Delayed treatment with W1-mAb, a chimpanzee-derived monoclonal antibody against protective antigen, reduces mortality from challenges with anthrax edema or lethal toxin in rats and with anthrax spores in mice

Objective: W1-mAb is a chimpanzee-derived monoclonal antibody to protective antigen that improved survival when administered before anthrax lethal toxin challenge in rats. To better define W1-mAb's efficacy for anthrax, we administered it after initiation of 24-hr infusions of edema toxin and lethal toxin either alone or together in rats or following anthrax spore challenge in mice. Interventions: W1-mAb or placebo treatment. Methods and Main Results: In toxin-challenged rats treated with placebo, survival rates were lower with edema toxin (500 &mgr;g/kg) compared to lethal toxin either alone (175 &mgr;g/kg) or with edema toxin (175 &mgr;g/kg each) (8%, 33%, and 32%, respectively), but the median time to death was longer (36, 11, and 9 hrs, respectively) (p ≤ .01 for all comparisons). W1-mAb administered up to 12 hrs after edema toxin and 6 hrs after lethal toxin increased survival and reduced hypotension (p ≤ .01). However, only administration of W1-mAb at 0 hrs improved these variables with lethal toxin and edema toxin together (p ≤ .0002). In C57BL/6J mice challenged with anthrax spores subcutaneously, compared to placebo treatment (0 of 15 animals survived), W1-mAb administered beginning 24 hrs after challenge increased survival (13 of 15 survived) (p ≤ .0001). Conclusion: While rapidity of lethality may influence the effectiveness of delayed W1-mAb treatment, these rat and mouse studies provide a basis for further exploring this agent's usefulness for anthrax.

[1]  Charles Natanson,et al.  Anthrax lethal and edema toxins produce different patterns of cardiovascular and renal dysfunction and synergistically decrease survival in canines. , 2010, The Journal of infectious diseases.

[2]  Case records of the Massachusetts General Hospital. Case 25-2010. A 24-year-old woman with abdominal pain and shock. , 2010, The New England journal of medicine.

[3]  T. Brooks,et al.  An outbreak of infection with Bacillus anthracis in injecting drug users in Scotland. , 2010, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[4]  S. Ullrich,et al.  Raxibacumab for the treatment of inhalational anthrax. , 2009, The New England journal of medicine.

[5]  S. Emerson,et al.  Novel Chimpanzee/Human Monoclonal Antibodies That Neutralize Anthrax Lethal Factor, and Evidence for Possible Synergy with Anti-Protective Antigen Antibody , 2009, Infection and Immunity.

[6]  J. Ward,et al.  The Heart Is an Early Target of Anthrax Lethal Toxin in Mice: A Protective Role for Neuronal Nitric Oxide Synthase (nNOS) , 2009, PLoS pathogens.

[7]  S. Meloche,et al.  Genetic inhibition of cardiac ERK1/2 promotes stress-induced apoptosis and heart failure but has no effect on hypertrophy in vivo , 2007, Proceedings of the National Academy of Sciences.

[8]  L. Rotz,et al.  A case of naturally acquired inhalation anthrax: clinical care and analyses of anti-protective antigen immunoglobulin G and lethal factor. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[9]  S. Leppla,et al.  Bacillus anthracis edema and lethal toxin have different hemodynamic effects but function together to worsen shock and outcome in a rat model. , 2007, The Journal of infectious diseases.

[10]  T. Koehler,et al.  Inactivation of Bacillus anthracis spores in murine primary macrophages , 2006, Cellular microbiology.

[11]  M. St. Claire,et al.  Efficient Neutralization of Anthrax Toxin by Chimpanzee Monoclonal Antibodies against Protective Antigen , 2006, The Journal of infectious diseases.

[12]  Douglas K Owens,et al.  Systematic Review: A Century of Inhalational Anthrax Cases from 1900 to 2005 , 2006, Annals of Internal Medicine.

[13]  S. Leppla,et al.  Genome Engineering in Bacillus anthracis Using Cre Recombinase , 2006, Infection and Immunity.

[14]  A. Steele,et al.  Anthrax lethal toxin induces endothelial barrier dysfunction. , 2005, The American journal of pathology.

[15]  S. Banks,et al.  Late treatment with a protective antigen-directed monoclonal antibody improves hemodynamic function and survival in a lethal toxin-infused rat model of anthrax sepsis. , 2005, The Journal of infectious diseases.

[16]  J. Miyazaki,et al.  Cardiac-specific disruption of the c-raf-1 gene induces cardiac dysfunction and apoptosis. , 2004, The Journal of clinical investigation.

[17]  John A. Young,et al.  Antitoxins: novel strategies to target agents of bioterrorism , 2004, Nature Reviews Microbiology.

[18]  P. Doevendans,et al.  MEK1-ERK2 Signaling Pathway Protects Myocardium From Ischemic Injury In Vivo , 2004, Circulation.

[19]  S. Banks,et al.  Lethality during continuous anthrax lethal toxin infusion is associated with circulatory shock but not inflammatory cytokine or nitric oxide release in rats. , 2004, American journal of physiology. Regulatory, integrative and comparative physiology.

[20]  Lee Bardwell,et al.  A Docking Site in MKK4 Mediates High Affinity Binding to JNK MAPKs and Competes with Similar Docking Sites in JNK Substrates* , 2003, Journal of Biological Chemistry.

[21]  Tanja Popovic,et al.  Fatal inhalational anthrax in a 94-year-old Connecticut woman. , 2002, JAMA.

[22]  R. Collier,et al.  Stoichiometry of anthrax toxin complexes. , 2002, Biochemistry.

[23]  C. P. Quinn,et al.  Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States. , 2001, Emerging infectious diseases.

[24]  R. Collier,et al.  A quantitative study of the interactions of Bacillus anthracis edema factor and lethal factor with activated protective antigen. , 2000, Biochemistry.

[25]  G. Woude,et al.  Anthrax lethal factor causes proteolytic inactivation of mitogen‐activated protein kinase kinase , 1999, Journal of applied microbiology.

[26]  M. Mock,et al.  Anthrax lethal factor cleaves the N-terminus of MAPKKs and induces tyrosine/threonine phosphorylation of MAPKs in cultured macrophages. , 1998, Biochemical and biophysical research communications.

[27]  M. Mock,et al.  Contribution of individual toxin components to virulence of Bacillus anthracis , 1991, Infection and immunity.

[28]  Dario DiFrancesco,et al.  Direct activation of cardiac pacemaker channels by intracellular cyclic AMP , 1991, Nature.

[29]  K. Murray,et al.  Cyclic AMP and mechanisms of vasolidation , 1990 .

[30]  K. Murray,et al.  Cyclic AMP and mechanisms of vasodilation. , 1990, Pharmacology & therapeutics.

[31]  P. Ehrlich,et al.  Potential of primate monoclonal antibodies to substitute for human antibodies: nucleotide sequence of chimpanzee Fab fragments. , 1990, Human antibodies and hybridomas.

[32]  S. Leppla,et al.  Anthrax toxin edema factor: a bacterial adenylate cyclase that increases cyclic AMP concentrations of eukaryotic cells. , 1982, Proceedings of the National Academy of Sciences of the United States of America.