title: Immune responses to Bacillus anthracis protective antigen in patients with bioterrorism-related cutaneous or inhalation anthrax.
abstract: Anti-protective antigen (PA) immunoglobulin (Ig) G, toxin neutralization, and PA-specific IgG memory B cell responses were studied in patients with bioterrorism-related cutaneous or inhalation anthrax and in a patient with laboratory-acquired cutaneous anthrax. Responses were determined for >1 year after the onset of symptoms. Eleven days after the onset of symptoms (15 days after likely exposure), anti-PA IgG was detected in 16 of 17 patients with confirmed or suspected clinical anthrax who were tested. Anti-PA IgG remained detectable 8-16 months after the onset of symptoms in all 6 survivors of inhalation anthrax and in 7 of 11 survivors of cutaneous anthrax who were tested. Anti-PA IgG levels and serum toxin neutralizing activity were strongly associated (R2=0.83). PA-specific IgG memory B cells were detectable in all 6 survivors of inhalation anthrax but in only 2 of 7 patients with cutaneous anthrax who were tested. Anti-PA IgG is an important diagnostic marker of anthrax, a predictor of serum anti-toxin activity, and a marker of immunological memory against anthrax.
authors.affiliation: Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30329, USA. cquinn@cdc.gov.
authors.forename: Conrad P
authors.initials: CP
authors.lastname: Quinn
authors.forename: Peter M
authors.initials: PM
authors.lastname: Dull
authors.forename: Vera
authors.initials: V
authors.lastname: Semenova
authors.forename: Han
authors.initials: H
authors.lastname: Li
authors.forename: Shane
authors.initials: S
authors.lastname: Crotty
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Taylor
authors.forename: Evelene
authors.initials: E
authors.lastname: Steward-Clark
authors.forename: Karen L
authors.initials: KL
authors.lastname: Stamey
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Schmidt
authors.forename: Kelly Wallace
authors.initials: KW
authors.lastname: Stinson
authors.forename: Alison E
authors.initials: AE
authors.lastname: Freeman
authors.forename: Cheryl M
authors.initials: CM
authors.lastname: Elie
authors.forename: Sandra K
authors.initials: SK
authors.lastname: Martin
authors.forename: Carolyn
authors.initials: C
authors.lastname: Greene
authors.forename: Rachael D
authors.initials: RD
authors.lastname: Aubert
authors.forename: John
authors.initials: J
authors.lastname: Glidewell
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Perkins
authors.forename: Rafi
authors.initials: R
authors.lastname: Ahmed
authors.forename: David S
authors.initials: DS
authors.lastname: Stephens
mesh_terms: D000881:Anthrax / Q000276:immunology*; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology*; D001402:B-Lymphocytes / Q000276:immunology; D001427:Bacterial Toxins / Q000276:immunology*; D023482:Bioterrorism; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007156:Immunologic Memory; D008171:Lung Diseases / Q000276:immunology; D009500:Neutralization Tests; D012871:Skin Diseases / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001427:Bacterial Toxins; D007074:Immunoglobulin G; C030325:anthrax toxin