title: Anthrax toxin-induced shock in rats is associated with pulmonary edema and hemorrhage.
abstract: Bacillus anthracis infections are frequently associated with severe and often irreversible hypotensive shock despite appropriate antibiotics and aggressive hemodynamic and pulmonary support. Based on the observations that the anthrax secreted proteins-protective antigen (PA), lethal factor (LF), and edema factor (EF) also produce shock and mortality in animal models, we chose to characterize further the clinical chemistries and microscopic pathology of toxin treated rats. Groups of three male Sprague Dawley rats received bolus intravenous infusions of PA/LF, PA/EF, LF, or EF alone and blood samples and tissues were collected and assayed for chemistries and tissue pathology. In PA/LF and PA/EF treated animals but not other groups, chemistries showed transaminasemia and elevated lactate dehydrogenase. PA/LF treated animals alone showed elevated hemoglobin and hematocrits; PA/EF treated animals alone showed lymphopenia. Pathology was remarkable for pulmonary edema in PA/LF treated rat lungs and pulmonary hemorrhage in PA/EF treated rat lungs. These results are consistent with our and others' previous findings that the morbidity and mortality associated with anthrax are not cytokine-mediated but due to a direct effect of the toxins on the cardiovascular system along with toxin-specific alterations in blood counts. PA/LF pathology matches that seen with acute cardiac failure, and PA/EF pathology coincides with direct vascular endothelial injury. These observations provide a rational basis for drug interventions to reduce the effect of these toxins on the heart and blood vessels.
authors.affiliation: Cancer Research Institute, Scott & White Memorial Hospital,Temple, TX 76502, USA.
authors.forename: Shu-Ru
authors.initials: SR
authors.lastname: Kuo
authors.forename: Mark C
authors.initials: MC
authors.lastname: Willingham
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Bour
authors.forename: Elissa A
authors.initials: EA
authors.lastname: Andreas
authors.forename: Seong Kyu
authors.initials: SK
authors.lastname: Park
authors.forename: Carney
authors.initials: C
authors.lastname: Jackson
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Duesbery
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Leppla
authors.forename: Wei-Jen
authors.initials: WJ
authors.lastname: Tang
authors.forename: Arthur E
authors.initials: AE
authors.lastname: Frankel
mesh_terms: D000818:Animals; D000881:Anthrax / Q000097:blood / Q000473:pathology* / Q000503:physiopathology; D000942:Antigens, Bacterial / Q000633:toxicity*; D001408:Bacillus anthracis / Q000737:chemistry / Q000276:immunology; D001427:Bacterial Toxins / Q000633:toxicity*; D001772:Blood Cell Count; D001774:Blood Chemical Analysis; D004195:Disease Models, Animal; D006470:Hemorrhage / Q000097:blood / Q000209:etiology / Q000473:pathology*; D008168:Lung / Q000473:pathology; D008297:Male; D011654:Pulmonary Edema / Q000097:blood / Q000209:etiology / Q000473:pathology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012772:Shock, Septic / Q000097:blood / Q000473:pathology / Q000503:physiopathology*
chemical_list: D000942:Antigens, Bacterial; D001427:Bacterial Toxins; C030325:anthrax toxin