Questionable Efficacy of Therapeutic Antibodies in the Treatment of Anthrax

Inhalational anthrax caused by Bacillus anthracis , a spore-forming Gram-positive bacterium, is a highly lethal infection. Antibodies targeting the protective antigen (PA) binding component of the toxins have recently been authorized as an adjunct to antibiotics, although no conclusive evidence demo...

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Bibliographic Details
Published in:mSphere Vol. 4; no. 3; pp. e00282 - 19
Main Authors: Tournier, Jean-Nicolas, Rougeaux, Clémence, Biot, Fabrice V., Goossens, Pierre L.
Format: Journal Article
Language:English
Published: United States American Society for Microbiology 19.06.2019
Subjects:
Animal models
Animals
Anthrax
Anthrax - immunology
Anthrax - therapy
Antibiotics
Antibodies
Antibodies, Bacterial
Antibodies, Bacterial - therapeutic use
Antibodies, Monoclonal
Antibodies, Monoclonal - therapeutic use
Antigens
Antigens, Bacterial
Antigens, Bacterial - immunology
Antitoxins
Antitoxins - therapeutic use
Bacillus anthracis
Bacillus anthracis - immunology
Bacterial Toxins
Bacterial Toxins - immunology
Disease Models, Animal
Drug Evaluation, Preclinical
Edema
Humans
Immunoglobulins
Immunotherapy
Infections
Kinases
Life Sciences
Monoclonal antibodies
Opinion/Hypothesis
Patients
Protective antigen
Respiratory Tract Infections
Respiratory Tract Infections - immunology
Respiratory Tract Infections - therapy
Sepsis
Studies
Therapeutics and Prevention
Toxins
Vaccines
France
United States > US
antitoxins
anthrax
protective antigen
toxins
monoclonal antibodies
ISSN:2379-5042, 2379-5042
Online Access:Get full text
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Summary:Inhalational anthrax caused by Bacillus anthracis , a spore-forming Gram-positive bacterium, is a highly lethal infection. Antibodies targeting the protective antigen (PA) binding component of the toxins have recently been authorized as an adjunct to antibiotics, although no conclusive evidence demonstrates that anthrax antitoxin therapy has any significant benefit. We discuss here the rational basis of anti-PA development regarding the pathogenesis of the disease. Inhalational anthrax caused by Bacillus anthracis , a spore-forming Gram-positive bacterium, is a highly lethal infection. Antibodies targeting the protective antigen (PA) binding component of the toxins have recently been authorized as an adjunct to antibiotics, although no conclusive evidence demonstrates that anthrax antitoxin therapy has any significant benefit. We discuss here the rational basis of anti-PA development regarding the pathogenesis of the disease. We argue that inductive reasoning may induce therapeutic bias. We identified anthrax animal model analysis as another bias. Further studies are needed to assess the benefit of anti-PA antibodies in the treatment of inhalational anthrax, while a clearer consensus should be established around what evidence should be proven in an anthrax model.
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PMCID: PMC6584371
Citation Tournier J-N, Rougeaux C, Biot FV, Goossens PL. 2019. Questionable efficacy of therapeutic antibodies in the treatment of anthrax. mSphere 4:e00282-19. https://doi.org/10.1128/mSphere.00282-19.
ISSN:2379-5042
2379-5042
DOI:10.1128/mSphere.00282-19