The sepsis model: an emerging hypothesis for the lethality of inhalation anthrax.
The sepsis model: an emerging hypothesis for the lethality of inhalation anthrax.
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DOI：
10.1111/jcmm.12075
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发表时间：
2013-07
影响因子：
5.3
通讯作者：
Kurosawa S
中科院分区：
文献类型：
--
作者：
Coggeshall KM;Lupu F;Ballard J;Metcalf JP;James JA;Farris D;Kurosawa S
吸入性炭疽常被描述为一种毒素介导的疾病。然而，毒血症模型并不能解释吸入性炭疽相对于其他形式的疾病的高死亡率，也不能解释吸入性炭疽的病理学。吸入性炭疽患者始终表现出极度的菌血症，与受到毒素攻击的动物相比，有败血症的迹象。而不是毒血症，我们认为，在吸入性炭疽死亡的结果是压倒性的菌血症，导致严重的败血症。根据我们的模型，炭疽毒素的核心作用是允许营养细菌逃避免疫检测。其他形式的炭疽芽胞杆菌感染死亡率较低，因为它们在病程早期的明显症状导致患者寻求医疗护理，而此时感染及其后遗症仍可通过抗生素逆转。因此，脓毒症模型解释了吸入性炭疽的关键特征，并可能为研究人员以及参与患者护理的人员提供更完整的疾病病理学理解。
Inhalation anthrax is often described as a toxin-mediated disease. However, the toxaemia model does not account for the high mortality of inhalation anthrax relative to other forms of the disease or for the pathology present in inhalation anthrax. Patients with inhalation anthrax consistently show extreme bacteraemia and, in contrast to animals challenged with toxin, signs of sepsis. Rather than toxaemia, we propose that death in inhalation anthrax results from an overwhelming bacteraemia that leads to severe sepsis. According to our model, the central role of anthrax toxin is to permit the vegetative bacteria to escape immune detection. Other forms of B. anthracis infection have lower mortality because their overt symptoms early in the course of disease cause patients to seek medical care at a time when the infection and its sequelae can still be reversed by antibiotics. Thus, the sepsis model explains key features of inhalation anthrax and may offer a more complete understanding of disease pathology for researchers as well as those involved in the care of patients.
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DOI：
10.1073/pnas.90.21.10198
发表时间：
1993-11-01
影响因子：
11.1
作者：
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通讯作者：
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影响因子：
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影响因子：
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作者：
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影响因子：
6
作者：
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通讯作者：
Zaki, SR
影响因子：
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作者：
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