis research. B. anthracis and anthrax are complex systems that raise many valuable questions regarding basic research. One may hope that B. anthracis research will be re-initiated under favourable circumstances later at Institut Pasteur.
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Milano A, Robbiati C, Declich S, Calistri P, Pediconi O, Amato L, Paronyan L, Avetisyan L, Manucharyan A, Avetisyan G, Yesayan T, Gevorgyan A, Markosyan T, Dente MG. Assessing the Adoption of One Health Approaches in National Plans to Combat Health Threats: The Pilot of a One Health Conceptual Framework in Armenia. Trop Med Infect Dis 2024; 9:22. [PMID: 38251220 PMCID: PMC10819525 DOI: 10.3390/tropicalmed9010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
Due to several factors, such as environmental and climate changes, the risk of health threats originating at the human-animal-environment interface, including vector-borne diseases (VBDs) and zoonoses, is increasing. Low-resource settings struggle to counter these multidimensional risks due to their already-strained health systems and are therefore disproportionally affected by the impact caused by these changes. Systemic approaches like One Health (OH) are sought to strengthen prevention and preparedness strategies by addressing the drivers of potential threats with a multidisciplinary and multisectoral approach, considering the whole system at the human-animal-environment interface. The integration of OH in national plans can be challenging due to the lack of effective coordination and collaboration among different sectors. To support the process of knowledge coproduction about the level of OH integration in prevention and preparedness strategies against health threats in Armenia, a situation analysis was performed on Crimean-Congo hemorrhagic fever/virus and anthrax (identified by local stakeholders as priorities to be addressed with the OH approach), and actions to strengthen the national OH system were identified with the support of a OH conceptual framework. The study highlighted that multidisciplinary and multisectoral efforts towards prevention and preparedness against VBDs and zoonoses threats need to be strengthened in Armenia, and priority actions to integrate the OH approach were identified.
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Affiliation(s)
- Alessia Milano
- National Center for Global Health, Italian National Institute of Health (Istituto Superiore di Sanità), 00161 Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudia Robbiati
- National Center for Global Health, Italian National Institute of Health (Istituto Superiore di Sanità), 00161 Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Silvia Declich
- National Center for Global Health, Italian National Institute of Health (Istituto Superiore di Sanità), 00161 Rome, Italy
| | - Paolo Calistri
- National Reference Centre for Veterinary Epidemiology, Programming, Information and Risk Analysis (COVEPI), Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, 64100 Teramo, Italy
| | - Ombretta Pediconi
- Training and Project Management Unit, Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, 64100 Teramo, Italy
| | - Laura Amato
- National Reference Centre for Veterinary Epidemiology, Programming, Information and Risk Analysis (COVEPI), Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’, 64100 Teramo, Italy
| | - Lusine Paronyan
- Zoonotic and Parasitic Diseases Epidemiology Department, National Center for Disease Control and Prevention, Yerevan 0096, Armenia
| | - Lilit Avetisyan
- National Center for Disease Control and Prevention, Yerevan 0096, Armenia
| | - Arsen Manucharyan
- Reference Laboratory Center Reference Laboratory of Episootology, Ectoparasitology and Entomology, National Center for Disease Control and Prevention, Yerevan 0096, Armenia
| | - Georgi Avetisyan
- Veterinary Inspectorate, Food Safety Inspection Body, MoE, Yerevan 0010, Armenia
| | - Tigran Yesayan
- Veterinary Inspectorate, Food Safety Inspection Body, MoE, Yerevan 0010, Armenia
| | - Arman Gevorgyan
- Veterinary Inspectorate, Food Safety Inspection Body, MoE, Yerevan 0010, Armenia
| | | | - Maria Grazia Dente
- National Center for Global Health, Italian National Institute of Health (Istituto Superiore di Sanità), 00161 Rome, Italy
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Oduoye MO, Scott GY, Dave T, Bolanle AHH, Mwinbong AD, Modupeoluwa OO. One health approach to mitigate anthrax in Ghana. Health Sci Rep 2024; 7:e1807. [PMID: 38196565 PMCID: PMC10775134 DOI: 10.1002/hsr2.1807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/21/2023] [Accepted: 12/22/2023] [Indexed: 01/11/2024] Open
Abstract
Anthrax outbreaks in Ghana have become a pressing public health concern, posing threats to human health, the agricultural sector, and social well-being. This letter to the editor highlights the gravity of the anthrax situation in Ghana and advocates for comprehensive interventions using a One Health approach. The epidemiology of anthrax, including its historical roots and modes of transmission, is discussed. The consequences of anthrax outbreaks, such as severe illness, economic losses, and social distress, are outlined. To combat this complex issue, the letter emphasizes the importance of enhanced awareness, prevention, accurate diagnosis, and timely treatment. Recommendations include vaccination of animals and humans, education campaigns, proper disposal of infected carcasses, strengthening healthcare systems, surveillance, and early detection. Collaboration and coordination among professionals in the human, animal, and environmental sectors are crucial. By adopting a One Health approach and implementing these measures, Ghana can effectively mitigate the impact of anthrax outbreaks and safeguard the health and well-being of its population and livestock.
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Affiliation(s)
- Malik O Oduoye
- Department of Research Medical Research Circle (MedReC) Bukavu Democratic Republic of the Congo
| | - Godfred Y Scott
- Department of Medical Diagnostics Kwame Nkrumah University of Science and Technology Kumasi Ghana
| | - Tirth Dave
- Bukovinian State Medical University Chernivtsi Ukraine
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Cox C, Askew DS. A simple undergraduate laboratory exercise for teaching the role of sentinel-level clinical microbiology testing in biological threat identification. J Microbiol Biol Educ 2023; 24:e00106-23. [PMID: 38108000 PMCID: PMC10720554 DOI: 10.1128/jmbe.00106-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/31/2023] [Indexed: 12/19/2023]
Abstract
Undergraduate students in the biomedical sciences are mostly unaware of how clinical microbiology laboratories handle suspected agents of bioterrorism or emerging infectious diseases. The Public Health Security Bioterrorism Preparedness and Response Act of 2002 requires the US Department of Health and Human Services (HHS) to maintain a list of microbes that pose serious biological threats to human health and safety, including Tier 1 agents with the potential for use in bioterrorism. The Laboratory Response Network (LRN), founded by the Centers for Disease Control and Prevention, the Federal Bureau of Investigation, and the Association of Public Health Laboratories, coordinates the response of sentinel, reference, and national laboratories to these biothreats. The sentinel laboratories, which comprise most hospital-based and commercial laboratories, are the first to encounter a suspicious agent. For this reason, the LRN has published a series of testing guidelines to assist the sentinel laboratories in deciding whether a microbial isolate should be considered potentially hazardous and thus sent to a reference or national laboratory for further characterization. Here, we describe a simple laboratory exercise that teaches sentinel-level testing requirements in the context of an applied setting of a potential outbreak of anthrax that would require a sentinel laboratory to recognize a potential threat, attempt to rule it out, and refer to a national laboratory for identification.
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Affiliation(s)
- Christina Cox
- Department of Pathology & Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - David S. Askew
- Department of Pathology & Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Baindara P, Aslam B. Editorial: Bacillus spp. - Transmission, pathogenesis, host-pathogen interaction, prevention and treatment. Front Microbiol 2023; 14:1307723. [PMID: 37928694 PMCID: PMC10622664 DOI: 10.3389/fmicb.2023.1307723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023] Open
Affiliation(s)
- Piyush Baindara
- Department of Radiation Oncology, University of Missouri, Columbia, MO, United States
| | - Bilal Aslam
- Institute of Microbiology, Government College University, Faisalabad, Pakistan
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9
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Timofeev V, Bakhteeva I, Khlopova K, Mironova R, Titareva G, Goncharova Y, Solomentsev V, Kravchenko T, Dyatlov I, Vergnaud G. New Research on the Bacillus anthracis Genetic Diversity in Siberia. Pathogens 2023; 12:1257. [PMID: 37887773 PMCID: PMC10610006 DOI: 10.3390/pathogens12101257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/13/2023] [Accepted: 10/14/2023] [Indexed: 10/28/2023] Open
Abstract
Anthrax is a particularly dangerous infection of humans and ungulates caused by the Gram-positive spore-forming bacterium Bacillus anthracis. The highly monomorphic and clonal species B. anthracis is commonly divided into three main lineages, A, B, and C, which in turn are divided into several canSNP groups. We report here a phylogenetic analysis based on the whole-genome sequence (WGS) data of fifteen strains isolated predominantly in Siberia or Central and Southern Russia. We confirm the wide distribution of the cluster of strains of the B.Br.001/002 group, endemic to the Russian Arctic, which is also present in the steppe zone of Southern Siberia. We characterize additional branches within the major A.Br.001/002 polytomy comprising the A.Br.Ames and A.Br.Sterne lineages, one of which is identified in the Arctic.
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Affiliation(s)
- Vitalii Timofeev
- State Research Center for Applied Microbiology and Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Irina Bakhteeva
- State Research Center for Applied Microbiology and Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Kseniya Khlopova
- State Research Center for Applied Microbiology and Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Raisa Mironova
- State Research Center for Applied Microbiology and Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Galina Titareva
- State Research Center for Applied Microbiology and Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Yulia Goncharova
- State Research Center for Applied Microbiology and Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Viktor Solomentsev
- State Research Center for Applied Microbiology and Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Tatiana Kravchenko
- State Research Center for Applied Microbiology and Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Ivan Dyatlov
- State Research Center for Applied Microbiology and Biotechnology (SRCAMB), 142279 Obolensk, Russia
| | - Gilles Vergnaud
- Institute for Integrative Biology of the Cell (I2BC), Université Paris-Saclay, CEA, CNRS, 91198 Gif-sur-Yvette, France
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Metrailer MC, Hoang TTH, Jiranantasak T, Luong T, Hoa LM, Ngoc DB, Pham QT, Pham VK, Hung TTM, Huong VTL, Pham TL, Ponciano JM, Hamerlinck G, Dang DA, Norris MH, Blackburn JK. Spatial and phylogenetic patterns reveal hidden infection sources of Bacillus anthracis in an anthrax outbreak in Son La province, Vietnam. Infect Genet Evol 2023; 114:105496. [PMID: 37678701 DOI: 10.1016/j.meegid.2023.105496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/07/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
Bacillus anthracis, the bacterial cause of anthrax, is a zoonosis affecting livestock and wildlife often spilling over into humans. In Vietnam, anthrax has been nationally reportable since 2015 with cases occurring annually, mostly in the northern provinces. In April 2022, an outbreak was reported in Son La province following the butchering of a water buffalo, Bubalus bubalis. A total of 137 humans from three villages were likely exposed to contaminated meat from the animal. Early epidemiological investigations suggested a single animal was involved in all exposures. Five B. anthracis isolates were recovered from human clinical cases along with one from the buffalo hide, another from associated maggots, and one from soil at the carcass site. The isolates were whole genome sequenced, allowing global, regional, and local molecular epidemiological analyses of the outbreak strains. All recovered B. anthracis belong to the A.Br.001/002 lineage based on canonical single nucleotide polymorphism analysis (canSNP). Although not previously identified in Vietnam, this lineage has been identified in the nearby countries of China, India, Indonesia, Thailand, as well as Australia. A twenty-five marker multi-locus variable number tandem repeat analysis (MLVA-25) was used to investigate the relationship between human, soil, and buffalo strains. Locally, four MLVA-25 genotypes were identified from the eight isolates. This level of genetic diversity is unusual for the limited geography and timing of cases and differs from past literature using MLVA-25. The coupled spatial and phylogenetic data suggest this outbreak originated from multiple, likely undetected, animal sources. These findings were further supported by local news reports that identified at least two additional buffalo deaths beyond the initial animal sampled in response to the human cases. Future outbreak response should include intensive surveillance for additional animal cases and additional molecular epidemiological traceback to identify pathogen sources.
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Affiliation(s)
- Morgan C Metrailer
- Spatial Epidemiology and Ecology Research Laboratory, Department of Geography, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | | | - Treenate Jiranantasak
- Spatial Epidemiology and Ecology Research Laboratory, Department of Geography, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Tan Luong
- Spatial Epidemiology and Ecology Research Laboratory, Department of Geography, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA; National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Luong Minh Hoa
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Do Bich Ngoc
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Quang Thai Pham
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Van Khang Pham
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | | | | | | | | | - Duc Anh Dang
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Michael H Norris
- Spatial Epidemiology and Ecology Research Laboratory, Department of Geography, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Jason K Blackburn
- Spatial Epidemiology and Ecology Research Laboratory, Department of Geography, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.
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Sabra DM, Krin A, Romeral AB, Frieß JL, Jeremias G. Anthrax revisited: how assessing the unpredictable can improve biosecurity. Front Bioeng Biotechnol 2023; 11:1215773. [PMID: 37795173 PMCID: PMC10546327 DOI: 10.3389/fbioe.2023.1215773] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/24/2023] [Indexed: 10/06/2023] Open
Abstract
B. anthracis is one of the most often weaponized pathogens. States had it in their bioweapons programs and criminals and terrorists have used or attempted to use it. This study is motivated by the narrative that emerging and developing technologies today contribute to the amplification of danger through greater easiness, accessibility and affordability of steps in the making of an anthrax weapon. As states would have way better preconditions if they would decide for an offensive bioweapons program, we focus on bioterrorism. This paper analyzes and assesses the possible bioterrorism threat arising from advances in synthetic biology, genome editing, information availability, and other emerging, and converging sciences and enabling technologies. Methodologically we apply foresight methods to encourage the analysis of contemporary technological advances. We have developed a conceptual six-step foresight science framework approach. It represents a synthesis of various foresight methodologies including literature review, elements of horizon scanning, trend impact analysis, red team exercise, and free flow open-ended discussions. Our results show a significant shift in the threat landscape. Increasing affordability, widespread distribution, efficiency, as well as ease of use of DNA synthesis, and rapid advances in genome-editing and synthetic genomic technologies lead to an ever-growing number and types of actors who could potentially weaponize B. anthracis. Understanding the current and future capabilities of these technologies and their potential for misuse critically shapes the current and future threat landscape and underlines the necessary adaptation of biosecurity measures in the spheres of multi-level political decision making and in the science community.
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Affiliation(s)
- Dunja Manal Sabra
- Carl Friedrich von Weizsäcker-Centre for Science and Peace Research (ZNF), University of Hamburg, Bogenallee, Hamburg, Germany
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12
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Bamidele TA, Odumosu BT, Adenola PT, Ameh J, Kareem OK, Osoba B, Ezechi OC, Salako BL. Anthrax toxins-producing Bacillus spp. isolated from handwashing stations during COVID-19 pandemic in Lagos, Nigeria. J Infect Dev Ctries 2023; 17:1076-1080. [PMID: 37699094 DOI: 10.3855/jidc.18228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/07/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION The virulence binding factor, protective antigen (pag) and poly-D-γ-glutamate capsular (cap) genes, peculiar to Bacillus anthracis are located in the pXO1 and pXO2 plasmids which are transferable horizontally to related species called "cereus group". The cereus group are usually isolated from the environmental/food samples and have been implicated in debilitating human and animal anthrax-like diseases. This study was designed to investigate the presence of the anthrax virulence genes in different Bacillus spp. isolated from handwashing facilities during COVID-19 pandemic in Lagos, Nigeria. METHODOLOGY The Bacillus anthracis (OK316847), B. thuringiensis (OK316855), B. amyloliquefaciens (OK316857), B. cereus (OK316858) and B. thuringiensis (OK316859) previously isolated from rinsates and bowl water in two local government areas (LGAs) of Lagos state were further investigated by the polymerase chain reaction (PCR) amplification of the pag and cap genes using specific primers. RESULTS Bacillus anthracis and B. cereus co-harboured the two 578 bp cap and 364 bp pag genes while B. thuringiensis only harboured the cap gene. Similarly, the non-cereus B. amyloliquefaciens was found to habour the pag gene. CONCLUSIONS The two anthrax toxin genes were amplified in the Bacillus spp isolated from rinsates and bowl water used in hand washing in the two study LGAs. Given that these virulence genes have a global consequence and are a potential threat to life, this study calls for an extensive surveillance, and reassessment of gene regulators and plasmid distribution among these strains in our environment.
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Affiliation(s)
| | | | | | - James Ameh
- University of Queensland, School of Veterinary Science, Brisbane, Australia
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Ouyang W, Xie T, Fang H, Frucht DM. Development of a New Cell-Based AP-1 Gene Reporter Potency Assay for Anti- Anthrax Toxin Therapeutics. Toxins (Basel) 2023; 15:528. [PMID: 37755954 PMCID: PMC10538138 DOI: 10.3390/toxins15090528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/18/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
Anthrax toxin is a critical virulence factor of Bacillus anthracis. The toxin comprises protective antigen (PA) and two enzymatic moieties, edema factor (EF) and lethal factor (LF), forming bipartite lethal toxin (LT) and edema toxin (ET). PA binds cellular surface receptors and is required for intracellular translocation of the enzymatic moieties. For this reason, anti-PA antibodies have been developed as therapeutics for prophylaxis and treatment of human anthrax infection. Assays described publicly for the control of anti-PA antibody potency quantify inhibition of LT-mediated cell death or the ET-induced increase in c-AMP levels. These assays do not fully reflect and/or capture the pathological functions of anthrax toxin in humans. Herein, we report the development of a cell-based gene reporter potency assay for anti-PA antibodies based on the rapid LT-induced degradation of c-Jun protein, a pathogenic effect that occurs in human cells. This new assay was developed by transducing Hepa1c1c7 cells with an AP-1 reporter lentiviral construct and has been qualified for specificity, accuracy, repeatability, intermediate precision, and linearity. This assay not only serves as a bioassay for LT activity, but has applications for characterization and quality control of anti-PA therapeutic antibodies or other products that target the AP-1 signaling pathway.
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Affiliation(s)
- Weiming Ouyang
- Division of Biotechnology Review and Research II, Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (T.X.); (H.F.)
| | | | | | - David M. Frucht
- Division of Biotechnology Review and Research II, Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA; (T.X.); (H.F.)
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Norris MH, Zincke D, Daegling DJ, Krigbaum J, McGraw WS, Kirpich A, Hadfield TL, Blackburn JK. Genomic and Phylogenetic Analysis of Bacillus cereus Biovar anthracis Isolated from Archival Bone Samples Reveals Earlier Natural History of the Pathogen. Pathogens 2023; 12:1065. [PMID: 37624025 PMCID: PMC10457788 DOI: 10.3390/pathogens12081065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023] Open
Abstract
(1) Background: Bacillus cereus biovar anthracis (Bcbva) was the causative agent of an anthrax-like fatal disease among wild chimpanzees in 2001 in Côte d'Ivoire. Before this, there had not been any description of an anthrax-like disease caused by typically avirulent Bacillus cereus. Genetic analysis found that B. cereus had acquired two anthrax-like plasmids, one a pXO1-like toxin producing plasmid and the other a pXO2-like plasmid encoding capsule. Bcbva caused animal fatalities in Cameroon, Democratic Republic of Congo, and the Central African Republic between 2004 and 2012. (2) Methods: The pathogen had acquired plasmids in the wild and that was discovered as the cause of widespread animal fatalities in the early 2000s. Primate bones had been shipped out of the endemic zone for anthropological studies prior to the realized danger of contamination with Bcbva. Spores were isolated from the bone fragments and positively identified as Bcbva. Strains were characterized by classical microbiological methods and qPCR. Four new Bcbva isolates were whole-genome sequenced. Chromosomal and plasmid phylogenomic analysis was performed to provide temporal and spatial context to these new strains and previously sequenced Bcbva. Tau and principal component analyses were utilized to identify genetic and spatial case patterns in the Taï National Park anthrax zone. (3) Results: Preliminary studies positively identified Bcbva presence in several archival bone fragments. The animals in question died between 1994 and 2010. Previously, the earliest archival strains of Bcbva were identified in 1996. Though the pathogen has a homogeneous genome, spatial analyses of a subset of mappable isolates from Taï National Park revealed strains found closer together were generally more similar, with strains from chimpanzees and duikers having the widest distribution. Ancestral strains were located mostly in the west of the park and had lower spatial clustering compared to more recent isolates, indicating a local increase in genetic diversity of Bcbva in the park over space and time. Global clustering analysis indicates patterns of genetic diversity and distance are shared between the ancestral and more recently isolated type strains. (4) Conclusions: Our strains have the potential to unveil historical genomic information not available elsewhere. This information sheds light on the evolution and emergence of a dangerous anthrax-causing pathogen.
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Affiliation(s)
- Michael H. Norris
- Spatial Epidemiology & Ecology Research Laboratory, Department of Geography, University of Florida, Gainesville, FL 32611, USA; (M.H.N.); (D.Z.); (T.L.H.)
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32611, USA
| | - Diansy Zincke
- Spatial Epidemiology & Ecology Research Laboratory, Department of Geography, University of Florida, Gainesville, FL 32611, USA; (M.H.N.); (D.Z.); (T.L.H.)
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32611, USA
| | - David J. Daegling
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; (D.J.D.); (J.K.)
| | - John Krigbaum
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; (D.J.D.); (J.K.)
| | - W. Scott McGraw
- Department of Anthropology, Ohio State University, Columbus, OH 43210, USA;
| | - Alexander Kirpich
- Department of Population Health Sciences, Georgia State University, Atlanta, GA 30302, USA;
| | - Ted L. Hadfield
- Spatial Epidemiology & Ecology Research Laboratory, Department of Geography, University of Florida, Gainesville, FL 32611, USA; (M.H.N.); (D.Z.); (T.L.H.)
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32611, USA
| | - Jason K. Blackburn
- Spatial Epidemiology & Ecology Research Laboratory, Department of Geography, University of Florida, Gainesville, FL 32611, USA; (M.H.N.); (D.Z.); (T.L.H.)
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32611, USA
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Kumari M, Subbarao N. Convolutional neural network-based quantitative structure-activity relationship and fingerprint analysis against inhibitors of anthrax lethal factor. Future Med Chem 2023. [PMID: 37248697 DOI: 10.4155/fmc-2023-0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Aim: To develop a one-dimensional convolutional neural network-based quantitative structure-activity relationship (1D-CNN-QSAR) model to identify novel anthrax inhibitors and analyze chemical space. Methods: We developed a 1D-CNN-QSAR model to identify novel anthrax inhibitors. Results: The statistical results of the 1D-CNN-QSAR model showed a mean square error of 0.045 and a predicted correlation coefficient of 0.79 for the test set. Further, chemical space analysis showed more than 80% fragment pair similarity, with activity cliffs associated with carboxylic acid, 2-phenylfurans, N-phenyldihydropyrazole, N-phenylpyrrole, furan, 4-methylene-1H-pyrazol-5-one, phenylimidazole, phenylpyrrole and phenylpyrazolidine. Conclusion: These fragments may serve as the basis for developing potent novel drug candidates for anthrax. Finally, we concluded that our proposed 1D-CNN-QSAR model and fingerprint analysis might be used to discover potential anthrax drug candidates.
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Affiliation(s)
- Madhulata Kumari
- Amity Institute of Biotechnology, Amity University, Rajasthan, Jaipur, India
| | - Naidu Subbarao
- School of Computational & Integrative Sciences, Jawaharlal Nehru University, New Delhi, 110067, India
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Kozytska T, Bassiouny M, Chechet O, Ordynska D, Galante D, Neubauer H, Wareth G. Retrospective Analysis of Official Data on Anthrax in Europe with a Special Reference to Ukraine. Microorganisms 2023; 11:1294. [PMID: 37317268 DOI: 10.3390/microorganisms11051294] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 06/16/2023] Open
Abstract
Anthrax is an acute infectious zoonotic disease caused by Bacillus anthracis that mostly affects grazing livestock and wildlife. Furthermore, B. anthracis is considered one of the most important biological agents of bioterrorism that could also be potentially misused in biological weapons. The distribution of anthrax in domestic animals and wildlife in Europe with a particular focus on Ukraine as a country of war was analyzed. Between 2005 and 2022, 267 anthrax cases were registered at the World Organization of Animal Health (WOAH) in animals in Europe, including 251 cases in domestic animals and 16 in wildlife. The highest numbers of cases were recorded in 2005 and 2016 followed by 2008, and the highest numbers of registered cases were reported from Albania, Russia, and Italy. In Ukraine, anthrax is currently a sporadic infection. Since 2007, 28 notifications were registered, with isolates mainly from soil samples. The highest number of confirmed anthrax cases was registered in 2018, and Odesa, which is close to Moldova, had the highest number of cases, followed by the Cherkasy region. The presence of thousands of biothermal pits and burial grounds of fallen cattle nationwide favors the re-emergence of new foci. Most confirmed cases were in cattle; however, single cases were confirmed in dogs, horses, and pigs. Further investigation of the disease in wildlife and in environmental samples is needed. The genetic analysis of isolates, investigation of susceptibility to antimicrobial compounds, and determination of virulence and pathogenicity factors are required in this volatile region of the world for awareness raising and preparedness.
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Affiliation(s)
- Tamara Kozytska
- Friedrich-Loeffler-Institut, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743 Jena, Germany
- State Research Institute for Laboratory Diagnostics and Veterinary and Sanitary Expertise, State Service of Ukraine for Food Safety and Consumer Protection, 30, Donetska St., 03151 Kyiv, Ukraine
| | - Marwa Bassiouny
- Friedrich-Loeffler-Institut, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743 Jena, Germany
| | - Olha Chechet
- State Research Institute for Laboratory Diagnostics and Veterinary and Sanitary Expertise, State Service of Ukraine for Food Safety and Consumer Protection, 30, Donetska St., 03151 Kyiv, Ukraine
| | - Diana Ordynska
- State Research Institute for Laboratory Diagnostics and Veterinary and Sanitary Expertise, State Service of Ukraine for Food Safety and Consumer Protection, 30, Donetska St., 03151 Kyiv, Ukraine
| | - Domenico Galante
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Anthrax Reference Institute of Italy, Via Manfredonia 20, 71121 Foggia, Italy
| | - Heinrich Neubauer
- Friedrich-Loeffler-Institut, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743 Jena, Germany
| | - Gamal Wareth
- Friedrich-Loeffler-Institut, Institute of Bacterial Infections and Zoonoses, Naumburger Str. 96a, 07743 Jena, Germany
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
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Maison RM, Priore MR, Brown VR, Bodenchuk MJ, Borlee BR, Bowen RA, Bosco-Lauth AM. Feral Swine as Indirect Indicators of Environmental Anthrax Contamination and Potential Mechanical Vectors of Infectious Spores. Pathogens 2023; 12:pathogens12040622. [PMID: 37111508 PMCID: PMC10142851 DOI: 10.3390/pathogens12040622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Anthrax is a disease that affects livestock, wildlife, and humans worldwide; however, its relative impacts on these populations remain underappreciated. Feral swine (Sus scrofa) are relatively resistant to developing anthrax, and past serosurveys have alluded to their utility as sentinels, yet empirical data to support this are lacking. Moreover, whether feral swine may assist in the dissemination of infectious spores is unknown. To address these knowledge gaps, we intranasally inoculated 15 feral swine with varying quantities of Bacillus anthracis Sterne 34F2 spores and measured the seroconversion and bacterial shedding over time. The animals also were inoculated either one or three times. The sera were evaluated by enzyme-linked immunosorbent assay (ELISA) for antibodies against B. anthracis, and nasal swabs were cultured to detect bacterial shedding from the nasal passages. We report that the feral swine developed antibody responses to B. anthracis and that the strength of the response correlated with the inoculum dose and the number of exposure events experienced. Isolation of viable bacteria from the nasal passages of the animals throughout the study period suggests that feral swine may assist in the spread of infectious spores on the landscape and have implications for the identification of environments contaminated with B. anthracis as well as the exposure risk to more susceptible hosts.
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Affiliation(s)
- Rachel M Maison
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO 80521, USA
| | - Maggie R Priore
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO 80521, USA
| | - Vienna R Brown
- U.S. Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Wildlife Research Center, Fort Collins, CO 80521, USA
| | - Michael J Bodenchuk
- U.S. Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, San Antonio, TX 78269, USA
| | - Bradley R Borlee
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO 80521, USA
| | - Richard A Bowen
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO 80521, USA
| | - Angela M Bosco-Lauth
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO 80521, USA
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Pérez-Díaz JL, Martín-Pérez T, Del Álamo C, Sánchez-García-Casarrubios J, Copa-Patiño JL, Soliveri J, Orellana-Muriana JM, Pérez-Serrano J, Llerena-Aguilar FJ. Optimal Fast Integral Decontamination of Bacillus thuringiensis Aerosols and Fast Disinfection of Contaminated Surfaces. Microorganisms 2023; 11:microorganisms11041021. [PMID: 37110444 PMCID: PMC10143539 DOI: 10.3390/microorganisms11041021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
Aerosolized anthrax (Bacillus anthracis) spores are of extreme health concern and can remain airborne for hours and contaminate all kinds of surfaces, constituting reservoirs from which resuspension is easily produced. The assessment of decontamination techniques must therefore consider both air and surfaces. In the present study, several kinds of disinfecting fogs were experimentally tested against Bacillus thuringiensis spores, which served as a surrogate for Bacillus anthracis, both as aerosols released into the air and spread on porous and non-porous surfaces with different positions and orientations. This technology removed Bacillus thuringiensis spores from the air in 20 min with just a 1 min application of fog. The dynamics and characteristics of the fog, related to aerosol and surface interactions, proved to be critical for optimal performance and decontamination. An optimal configuration could provide effective disinfection even on indirectly reached surfaces. In all cases, 8% hydrogen peroxide (H2O2) provided a higher disinfection rate than 2% glutaraldehyde.
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Affiliation(s)
- José Luis Pérez-Díaz
- Escuela Politécnica Superior, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
| | - Tania Martín-Pérez
- Department of Biomedicine and Biotechnology, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
| | - Cristina Del Álamo
- Escuela Politécnica Superior, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
| | | | - José Luis Copa-Patiño
- Department of Biomedicine and Biotechnology, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
| | - Juan Soliveri
- Department of Biomedicine and Biotechnology, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
| | | | - Jorge Pérez-Serrano
- Department of Biomedicine and Biotechnology, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
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Xu Z, Ma T, Han X, Liu G, Luo T, Yu M, Han L, Chen K, Chen G. Study on the detection of anthrax by ICP-MS based on gold nanoparticle labeling. Technol Health Care 2023; 31:283-292. [PMID: 37066929 DOI: 10.3233/thc-236024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
BACKGROUND In recent years, inductively coupled plasma mass spectrometry (ICP-MS) has been widely used in the field of molecular biology because of its unique advantages. Anthrax is a widespread and long-standing infectious disease, which affects and restricts people's work and life seriously. OBJECTIVE The study goal is to develop a new method for the detection of anthrax. METHODS A rapid, sensitive and accurate method for the detection of anthrax characteristic DNA was proposed by combing gold nanoparticles (AuNPs) and inductively coupled plasma mass spectrometry. RESULTS The linear range of this method is 100-2500 pmol/L and the limit of detection of 16.61 pmol/L. CONCLUSION The proposed method has numerous advantages, including simplicity of operation, high sensitivity, and specificity, which provides a new idea for the detection of anthrax. Importantly, this methodology has good potential for the detection of other biological substances such as bacteria and viruses by changing the modification sequence on the nanoparticle probe.
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Zhao F, Zhao C, Bai S, Yao L, Zhang Y. Triage Algorithms for Mass-Casualty Bioterrorism: A Systematic Review. Int J Environ Res Public Health 2023; 20:ijerph20065070. [PMID: 36981980 PMCID: PMC10049471 DOI: 10.3390/ijerph20065070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To understand existing triage algorithms, propose improvement measures through comparison to better deal with mass-casualty incidents caused by bioterrorism. STUDY DESIGN Systematic review. METHODS Medline, Scopus and Web of Science were searched up to January 2022. The studies investigating triage algorithms for mass-casualty bioterrorism. Quality assessment was performed using the International Narrative Systematic Assessment tool. Data extractions were performed by four reviewers. RESULTS Of the 475 titles identified in the search, 10 studies were included. There were four studies on triage algorithms for most bioterrorism events, four studies on triage algorithms for anthrax and two studies on triage algorithms for mental or psychosocial problems caused by bioterrorism events. We introduced and compared 10 triage algorithms used for different bioterrorism situations. CONCLUSION For triage algorithms for most bioterrorism events, it is necessary to determine the time and place of the attack as soon as possible, control the number of exposed and potentially exposed people, prevent infection and determine the type of biological agents used. Research on the effects of decontamination on bioterrorism attacks needs to continue. For anthrax triage, future research should improve the distinction between inhalational anthrax symptoms and common disease symptoms and improve the efficiency of triage measures. More attention should be paid to triage algorithms for mental or psychosocial problems caused by bioterrorism events.
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Affiliation(s)
- Feida Zhao
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China
| | - Chao Zhao
- Center for Biosafety Research and Strategy, Tianjin University, Tianjin 300072, China
| | - Song Bai
- Evaluation and Optimization of Health Emergency Response Capacity, Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China
| | - Lulu Yao
- Emergency Medicine, Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China
| | - Yongzhong Zhang
- Epidemiology and Health Statistics, Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China
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Hsieh HY, Stewart GC. Does environmental replication contribute to Bacillus anthracis spore persistence and infectivity in soil? Res Microbiol 2023;:104052. [PMID: 36921704 DOI: 10.1016/j.resmic.2023.104052] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
Bacillus anthracis is the zoonotic causal agent of anthrax. Its infectious form is the spore, which can persist in soil. Herbivores usually acquire the disease from grazing in spore-contaminated sites. There are two schools of thought regarding B. anthracis activities in soil. One contends the bacteria are obligate animal parasites and soil-based spores remain inert until taken up by another animal host. Others contend that spores can germinate in soil and the bacteria replicate and re-sporulate to maintain and/or increase spore numbers. This review discusses whether soil replication of B. anthracis is an important part of its life cycle.
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Oudejans L, Richter W, Sunderman M, Calfee MW, Mickelsen RL, Hofacre K, Keyes P, Lee SD. Passenger vehicle interior decontamination by low concentration hydrogen peroxide vapor following a wide area biological contamination incident. J Appl Microbiol 2023; 134:lxad039. [PMID: 36822624 PMCID: PMC10257935 DOI: 10.1093/jambio/lxad039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/09/2023] [Accepted: 02/22/2023] [Indexed: 02/25/2023]
Abstract
AIMS To assess low concentration hydrogen peroxide (LCHP) (H2O2) vapor dispersed with a home humidifier for its ability to decontaminate vehicle interiors contaminated with Bacillus anthracis surrogate Bacillus atrophaeus spores. METHODS AND RESULTS Efficacy of a vaporized 3% H2O2 solution was evaluated for liquid volumes, on/off vehicle heating, ventilation, and air conditioning (HVAC) system operations, and temperatures that ranged from 5 to 27°C. Survival of the spores was assessed by quantification of remaining viable spores with efficacy quantified in terms of mean log10 reduction. Decontamination efficacy after the 6-day dwell time increased when the 3% H2O2 liquid volume was doubled, increasing from 4-of-10 to 10-of-10 nondetects (zero colonies counted using standard dilution and filter plating) inside the vehicle cabin. Recirculating cabin air through the HVAC system during decontamination decreased efficacy to 6-of-10 non-detects. While no 6-log10 reduction in viable spores was observed on the cabin filter with the cabin filter kept in place, a 6-log10 reduction was achieved after its removal and placement in the cabin during treatment. CONCLUSIONS Results from this study allow for informed decisions on the use of LCHP vapor as an effective decontamination approach for vehicle interiors.
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Affiliation(s)
- Lukas Oudejans
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Research Triangle Park, NC 27711, USA
| | | | | | - M. Worth Calfee
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Research Triangle Park, NC 27711, USA
| | - R. Leroy Mickelsen
- U.S. Environmental Protection Agency, Office of Land and Emergency Management, Chemical, Biological, Radiological, and Nuclear Consequence Management Advisory Division, Research Triangle Park, NC 27711, USA
| | - Kent Hofacre
- Battelle Memorial Institute, Columbus, OH 43201, USA
| | - Patrick Keyes
- Battelle Memorial Institute, Columbus, OH 43201, USA
| | - Sang Don Lee
- U.S. Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Research Triangle Park, NC 27711, USA
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Taylor-Joyce G, Manoharan S, Brooker TA, Hernández-Rodríguez CS, Baillie L, Oyston PCF, Hapeshi A, Waterfield NR. The influence of extrachromosomal elements in the anthrax "cross-over" strain Bacillus cereus G9241. Front Microbiol 2023; 14:1113642. [PMID: 37213513 PMCID: PMC10196113 DOI: 10.3389/fmicb.2023.1113642] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/31/2023] [Indexed: 05/23/2023] Open
Abstract
Bacillus cereus G9241 was isolated from a welder who survived a pulmonary anthrax-like disease. Strain G9241 carries two virulence plasmids, pBCX01 and pBC210, as well as an extrachromosomal prophage, pBFH_1. pBCX01 has 99.6% sequence identity to pXO1 carried by Bacillus anthracis and encodes the tripartite anthrax toxin genes and atxA, a mammalian virulence transcriptional regulator. This work looks at how the presence of pBCX01 and temperature may affect the lifestyle of B. cereus G9241 using a transcriptomic analysis and by studying spore formation, an important part of the B. anthracis lifecycle. Here we report that pBCX01 has a stronger effect on gene transcription at the mammalian infection relevant temperature of 37°C in comparison to 25°C. At 37°C, the presence of pBCX01 appears to have a negative effect on genes involved in cell metabolism, including biosynthesis of amino acids, whilst positively affecting the transcription of many transmembrane proteins. The study of spore formation showed B. cereus G9241 sporulated rapidly in comparison to the B. cereus sensu stricto type strain ATCC 14579, particularly at 37°C. The carriage of pBCX01 did not affect this phenotype suggesting that other genetic elements were driving rapid sporulation. An unexpected finding of this study was that pBFH_1 is highly expressed at 37°C in comparison to 25°C and pBFH_1 expression leads to the production of Siphoviridae-like phage particles in the supernatant of B. cereus G9241. This study provides an insight on how the extrachromosomal genetic elements in B. cereus G9241 has an influence in bacterial phenotypes.
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Affiliation(s)
- Grace Taylor-Joyce
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Shathviga Manoharan
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Thomas A. Brooker
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | | | - Les Baillie
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United Kingdom
| | | | - Alexia Hapeshi
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Nicholas R. Waterfield
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- *Correspondence: Nicholas R. Waterfield,
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24
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Holay M, Krishnan N, Zhou J, Duan Y, Guo Z, Gao W, Fang RH, Zhang L. Single Low-Dose Nanovaccine for Long-Term Protection against Anthrax Toxins. Nano Lett 2022; 22:9672-9678. [PMID: 36448694 PMCID: PMC9970955 DOI: 10.1021/acs.nanolett.2c03881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Anthrax infections caused by Bacillus anthracis are an ongoing bioterrorism and livestock threat worldwide. Current approaches for management, including extended passive antibody transfusion, antibiotics, and prophylactic vaccination, are often cumbersome and associated with low patient compliance. Here, we report on the development of an adjuvanted nanotoxoid vaccine based on macrophage membrane-coated nanoparticles bound with anthrax toxins. This design leverages the natural binding interaction of protective antigen, a key anthrax toxin, with macrophages. In a murine model, a single low-dose vaccination with the nanotoxoids generates long-lasting immunity that protects against subsequent challenge with anthrax toxins. Overall, this work provides a new approach to address the ongoing threat of anthrax outbreaks and bioterrorism by taking advantage of an emerging biomimetic nanotechnology.
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25
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Gazi E, Bayliss M, O'Sullivan C, Butler‐Ellis C, France B, Clapperton RM, Payne D, Govan N. Dose-response analysis of Bacillus thuringiensis HD-1 cry- spore reduction on surfaces using formaldehyde with pre-germination. J Appl Microbiol 2022; 133:3424-3437. [PMID: 35945896 PMCID: PMC9828334 DOI: 10.1111/jam.15767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/24/2022] [Accepted: 08/01/2022] [Indexed: 01/12/2023]
Abstract
AIM To establish a basis for rapid remediation of large areas contaminated with Bacillus anthracis spores. METHODS AND RESULTS Representative surfaces of wood, steel and cement were coated by nebulization with B. thuringiensis HD-1 cry- (a simulant for B. anthracis) at 5.9 ± 0.2, 6.3 ± 0.2 and 5.8 ± 0.2 log10 CFU per cm2 , respectively. These were sprayed with formaldehyde, either with or without pre-germination. Low volume (equivalent to ≤2500 L ha-1 ) applications of formaldehyde at 30 g l-1 to steel or cement surfaces resulted in ≥4 or ≤2 log10 CFU per cm2 reductions respectively, after 2 h exposure. Pre-germinating spores (500 mmol l-1 l-alanine and 25 mmol l-1 inosine, pH 7) followed by formaldehyde application showed higher levels of spore inactivation than formaldehyde alone with gains of up to 3.4 log10 CFU per cm2 for a given dose. No loss in B. thuringiensis cry- viability was measured after the 2 h germination period, however, a pre-heat shock log10 reduction was seen for B. anthracis strains: LSU149 (1.7 log10), Vollum and LSU465 (both 0.9 log10), LSU442 (0.2 log10), Sterne (0.8 log10) and Ames (0.6 log10). CONCLUSIONS A methodology was developed to produce representative spore contamination of surfaces along with a laboratory-based technique to measure the efficacy of decontamination. Dose-response analysis was used to optimize decontamination. Pre-germinating spores was found to increase effectiveness of decontamination but requires careful consideration of total volume used (germinant and decontaminant) by surface type. SIGNIFICANCE AND IMPACT OF THE STUDY To be practically achievable, decontamination of a wide area contaminated with B. anthracis spores must be effective, timely and minimize the amount of materials required. This study uses systematic dose-response methodology to demonstrate that such an approach is feasible.
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Klimko CP, Welkos SL, Shoe JL, Mou S, Hunter M, Rill NO, DeShazer D, Cote CK. Efficacy of Treatment with the Antibiotic Novobiocin against Infection with Bacillus anthracis or Burkholderia pseudomallei. Antibiotics (Basel) 2022; 11. [PMID: 36551342 DOI: 10.3390/antibiotics11121685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022] Open
Abstract
The microbial pathogens Burkholderia pseudomallei and Bacillus anthracis are unrelated bacteria, yet both are the etiologic agents of naturally occurring diseases in animals and humans and are classified as Tier 1 potential biothreat agents. B. pseudomallei is the gram-negative bacterial agent of melioidosis, a major cause of sepsis and mortality globally in endemic tropical and subtropical regions. B. anthracis is the gram-positive spore-forming bacterium that causes anthrax. Infections acquired by inhalation of these pathogens are challenging to detect early while the prognosis is best; and they possess innate multiple antibiotic resistance or are amenable to engineered resistance. Previous studies showed that the early generation, rarely used aminocoumarin novobiocin was very effective in vitro against a range of highly disparate biothreat agents. The objective of the current research was to begin to characterize the therapeutic efficacy of novobiocin in mouse models of anthrax and melioidosis. The antibiotic was highly efficacious against infections by both pathogens, especially B. pseudomallei. Our results supported the concept that specific older generation antimicrobials can be effective countermeasures against infection by bacterial biothreat agents. Finally, novobiocin was shown to be a potential candidate for inclusion in a combined pre-exposure vaccination and post-exposure treatment strategy designed to target bacterial pathogens refractory to a single medical countermeasure.
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27
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Thompson JM, Cook R, Person MK, Negrón ME, Traxler RM, Bower WA, Hendricks K. Risk Factors for Death or Meningitis in Adults Hospitalized for Cutaneous Anthrax, 1950-2018: A Systematic Review. Clin Infect Dis 2022; 75:S459-S467. [PMID: 36251551 PMCID: PMC9649426 DOI: 10.1093/cid/ciac533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Cutaneous anthrax accounts for approximately 95% of anthrax cases worldwide. About 24% of untreated patients die, and many cases are complicated by meningitis. Here, we explore clinical features of cutaneous disease associated with poor outcomes. METHODS A systematic review identified 303 full-text articles published from 1950 through 2018 that met predefined inclusion criteria. Cases were abstracted, and descriptive analyses and univariate logistic regression were conducted to identify prognostic indicators for cutaneous anthrax. RESULTS Of 182 included patients, 47 (25.8%) died. Previously reported independent predictors for death or meningitis that we confirmed included fever or chills; nausea or vomiting; headache; severe headache; nonheadache, nonmeningeal signs; leukocytosis; and bacteremia. Newly identified predictors included anxiety, abdominal pain, diastolic hypotension, skin trauma, thoracic edema, malignant pustule edema, lymphadenopathy, and evidence of coagulopathy (all with P < .05). CONCLUSIONS We identified patient presentations not previously associated with poor outcomes.
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Affiliation(s)
- Julie M Thompson
- Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112, USA
| | - Rachel Cook
- Oak Ridge Institute for Science and Education, CDC Fellowship Program, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
| | - Marissa K Person
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
| | - María E Negrón
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
| | - Rita M Traxler
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
| | - William A Bower
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
| | - Katherine Hendricks
- Correspondence: K. Hendricks, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Road, H24-12, Atlanta, GA 30329-4027 ()
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Parker CM, Karchmer AW, Fisher MC, Muhammad KM, Yu PA. Safety of Antimicrobials for Postexposure Prophylaxis and Treatment of Anthrax: A Review. Clin Infect Dis 2022; 75:S417-S431. [PMID: 36251549 PMCID: PMC9649414 DOI: 10.1093/cid/ciac592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Bacillus anthracis, the causative agent for anthrax, poses a potential bioterrorism threat and is capable of causing mass morbidity and mortality. Antimicrobials are the mainstay of postexposure prophylaxis (PEP) and treatment of anthrax. We conducted this safety review of 24 select antimicrobials to identify any new or emerging serious or severe adverse events (AEs) to help inform their risk-benefit evaluation for anthrax. METHODS Twenty-four antimicrobials were included in this review. Tertiary data sources (e.g. Lactmed, Micromedex, REPROTOX) were reviewed for safety information and summarized to evaluate the known risks of these antimicrobials. PubMed was also searched for published safety information on serious or severe AEs with these antimicrobials; AEs that met inclusion criteria were abstracted and reviewed. RESULTS A total of 1316 articles were reviewed. No consistent observations or patterns were observed among the abstracted AEs for a given antimicrobial; therefore, the literature review did not reveal evidence of new or emerging AEs that would add to the risk-benefit profiles already known from tertiary data sources. CONCLUSIONS The reviewed antimicrobials have known and/or potential serious or severe risks that may influence selection when recommending an antimicrobial for PEP or treatment of anthrax. Given the high fatality rate of anthrax, the risk-benefit evaluation favors use of these antimicrobials for anthrax. The potential risks of antimicrobials should not preclude these reviewed antimicrobials from clinical consideration for anthrax but rather guide appropriate antimicrobial selection and prioritization across different patient populations with risk mitigation measures as warranted.
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Affiliation(s)
- Corinne M Parker
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Adolf W Karchmer
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Margaret C Fisher
- Clinical Professor of Pediatrics, Rutgers Robert Wood Johnson School of Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA
| | - Kalimah M Muhammad
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education Centers for Disease Control and Prevention Fellowship Program, Atlanta, Georgia, USA
| | - Patricia A Yu
- Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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29
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Lombarte Espinosa E, Villuendas Usón MC, Arribas García J, Jado García I, Huarte Lacunza R, Zárate Chug P, Claraco Vega LM, Jesús Santed Andrés M, Ríos MJ, Cook R, Simard JM, Boyer AE, Rezusta A. Survival of Patient With Hemorrhagic Meningitis Associated With Inhalation Anthrax. Clin Infect Dis 2022; 75:S364-S372. [PMID: 36251557 DOI: 10.1093/cid/ciac531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 11/05/2022] Open
Abstract
This report describes a 49-year-old male construction worker who acquired a Bacillus anthracis infection after working on a sheep farm. He experienced a severe respiratory infection, septic shock, and hemorrhagic meningoencephalitis with severe intracranial hypertension. After several weeks with multiple organ dysfunction syndrome, he responded favorably to antibiotic treatment. Three weeks into his hospitalization, an intracranial hemorrhage and cerebral edema led to an abrupt deterioration in his neurological status. A single dose of raxibacumab was added to his antimicrobial regimen on hospital day 27. His overall status, both clinical and radiographic, improved within a few days. He was discharged 2 months after admission and appears to have fully recovered.
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Affiliation(s)
- Evelyn Lombarte Espinosa
- Servicio Medicina Intensiva, UCI Polivalente, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - Isabel Jado García
- Laboratorio de Referencia e Investigación en Patógenos Especiales, Centro Nacional de Microbiología. Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Huarte Lacunza
- Servicio de Farmacia Hospitalaria, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Paola Zárate Chug
- Servicio Medicina Intensiva, UCI Polivalente, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Luis Manuel Claraco Vega
- Servicio Medicina Intensiva, UCI Polivalente, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - María Jiménez Ríos
- Servicio Medicina Intensiva, UCI Polivalente, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Rachel Cook
- Oak Ridge Institute for Science and Education, CDC Fellowship Program, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - J Marc Simard
- Departments of Neurosurgery, Pathology and Physiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Anne E Boyer
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Antonio Rezusta
- Servicio Microbiología, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, Spain
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Binney S, Person MK, Traxler RM, Cook R, Bower WA, Hendricks K. Algorithms for the Identification of Anthrax Meningitis During a Mass Casualty Event Based on a Systematic Review of Systemic Anthrax From 1880 Through 2018. Clin Infect Dis 2022; 75:S468-S477. [PMID: 36251554 PMCID: PMC9649431 DOI: 10.1093/cid/ciac546] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND During an anthrax mass casualty event, prompt identification of patients with anthrax meningitis is important. Previous research has suggested use of a screening tool based on neurological symptoms and signs. METHODS Using historical anthrax patient data from 1880 through 2018, we analyzed risk factors for meningitis. We developed lists of symptoms and signs (ie, algorithms) for predicting meningitis with high sensitivity and specificity. We evaluated both single and paired algorithms as screening tools. RESULTS A single algorithm with 1 or more neurological symptoms or signs identifying patients with likely meningitis achieved high sensitivity (86%; 95% confidence interval [CI], 71%-100%) and specificity (90%; 95% CI, 82%-98%). Pairing algorithms with the same symptoms and signs (severe headache, altered mental status, meningeal signs, and "other neurological deficits") improved specificity (99%; 95% CI, 97%-100%) but left 17.3% of patients in a middle "indeterminate" meningitis category and in need of additional diagnostic testing to determine likely meningitis status. Pairing algorithms with differing symptoms and signs also improved specificity over the single algorithm (92%; 95% CI, 85%-99%) but categorized just 2.5% of patients as indeterminate. CONCLUSIONS Our study confirms prior research suggesting quick and reliable assessment of patients for anthrax meningitis is possible based on the presence or absence of certain symptoms and signs. A single algorithm was adequate; however, if we assumed low-resource diagnostic testing was feasible for some patients, pairing algorithms improved specificity. Pairing algorithms with differing symptoms and signs minimized the proportion of patients requiring additional diagnostics.
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Affiliation(s)
- Sophie Binney
- Correspondence: S. Binney, School of Public Health, Georgia State University, 1083 Seville Dr, Clarkston, GA, 30021 ()
| | - Marissa K Person
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rita M Traxler
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rachel Cook
- Oak Ridge Institute for Science and Education, CDC Fellowship Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William A Bower
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katherine Hendricks
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Kutmanova A, Zholdoshev S, Roguski KM, Sholpanbay uulu M, Person MK, Cook R, Bugrysheva J, Nadol P, Buranchieva A, Imanbaeva L, Dzhangazieva A, Bower WA, Hendricks K. Risk Factors for Severe Cutaneous Anthrax in a Retrospective Case Series and Use of a Clinical Algorithm to Identify Likely Meningitis and Evaluate Treatment Outcomes, Kyrgyz Republic, 2005-2012. Clin Infect Dis 2022; 75:S478-S486. [PMID: 36251556 PMCID: PMC9649429 DOI: 10.1093/cid/ciac537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND US Centers for Disease Control and Prevention guidelines currently recommend triple-therapy antimicrobial treatment for anthrax meningitis. In the Kyrgyz Republic, a country with endemic anthrax, cutaneous anthrax patients are routinely hospitalized and treated successfully with only monotherapy or dual therapy. Clinical algorithms have been developed to identify patients with likely anthrax meningitis based on signs and symptoms alone. We sought to retrospectively identify likely meningitis patients in the Kyrgyz Republic using a clinical algorithm and evaluate risk factors and their outcomes by type of treatment. METHODS We conducted a retrospective chart review of cutaneous anthrax patients in the Kyrgyz Republic from 2005 through 2012. Using previous methods, we developed a highly specific algorithm to categorize patients by meningitis status. We then evaluated patient risk factors, treatments, and outcomes by disease severity and meningitis status. RESULTS We categorized 37 of 230 cutaneous anthrax patients as likely having meningitis. All 37 likely meningitis patients survived, receiving only mono- or dual-therapy antimicrobials. We identified underlying medical conditions, such as obesity, hypertension, and chronic obstructive pulmonary disease, and tobacco and alcohol use, as potential risk factors for severe anthrax and anthrax meningitis. CONCLUSIONS Based on our analyses, treatment of anthrax meningitis may not require 3 antimicrobials, which could impact future anthrax treatment recommendations. In addition, chronic comorbidities may increase risk for severe anthrax and anthrax meningitis. Future research should further investigate potential risk factors for severe anthrax and their impact on laboratory-confirmed meningitis and evaluate mono- and dual-therapy antimicrobial regimens for anthrax meningitis.
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Affiliation(s)
- Ainura Kutmanova
- Correspondence: A. Kutmanova, PhD, Department of Infectious Diseases, International Higher School of Medicine, 720054 Bishkek, Kyrgyz Republic ()
| | - Saparbai Zholdoshev
- Department of Epidemiology, Microbiology with a course of Infectious Diseases, Osh State University, Osh, Kyrgyz Republic
| | - Katherine M Roguski
- Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melis Sholpanbay uulu
- Department of Infectious Diseases, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
| | - Marissa K Person
- Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rachel Cook
- Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Julia Bugrysheva
- Division of Preparedness and Emerging Infections, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Patrick Nadol
- CDC Kyrgyzstan, US Centers for Disease Control and Prevention, Bishkek, Kyrgyz Republic
| | - Aisuluu Buranchieva
- Department of Infectious Diseases, International Higher School of Medicine, Bishkek, Kyrgyz Republic
| | - Lira Imanbaeva
- Department of Infectious Diseases, International Higher School of Medicine, Bishkek, Kyrgyz Republic
| | - Ainura Dzhangazieva
- Department of Infectious Diseases, International Higher School of Medicine, Bishkek, Kyrgyz Republic
| | - William A Bower
- Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katherine Hendricks
- Division of High-Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Kennedy JL, Bulitta JB, Chatham-Stephens K, Person MK, Cook R, Mongkolrattanothai T, Shin E, Yu P, Negron ME, Bower WA, Hendricks K. Postexposure Prophylaxis and Treatment of Bacillus anthracis Infections: A Systematic Review and Meta-analyses of Animal Models, 1947-2019. Clin Infect Dis 2022; 75:S379-S391. [PMID: 36251546 PMCID: PMC9649436 DOI: 10.1093/cid/ciac591] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Anthrax is endemic to many countries, including the United States. The causative agent, Bacillus anthracis, poses a global bioterrorism threat. Without effective antimicrobial postexposure prophylaxis (PEPAbx) and treatment, the mortality of systemic anthrax is high. To inform clinical guidelines for PEPAbx and treatment of B. anthracis infections in humans, we systematically evaluated animal anthrax treatment model studies. METHODS We searched for survival outcome data in 9 scientific search engines for articles describing antimicrobial PEPAbx or treatment of anthrax in animals in any language through February 2019. We performed meta-analyses of efficacy of antimicrobial PEPAbx and treatment for each drug or drug combination using random-effects models. Pharmacokinetic/pharmacodynamic relationships were developed for 5 antimicrobials with available pharmacokinetic data. Monte Carlo simulations were used to predict unbound drug exposures in humans. RESULTS We synthesized data from 34 peer-reviewed studies with 3262 animals. For PEPAbx and treatment of infection by susceptible B. anthracis, effective monotherapy can be accomplished with fluoroquinolones, tetracyclines, β-lactams (including penicillin, amoxicillin-clavulanate, and imipenem-cilastatin), and lipopeptides or glycopeptides. For naturally occurring strains, unbound drug exposures in humans were predicted to adequately cover the minimal inhibitory concentrations (MICs; those required to inhibit the growth of 50% or 90% of organisms [MIC50 or MIC90]) for ciprofloxacin, levofloxacin, and doxycycline for both the PEPAbx and treatment targets. Dalbavancin covered its MIC50 for PEPAbx. CONCLUSIONS These animal studies show many reviewed antimicrobials are good choices for PEPAbx or treatment of susceptible B. anthracis strains, and some are also promising options for combating resistant strains. Monte Carlo simulations suggest that oral ciprofloxacin, levofloxacin, and doxycycline are particularly robust choices for PEPAbx or treatment.
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Affiliation(s)
- Jordan L Kennedy
- Correspondence: J. L. Kennedy, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, 1600 Clifton Rd, H24-12, Atlanta, GA 30329-4027 ()
| | - Jürgen B Bulitta
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, Florida, USA
| | - Kevin Chatham-Stephens
- Division of Human Development and Disability, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marissa K Person
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rachel Cook
- Oak Ridge Institute for Science and Education, CDC Fellowship Program, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Thitipong Mongkolrattanothai
- Oak Ridge Institute for Science and Education, CDC Fellowship Program, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eunjeong Shin
- Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, Orlando, Florida, USA
| | - Patricia Yu
- Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maria E Negron
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William A Bower
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katherine Hendricks
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Hendricks K, Person MK, Bradley JS, Mongkolrattanothai T, Hupert N, Eichacker P, Friedlander AM, Bower WA. Clinical Features of Patients Hospitalized for All Routes of Anthrax, 1880-2018: A Systematic Review. Clin Infect Dis 2022; 75:S341-S353. [PMID: 36251560 PMCID: PMC9649428 DOI: 10.1093/cid/ciac534] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Anthrax is a toxin-mediated zoonotic disease caused by Bacillus anthracis, with a worldwide distribution recognized for millennia. Bacillus anthracis is considered a potential biowarfare agent. METHODS We completed a systematic review for clinical and demographic characteristics of adults and children hospitalized with anthrax (cutaneous, inhalation, ingestion, injection [from contaminated heroin], primary meningitis) abstracted from published case reports, case series, and line lists in English from 1880 through 2018, assessing treatment impact by type and severity of disease. We analyzed geographic distribution, route of infection, exposure to anthrax, and incubation period. RESULTS Data on 764 adults and 167 children were reviewed. Most cases reported for 1880 through 1915 were from Europe; those for 1916 through 1950 were from North America; and from 1951 on, cases were from Asia. Cutaneous was the most common form of anthrax for all populations. Since 1960, adult anthrax mortality has ranged from 31% for cutaneous to 90% for primary meningitis. Median incubation periods ranged from 1 day (interquartile range [IQR], 0-4) for injection to 7 days (IQR, 4-9) for inhalation anthrax. Most patients with inhalation anthrax developed pleural effusions and more than half with ingestion anthrax developed ascites. Treatment and critical care advances have improved survival for those with systemic symptoms, from approximately 30% in those untreated to approximately 70% in those receiving antimicrobials or antiserum/antitoxin. CONCLUSIONS This review provides an improved evidence base for both clinical care of individual anthrax patients and public health planning for wide-area aerosol releases of B. anthracis spores.
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Affiliation(s)
- Katherine Hendricks
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marissa K Person
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John S Bradley
- Division of Infectious Diseases, Rady Children’s Hospital San Diego and the University of California San Diego School of Medicine, San Diego, California, USA
| | - Thitipong Mongkolrattanothai
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA,Oak Ridge Institute for Science and Education, CDC Fellowship Program, Oak Ridge, Tennessee, USA
| | - Nathaniel Hupert
- Departments of Population Health Sciences and of Medicine, Weill Cornell Medicine, Cornell University, and New York-Presbyterian Hospital, New York, New York, USA
| | - Peter Eichacker
- Department of Critical Care Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Arthur M Friedlander
- US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA,Department of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA
| | - William A Bower
- Correspondence: W. A. Bower, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS H24-12, Atlanta, GA 30329, USA ()
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Person MK, Cook R, Bradley JS, Hupert N, Bower WA, Hendricks K. Systematic Review of Hospital Treatment Outcomes for Naturally Acquired and Bioterrorism-Related Anthrax, 1880-2018. Clin Infect Dis 2022; 75:S392-S401. [PMID: 36251553 PMCID: PMC9649424 DOI: 10.1093/cid/ciac536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Bacillus anthracis can cause anthrax and is a potential bioterrorism agent. The 2014 Centers for Disease Control and Prevention recommendations for medical countermeasures against anthrax were based on in vitro data and expert opinion. However, a century of previously uncompiled observational human data that often includes treatment and outcomes is available in the literature for analysis. METHODS We reviewed treatment outcomes for patients hospitalized with anthrax. We stratified patients by meningitis status, route of infection, and systemic criteria, then analyzed survival by treatment type, including antimicrobials, antitoxin/antiserum, and steroids. Using logistic regression, we calculated odds ratios and 95% confidence intervals to compare survival between treatments. We also calculated hospital length of stay. Finally, we evaluated antimicrobial postexposure prophylaxis (PEPAbx) using data from a 1970 Russian-language article. RESULTS We identified 965 anthrax patients reported from 1880 through 2018. After exclusions, 605 remained: 430 adults, 145 children, and 30 missing age. Survival was low for untreated patients and meningitis patients, regardless of treatment. Most patients with localized cutaneous or nonmeningitis systemic anthrax survived with 1 or more antimicrobials; patients with inhalation anthrax without meningitis fared better with at least 2. Bactericidal antimicrobials were effective for systemic anthrax; addition of a protein synthesis inhibitor(s) (PSI) to a bactericidal antimicrobial(s) did not improve survival. Likewise, addition of antitoxin/antiserum to antimicrobials did not improve survival. Mannitol improved survival for meningitis patients, but steroids did not. PEPAbx reduced risk of anthrax following exposure to B. anthracis. CONCLUSIONS Combination therapy appeared to be superior to monotherapy for inhalation anthrax without meningitis. For anthrax meningitis, neither monotherapy nor combination therapy were particularly effective; however, numbers were small. For localized cutaneous anthrax, monotherapy was sufficient. For B. anthracis exposures, PEPAbx was effective.
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Affiliation(s)
- Marissa K Person
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rachel Cook
- Oak Ridge Institute for Science and Education, CDC Fellowship Program, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, USA
| | - John S Bradley
- Division of Infectious Diseases, Rady Children’s Hospital San Diego and the University of California San Diego School of Medicine, San Diego, California, USA
| | - Nathaniel Hupert
- Departments of Population Health Sciences and of Medicine, Weill Cornell Medicine (Cornell University) and New York-Presbyterian Hospital, New York, New York, USA
| | - William A Bower
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katherine Hendricks
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Abstract
The neurological sequelae of Bacillus anthracis infection include a rapidly progressive fulminant meningoencephalitis frequently associated with intracranial hemorrhage, including subarachnoid and intracerebral hemorrhage. Higher mortality than other forms of bacterial meningitis suggests that antimicrobials and cardiopulmonary support alone may be insufficient and that strategies targeting the hemorrhage might improve outcomes. In this review, we describe the toxic role of intracranial hemorrhage in anthrax meningoencephalitis. We first examine the high incidence of intracranial hemorrhage in patients with anthrax meningoencephalitis. We then review common diseases that present with intracranial hemorrhage, including aneurysmal subarachnoid hemorrhage and spontaneous intracerebral hemorrhage, postulating applicability of established and potential neurointensive treatments to the multimodal management of hemorrhagic anthrax meningoencephalitis. Finally, we examine the therapeutic potential of minocycline, an antimicrobial that is effective against B. anthracis and that has been shown in preclinical studies to have neuroprotective properties, which thus might be repurposed for this historically fatal disease.
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Affiliation(s)
- Nicholas Caffes
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Katherine Hendricks
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - John S Bradley
- Department of Pediatrics, San Diego School of Medicine and Rady Children’s Hospital, University of California, San Diego, California, USA
| | - Nancy A Twenhafel
- Division of Pathology, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - J Marc Simard
- Correspondence: J. M. Simard, Department of Neurosurgery, University of Maryland School of Medicine, 22 S Greene St, Suite S12D, Baltimore, MD 21201, USA ()
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Matharoo K, Chua J, Park JR, Ingavale S, Jelacic TM, Jurkouich KM, Compton JR, Meinig JM, Chabot D, Friedlander AM, Legler PM. Engineering an Fc-Fusion of a Capsule Degrading Enzyme for the Treatment of Anthrax. ACS Infect Dis 2022; 8:2133-2148. [PMID: 36102590 DOI: 10.1021/acsinfecdis.2c00227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Polymers of d-glutamic acid (PDGA) form the capsule of the highly virulent Ames strain of B. anthracis. PDGA is antiphagocytic and weakly immunogenic; it enables the bacteria to evade the innate immune responses. CapD is an enzyme that catalyzes the covalent anchoring of PDGA. CapD is an Ntn-amido hydrolase that utilizes an internal Thr-352 as its nucleophile and general acid and base. An internal cleavage produces a free N-terminal Thr-352 and a short and long polypeptide chain. The chains were circularly permuted (CP) to move Thr-352 to the N-terminus of the polypeptide. We previously showed that a branched PEG-CapDS334C-CP could protect mice (80% survival) against a 5 LD50 challenge with B. anthracis Ames without the use of antibiotics, monoclonals, or vaccines. In attempts to improve the in vivo circulation time of CapD and enhance its avidity to its polymeric substrate, an Fc-domain of a mouse IgG1 was fused to CapDS334C-CP and the linker length and sequence were optimized. The resulting construct, Fc-CapDS334C-CP, then was pegylated with a linear 2 kDa mPEG at S334C to produce mPEG-Fc-CapDS334C-CP. Interestingly, the fusion of the Fc-domain and incorporation of the S334C mutation imparted acid stability, but slightly reduced the kcat (∼ 2-fold lower). In vivo, the measured protein concentration in sera was higher for the Fc-fusion constructs compared to the mPEG-Fc-CapDS334C-CP. However, the exposure calculated from measured sera enzymatic activity was higher for the mPEG-CapDS334C-CP. The pegylated Fc-fusion was less active than the PEG-CapDS334C-CP, but detectable in sera at 24 h by immunoblot. Here we describe the engineering of a soluble, active, pegylated Fc-fusion of B. anthracis CapD (mPEG-Fc-CapD-CP) with activity in vitro, in serum, and on encapsulated bacteria.
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Affiliation(s)
- Khushie Matharoo
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia 22904, United States
| | - Jennifer Chua
- United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702, United States
| | - Junyoung R Park
- West Springfield High School, Springfield, Virginia 22152, United States
| | - Susham Ingavale
- United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702, United States
| | - Tanya M Jelacic
- United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702, United States
| | - Kayla M Jurkouich
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106, United States
| | - Jaimee R Compton
- Center for Bio/Molecular Science and Engineering, U.S. Naval Research Laboratories, Washington, D.C. 20375, United States
| | - J Matthew Meinig
- United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702, United States
| | - Donald Chabot
- United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702, United States
| | - Arthur M Friedlander
- United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702, United States
| | - Patricia M Legler
- Center for Bio/Molecular Science and Engineering, U.S. Naval Research Laboratories, Washington, D.C. 20375, United States
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Witt N, Galante D, Andreotti S, Abdel Glil M, Fasanella A, Meierhofer D, Tomaso H. Identification of Universally Applicable and Species-Specific Marker Peptides for Bacillus anthracis. Life (Basel) 2022; 12:1549. [PMID: 36294983 DOI: 10.3390/life12101549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/09/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022]
Abstract
Anthrax is a zoonotic infection caused by the bacterium Bacillus anthracis (BA). Specific identification of this pathogen often relies on targeting genes located on two extrachromosomal plasmids, which represent the major pathogenicity factors of BA. However, more recent findings show that these plasmids have also been found in other closely related Bacillus species. In this study, we investigated the possibility of identifying species-specific and universally applicable marker peptides for BA. For this purpose, we applied a high-resolution mass spectrometry-based approach for 42 BA isolates. Along with the genomic sequencing data and by developing a bioinformatics data evaluation pipeline, which uses a database containing most of the publicly available protein sequences worldwide (UniParc), we were able to identify eleven universal marker peptides unique to BA. These markers are located on the chromosome and therefore, might overcome known problems, such as observable loss of plasmids in environmental species, plasmid loss during cultivation in the lab, and the fact that the virulence plasmids are not necessarily a unique feature of BA. The identified chromosomally encoded markers in this study could extend the small panel of already existing chromosomal targets and along with targets for the virulence plasmids, may pave the way to an even more reliable identification of BA using genomics- as well as proteomics-based techniques.
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Carroll LM, Matle I, Kovac J, Cheng RA, Wiedmann M. Laboratory Misidentifications Resulting from Taxonomic Changes to Bacillus cereus Group Species, 2018-2022. Emerg Infect Dis 2022; 28:1877-1881. [PMID: 35997597 PMCID: PMC9423903 DOI: 10.3201/eid2809.220293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Whole-genome sequencing (WGS) is being applied increasingly to Bacillus cereus group species; however, misinterpretation of WGS results may have severe consequences. We report 3 cases, 1 of which was an outbreak, in which misinterpretation of B. cereus group WGS results hindered communication within public health and industrial laboratories.
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Deka MA, Vieira AR, Bower WA. Modelling the ecological niche of naturally occurring anthrax at global and circumpolar extents using an ensemble modelling framework. Transbound Emerg Dis 2022; 69:e2563-e2577. [PMID: 35590480 PMCID: PMC10961590 DOI: 10.1111/tbed.14602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/25/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
Bacillus anthracis, the causative agent of anthrax, is a spore-forming bacterium that primarily affects herbivorous livestock, wildlife and humans exposed to direct contact with infected animal carcasses or products. To date, there are a limited number of studies that have delineated the potential global distribution of anthrax, despite the importance of the disease from both an economic and public health standpoint. This study compiled occurrence data (n = 874) of confirmed human and animal cases from 1954 to 2021 in 94 countries. Using an ensemble ecological niche model framework, we developed updated maps of the global predicted ecological suitability of anthrax to measure relative risk at multiple scales of analysis, including a model for circumpolar regions. Additionally, we produced maps quantifying the disease transmission risk associated with anthrax to cattle, sheep and goat populations. Environmental suitability for B. anthracis globally is concentred throughout Eurasia, sub-Saharan Africa, the Americas, Southeast Asia, Australia and Oceania. Suitable environments for B. anthracis at the circumpolar scale extend above the Arctic Circle into portions of Russia, Canada, Alaska and northern Scandinavia. Environmental factors driving B. anthracis suitability globally include vegetation, land surface temperature, soil characteristics, primary climate conditions and topography. At the circumpolar scale, suitability is influenced by soil factors, topography and the derived climate characteristics. The greatest risk to livestock is concentrated within the Indian subcontinent, Australia, Anatolia, the Caucasus region, Central Asia, the European Union, Argentina, Uruguay, China, the United States, Canada and East Africa. This study expands on previous work by providing enhanced knowledge of the potential spatial distribution of anthrax in the Southern Hemisphere, sub-Saharan Africa, Asia and circumpolar regions of the Northern Hemisphere. We conclude that these updated maps will provide pertinent information to guide disease control programs, inform policymakers and raise awareness at the global level to lessen morbidity and mortality among animals and humans located in environmentally suitable areas.
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Affiliation(s)
- Mark A Deka
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Antonio R Vieira
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William A Bower
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Bower WA, Hendricks KA, Vieira AR, Traxler RM, Weiner Z, Lynfield R, Hoffmaster A. What Is Anthrax? Pathogens 2022; 11:690. [PMID: 35745544 DOI: 10.3390/pathogens11060690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022] Open
Abstract
Anthrax has been feared for its high mortality in animals and humans for centuries. The etiologic agent is considered a potentially devastating bioweapon, and since 1876―when Robert Koch demonstrated that Bacillus anthracis caused anthrax―it has been considered the sole cause of the disease. Anthrax is, however, a toxin-mediated disease. The toxins edema toxin and lethal toxin are formed from protein components encoded for by the pXO1 virulence plasmid present in pathogenic B. anthracis strains. However, other members of the Bacillus cereus group, to which B. anthracis belongs, have recently been shown to harbor the pXO1 plasmid and produce anthrax toxins. Infection with these Bacillus cereus group organisms produces a disease clinically similar to anthrax. This suggests that anthrax should be defined by the exotoxins encoded for by the pXO1 plasmid rather than the bacterial species it has historically been associated with, and that the definition of anthrax should be expanded to include disease caused by any member of the B. cereus group containing the toxin-producing pXO1 plasmid or anthrax toxin genes specifically.
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Bakhteeva I, Timofeev V. Some Peculiarities of Anthrax Epidemiology in Herbivorous and Carnivorous Animals. Life (Basel) 2022; 12:life12060870. [PMID: 35743901 PMCID: PMC9224990 DOI: 10.3390/life12060870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 11/28/2022]
Abstract
Anthrax is an especially dangerous zooanthroponosis caused by the Gram-positive spore-forming bacterium Bacillus anthracis. A notable feature of this disease is the difference in susceptibility to it among different groups of animals. Anthrax primarily affects herbivorous ungulate mammals; they are easily infected, and their disease often leads to rapid, even sudden, death. However, predators and scavengers are extremely resistant to anthrax, and if they become infected, they usually become mildly ill. As the result of the increased sensitivity of ungulates to anthrax and the possibility of disease transmission from them to humans, most studies of anthrax have focused on the diagnosis, prevention, and treatment of infection in farm animals and humans. The issues of anthrax in other animals, such as predators, and the peculiarities of anthrax epidemiology in wild ungulates have not been sufficiently detailed in the literature. In this article, we provide a review of literature sources that describe the differential susceptibility to infection of various groups of animals to anthrax and some epidemiological features of anthrax in animals that are not the main hosts of B. anthracis.
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Gates-Hollingsworth MA, Kolton CB, Hoffmaster AR, Meister GT, Moore AE, Green HR, Pogoda JM, Pillai SP, Kozel TR. Rapid Capsular Antigen Immunoassay for Diagnosis of Inhalational Anthrax: Preclinical Studies and Evaluation in a Nonhuman Primate Model. mBio 2022;:e0093122. [PMID: 35546539 DOI: 10.1128/mbio.00931-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Inhalational anthrax is a fatal infectious disease. Rapid and effective treatment is critically dependent on early and accurate diagnosis. Blood culture followed by identification and confirmation may take days to provide clinically relevant information. In contrast, immunoassay for a shed antigen, the capsular polypeptide gamma-d-polyglutamate (γDPGA), can provide rapid results at the point of care. In this study, a lateral flow immunoassay for γDPGA was evaluated in a robust nonhuman primate model of inhalational anthrax. The results showed that the time to a positive result with the rapid test using either serum or blood as a clinical specimen was similar to the time after infection when a blood culture became positive. In vitro testing showed that the test was equally sensitive with cultures of the three major clades of Bacillus anthracis. Cultures from other Bacillus spp. that are known to produce γDPGA also produced positive results. The test was negative with human sera from 200 normal subjects and 45 subjects with culture-confirmed nonanthrax bacterial or fungal sepsis. Taken together, the results showed that immunoassay for γDPGA is an effective surrogate for blood culture in a relevant cynomolgus monkey model of inhalational anthrax. The test would be a valuable aid in early diagnosis of anthrax, which is critical for rapid intervention and a positive outcome. Use of the test could facilitate triage of patients with signs and symptoms of anthrax in a mass-exposure incident and in low-resource settings where laboratory resources are not readily available.
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Luta EP, Miller BL. Development of Methods for Specific Capture of Biological Targets on Aluminum Substrates: Application to Bacillus subtilis Spore Detection as a Model for Anthrax. Sensors (Basel) 2022; 22:3441. [PMID: 35591130 DOI: 10.3390/s22093441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/20/2022] [Accepted: 04/26/2022] [Indexed: 02/04/2023]
Abstract
Many (if not most) biosensors rely on functional silane coatings as a first step toward covalent immobilization of specific capture molecules. While methods for silanization of silica (SiO2) surfaces are very well developed, less has been done to develop and characterize silanization methods for alternative substrates, such as alumina (Al2O3). In particular, the behavior of Al2O3 coatings grown on aluminum under ambient conditions has not been studied. To address this issue, we have tested solution-phase deposition of two silanes on Al2O3 (3-aminopropyl triethoxysilane and 3-triethoxysilyl)propylsuccinic anhydride) and their applicability to analyte-specific biosensing. Contact angle measurements and imaging via Scanning Electron Microsopy (SEM) were employed to characterize surfaces. We find that 3-aminopropyl triethoxysilane produces well-behaved films and demonstrate that this surface can undergo further reaction with glutaraldehyde followed by an anti-Bacillus subtilis antibody to yield functionalized Al2O3 surfaces capable of specific capture of B. subtilis spores (a model of B. anthracis, the causative organism of Anthrax). In contrast, 3-triethoxysilyl)propylsuccinic anhydride did not behave well with Al/Al2O3 under the reaction conditions tested. In addition to providing specific protocols for Al/Al2O3 functionalization, this work highlights the importance of surface chemistry assessment in the development of new sensors.
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Song X, Zhang W, Zhai L, Guo J, Zhao Y, Zhang L, Hu L, Xiong X, Zhou D, Lv M, Yang W. Aerosolized Intratracheal Inoculation of Recombinant Protective Antigen (rPA) Vaccine Provides Protection Against Inhalational Anthrax in B10.D2-Hc 0 Mice. Front Immunol 2022; 13:819089. [PMID: 35154137 PMCID: PMC8826967 DOI: 10.3389/fimmu.2022.819089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Anthrax caused by Bacillus anthracis is a fatal zoonotic disease with a high lethality and poor prognosis. Inhalational anthrax is the most severe of the three forms of anthrax. The currently licensed commercial human anthrax vaccines require a complex immunization procedure for efficacy and have side effects that limit its use in emergent situations. Thus, development of a better anthrax vaccine is necessary. In this study, we evaluate the potency and efficacy of aerosolized intratracheal (i.t.) inoculation with recombinant protective antigen (rPA) subunit vaccines against aerosolized B. anthracis Pasteur II spores (an attenuated strain) challenge in a B10.D2-Hc0 mouse (deficient in complement component C5) model. Immunization of rPA in liquid, powder or powder reconstituted formulations via i.t. route conferred 100% protection against a 20× LD50 aerosolized Pasteur II spore challenge in mice, compared with only 50% of subcutaneous (s.c.) injection with liquid rPA. Consistently, i.t. inoculation of rPA vaccines induced a higher lethal toxin (LeTx) neutralizing antibody titer, a stronger lung mucosal immune response and a greater cellular immune response than s.c. injection. Our results demonstrate that immunization with rPA dry powder vaccine via i.t. route may provide a stable and effective strategy to improve currently available anthrax vaccines and B10.D2-Hc0 mice challenged with B. anthracis attenuated strains might be an alternative model for anthrax vaccine candidate screening.
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Affiliation(s)
- Xiaolin Song
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Wei Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Lina Zhai
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Jianshu Guo
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Yue Zhao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Lili Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Lingfei Hu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Xiaolu Xiong
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Dongsheng Zhou
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Meng Lv
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Wenhui Yang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
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Thomas G, Couture F, Kwiatkowska A. The Path to Therapeutic Furin Inhibitors: From Yeast Pheromones to SARS-CoV-2. Int J Mol Sci 2022; 23:3435. [PMID: 35408793 DOI: 10.3390/ijms23073435] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 02/06/2023] Open
Abstract
The spurious acquisition and optimization of a furin cleavage site in the SARS-CoV-2 spike protein is associated with increased viral transmission and disease, and has generated intense interest in the development and application of therapeutic furin inhibitors to thwart the COVID-19 pandemic. This review summarizes the seminal studies that informed current efforts to inhibit furin. These include the convergent efforts of endocrinologists, virologists, and yeast geneticists that, together, culminated in the discovery of furin. We describe the pioneering biochemical studies which led to the first furin inhibitors that were able to block the disease pathways which are broadly critical for pathogen virulence, tumor invasiveness, and atherosclerosis. We then summarize how these studies subsequently informed current strategies leading to the development of small-molecule furin inhibitors as potential therapies to combat SARS-CoV-2 and other diseases that rely on furin for their pathogenicity and progression.
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Abstract
Bacillus anthracis, the anthrax agent, exhibits robust proliferation in diverse niches of mammalian hosts. The metabolic attributes of B. anthracis that permit rapid growth in multiple mammalian tissues have not been established. We posit that branched-chain amino acid (BCAA) (isoleucine, leucine, and valine) metabolism is key to B. anthracis pathogenesis. Increasing evidence indicates the relationships between B. anthracis virulence and the expression of BCAA-related genes. The expression of some BCAA-related genes is altered during culture in bovine blood in vitro, and the bacterium exhibits valine auxotrophy in a blood serum mimic medium. Transcriptome analyses have revealed that the virulence regulator AtxA, which positively affects the expression of the anthrax toxin and capsule genes, negatively regulates genes predicted to be associated with BCAA biosynthesis and transport. Here, we show that B. anthracis growth in defined medium is severely restricted in the absence of exogenous BCAAs, indicating that BCAA transport is required for optimal growth in vitro. We demonstrate functional redundancy among multiple BrnQ-type BCAA transporters. Three transporters are associated with isoleucine and valine transport, and the deletion of one, BrnQ3, attenuates virulence in a murine model for anthrax. Interestingly, an ilvD-null mutant lacking dihydroxy acid dehydratase, an enzyme essential for BCAA synthesis, exhibits unperturbed growth when cultured in medium containing BCAAs but is highly attenuated in the murine model. Finally, our data show that BCAAs enhance AtxA activity in a dose-dependent manner, suggesting a model in which BCAAs serve as a signal for virulence gene expression. IMPORTANCE Infection with B. anthracis can result in systemic disease with large numbers of the bacterium in multiple tissues. We found that branched-chain amino acid (BCAA) synthesis is insufficient for the robust growth of B. anthracis; access to BCAAs is necessary for the proliferation of the pathogen during culture and during infection in a murine model for anthrax. B. anthracis produces an unusually large repertoire of BCAA-related transporters. We identified three isoleucine/valine transporters with partial functional redundancy during culture. The deletion of one of these transporters, BrnQ3, resulted in attenuated virulence. Interestingly, a BCAA biosynthesis mutant grew well in medium containing BCAAs but, like BrnQ3, was attenuated for virulence. These results suggest that BCAAs are limiting in multiple niches during infection and further our understanding of the nutritional requirements of this important pathogen.
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Braun P, Zimmermann F, Walter MC, Mantel S, Aistleitner K, Stürz I, Grass G, Stoecker K. In-Depth Analysis of Bacillus anthracis 16S rRNA Genes and Transcripts Reveals Intra- and Intergenomic Diversity and Facilitates Anthrax Detection. mSystems 2022;:e0136121. [PMID: 35076271 DOI: 10.1128/msystems.01361-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Analysis of 16S rRNA (rRNA) genes provides a central means of taxonomic classification of bacterial species. Based on presumed sequence identity among species of the Bacillus cereus sensu lato group, the 16S rRNA genes of B. anthracis have been considered unsuitable for diagnosis of the anthrax pathogen. With the recent identification of a single nucleotide polymorphism in some 16S rRNA gene copies, specific identification of B. anthracis becomes feasible. Here, we designed and evaluated a set of in situ, in vitro, and in silico assays to assess the unknown 16S state of B. anthracis from different perspectives. Using a combination of digital PCR, fluorescence in situ hybridization, long-read genome sequencing, and bioinformatics, we were able to detect and quantify a unique 16S rRNA gene allele of B. anthracis (16S-BA-allele). This allele was found in all available B. anthracis genomes and may facilitate differentiation of the pathogen from any close relative. Bioinformatics analysis of 959 B. anthracis SRA data sets inferred that abundances and genomic arrangements of the 16S-BA-allele and the entire rRNA operon copy numbers differ considerably between strains. Expression ratios of 16S-BA-alleles were proportional to the respective genomic allele copy numbers. The findings and experimental tools presented here provide detailed insights into the intra- and intergenomic diversity of 16S rRNA genes and may pave the way for improved identification of B. anthracis and other pathogens with diverse rRNA operons. IMPORTANCE For severe infectious diseases, precise pathogen detection is crucial for antibiotic therapy and patient survival. Identification of Bacillus anthracis, the causative agent of the zoonosis anthrax, can be challenging when querying specific nucleotide sequences such as in small subunit rRNA (16S rRNA) genes, which are commonly used for typing of bacteria. This study analyzed on a broad genomic scale a cryptic and hitherto underappreciated allelic variant of the bacterium’s 16S rRNA genes and their transcripts using a set of in situ, in vitro, and in silico assays and found significant intra- and intergenomic heterogeneity in the distribution of the allele and overall rRNA operon copy numbers. This allelic variation was uniquely species specific, which enabled sensitive pathogen detection on both DNA and transcript levels. The methodology used here is likely also applicable to other pathogens that are otherwise difficult to discriminate from their less harmful relatives.
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Van Hauwermeiren F, Van Opdenbosch N, Van Gorp H, de Vasconcelos N, van Loo G, Vandenabeele P, Kanneganti TD, Lamkanfi M. Bacillus anthracis induces NLRP3 inflammasome activation and caspase-8-mediated apoptosis of macrophages to promote lethal anthrax. Proc Natl Acad Sci U S A 2022; 119:e2116415119. [PMID: 34996874 PMCID: PMC8764678 DOI: 10.1073/pnas.2116415119] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 12/29/2022] Open
Abstract
Lethal toxin (LeTx)-mediated killing of myeloid cells is essential for Bacillus anthracis, the causative agent of anthrax, to establish systemic infection and induce lethal anthrax. The "LeTx-sensitive" NLRP1b inflammasome of BALB/c and 129S macrophages swiftly responds to LeTx intoxication with pyroptosis and secretion of interleukin (IL)-1β. However, human NLRP1 is nonresponsive to LeTx, prompting us to investigate B. anthracis host-pathogen interactions in C57BL/6J (B6) macrophages and mice that also lack a LeTx-sensitive Nlrp1b allele. Unexpectedly, we found that LeTx intoxication and live B. anthracis infection of B6 macrophages elicited robust secretion of IL-1β, which critically relied on the NLRP3 inflammasome. TNF signaling through both TNF receptor 1 (TNF-R1) and TNF-R2 were required for B. anthracis-induced NLRP3 inflammasome activation, which was further controlled by RIPK1 kinase activity and LeTx-mediated proteolytic inactivation of MAP kinase signaling. In addition to activating the NLRP3 inflammasome, LeTx-induced MAPKK inactivation and TNF production sensitized B. anthracis-infected macrophages to robust RIPK1- and caspase-8-dependent apoptosis. In agreement, purified LeTx triggered RIPK1 kinase activity- and caspase-8-dependent apoptosis only in macrophages primed with TNF or following engagement of TRIF-dependent Toll-like receptors. Consistently, genetic and pharmacological inhibition of RIPK1 inhibited NLRP3 inflammasome activation and apoptosis of LeTx-intoxicated and B. anthracis-infected macrophages. Caspase-8/RIPK3-deficient mice were significantly protected from B. anthracis-induced lethality, demonstrating the in vivo pathophysiological relevance of this cytotoxic mechanism. Collectively, these results establish TNF- and RIPK1 kinase activity-dependent NLRP3 inflammasome activation and macrophage apoptosis as key host-pathogen mechanisms in lethal anthrax.
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Affiliation(s)
- Filip Van Hauwermeiren
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent B-9000, Belgium
- Center for Inflammation Research, VIB, Ghent B-9000, Belgium
| | - Nina Van Opdenbosch
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent B-9000, Belgium
- Center for Inflammation Research, VIB, Ghent B-9000, Belgium
| | - Hanne Van Gorp
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent B-9000, Belgium
- Center for Inflammation Research, VIB, Ghent B-9000, Belgium
| | - Nathalia de Vasconcelos
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent B-9000, Belgium
- Center for Inflammation Research, VIB, Ghent B-9000, Belgium
| | - Geert van Loo
- Center for Inflammation Research, VIB, Ghent B-9000, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent B-9052, Belgium
| | - Peter Vandenabeele
- Center for Inflammation Research, VIB, Ghent B-9000, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent B-9052, Belgium
| | | | - Mohamed Lamkanfi
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent B-9000, Belgium;
- Center for Inflammation Research, VIB, Ghent B-9000, Belgium
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Harioputro DR, Sanjaya W, Werdiningsih Y. COMPARISON OF PROPOLIS EFFECTS ON TUMOR NECROSIS FACTOR ALPHA AND MALONDIALDEHYDE BETWEEN INHALATION AND CUTANEOUS ANTHRAX ANIMAL MODELS. Afr J Infect Dis 2021; 16:1-5. [PMID: 35047724 PMCID: PMC8751393 DOI: 10.21010/ajid.v16i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 09/11/2021] [Accepted: 09/17/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Inflammatory response and oxidative stress can be found in anthrax characterized by increased level of serum Tumor Necrosis Factor Alpha (TNF-α) and Malondialdehyde (MDA). The use of antibiotics in anthrax has been known to cause some disturbing side-effects, such as allergic reaction, nausea, vomiting, and antibiotic resistance. Thus, ethanolic extract of propolis (EEP) might be the alternative regimen, due to its anti-inflammatory and antioxidant properties. This study aimed to compare the effects of ethanolic extract of propolis (EEP) on TNF-α and MDA between the inhalation and cutaneous anthrax animal model. MATERIALS AND METHODS This was an experimental study with a post-test-only control group design on 40 samples of Rattus norvegicus. Samples were randomized into 5 groups: control, inhalation anthrax model, inhalation anthrax model + EEP, cutaneous anthrax model, and cutaneous anthrax model + EEP. After 14 days, the level of TNF-α and MDA were measured. To compare the data, we used the ANOVA test continued by the post-hoc Turkey test. RESULTS The results obtained showed that the level of TNF-α and MDA between the inhalation and cutaneous anthrax animal models treated with EEP were statistically different (p < 0.05). The P5 group showed the lowest level of TNF-α (6.822 ± 0.383 pg/ml) and MDA (2.717 ± 0.383 nmol/ml). CONCLUSION EEP has a better effect on reducing TNF-α and MDA in cutaneous anthrax animal models compared to the inhalation anthrax animal model.
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Affiliation(s)
- Dhani Redhono Harioputro
- Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Wisnu Sanjaya
- Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Yulyani Werdiningsih
- Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
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Michelman-Ribeiro A, Rubinson KA, Silin V, Kasianowicz JJ. Solution Structures of Bacillus anthracis Protective Antigen Proteins Using Small Angle Neutron Scattering and Protective Antigen 63 Ion Channel Formation Kinetics. Toxins (Basel) 2021; 13:888. [PMID: 34941724 DOI: 10.3390/toxins13120888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Abstract
We are studying the structures of bacterial toxins that form ion channels and enable macromolecule transport across membranes. For example, the crystal structure of the Staphylococcus aureus α-hemolysin (α-HL) channel in its functional state was confirmed using neutron reflectometry (NR) with the protein reconstituted in membranes tethered to a solid support. This method, which provides sub-nanometer structural information, could also test putative structures of the Bacillus anthracis protective antigen 63 (PA63) channel, locate where B. anthracis lethal factor and edema factor toxins (LF and EF, respectively) bind to it, and determine how certain small molecules can inhibit the interaction of LF and EF with the channel. We report here the solution structures of channel-forming PA63 and its precursor PA83 (which does not form channels) obtained with small angle neutron scattering. At near neutral pH, PA83 is a monomer and PA63 a heptamer. The latter is compared to two cryo-electron microscopy structures. We also show that although the α-HL and PA63 channels have similar structural features, unlike α-HL, PA63 channel formation in lipid bilayer membranes ceases within minutes of protein addition, which currently precludes the use of NR for elucidating the interactions between PA63, LF, EF, and potential therapeutic agents.
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