title: Molecular determinants for a cardiovascular collapse in anthrax.
abstract: Bacillus anthracis releases two bipartite proteins, lethal toxin and edema factor, that contribute significantly to the progression of anthrax-associated shock. As blocking the anthrax toxins prevents disease, the toxins are considered the main virulence factors of the bacterium. The anthrax bacterium and the anthrax toxins trigger multi-organ failure associated with enhanced vascular permeability, hemorrhage and cardiac dysfunction in animal challenge models. A recent study using mice that either lacked the anthrax toxin receptor in specific cells and corresponding mice expressing the receptor in specific cell types demonstrated that cardiovascular cells are critical for disease mediated by anthrax lethal toxin. These studies are consistent with involvement of the cardiovascular system, and with an increase of cardiac failure markers observed in human anthrax and in animal models using B. anthracis and anthrax toxins. This review discusses the current state of knowledge regarding the pathophysiology of anthrax and tries to provide a mechanistic model and molecular determinants for the circulatory shock in anthrax.
authors.affiliation: Department of Microbiology and Immunology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY.
authors.forename: Jurgen
authors.initials: J
authors.lastname: Brojatsch
authors.affiliation: Department of Microbiology and Immunology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY.
authors.forename: Arturo
authors.initials: A
authors.lastname: Casadevall
authors.affiliation: Department of Microbiology and Immunology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY.
authors.forename: David L
authors.initials: DL
authors.lastname: Goldman
mesh_terms: D000818:Animals; D000881:Anthrax / Q000150:complications / Q000503:physiopathology*; D000942:Antigens, Bacterial / Q000633:toxicity*; D051017:Apoptosis Regulatory Proteins / Q000378:metabolism; D001408:Bacillus anthracis / Q000737:chemistry*; D016667:Bacterial Capsules; D001427:Bacterial Toxins / Q000633:toxicity*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000378:metabolism*; D002473:Cell Wall; D016207:Cytokines / Q000378:metabolism*; D042783:Endothelial Cells / Q000187:drug effects; D006801:Humans; D008099:Liver / Q000187:drug effects; D020935:MAP Kinase Signaling System / Q000187:drug effects*; D051379:Mice; D012769:Shock / Q000209:etiology / Q000378:metabolism*
chemical_list: D000942:Antigens, Bacterial; D051017:Apoptosis Regulatory Proteins; D001427:Bacterial Toxins; D016207:Cytokines; C509168:Nalp1b protein, mouse; C030325:anthrax toxin