NDLI: Raxibacumab augments hemodynamic support and improves outcomes during shock with B. anthracis edema toxin alone or together with lethal toxin in canines.

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Raxibacumab augments hemodynamic support and improves outcomes during shock with B. anthracis edema toxin alone or together with lethal toxin in canines.

Content Provider	Europe PMC
Author	Remy, Kenneth E Cui, Xizhong Li, Yan Sun, Junfeng Solomon, Steven B Fitz, Yvonne Barochia, Amisha V Al-Hamad, Mariam Moayeri, Mahtab Leppla, Stephen H Eichacker, Peter Q
Abstract	BackgroundLethal and edema toxin contribute to shock and lethality with Bacillus anthracis. We showed previously in a 96-h sedated canine model that raxibacumab, a monoclonal antibody against protective antigen, augmented hemodynamic support (HS) and improved survival with lethal toxin challenge. Here we study raxibacumab further. Using this model, we have now studied raxibacumab with 24 h edema toxin challenges (Study 1), and lethal and edema toxin challenges together (Study 2).MethodsUsing our canine model, we have now studied raxibacumab with 24h edema toxin challenges (Study-1), and lethal and edema toxin challenges together (Study-2).ResultsIn Study 1, compared to no treatment, HS (titrated fluid and norepinephrine) increased mean arterial blood pressure (MAP, p ≤ 0.05) but not survival [0 of 10 (0/10) animals survived in each group] or median survival time [43.8 h (range 16.8 to 80.3) vs. 45.2 h (21.0 to 57.1)]. Compared to HS, HS with raxibacumab treatment at or 6 h after the beginning of edema toxin increased MAP and survival rate (6/7 and 7/8, respectively) and time [96.0 h (39.5 to 96.0) and 96.0 h (89.5 to 96.0), respectively]; (p ≤ 0.05). HS with raxibacumab at 12 h increased MAP (p ≤ 0.05) but not survival [1/5; 55.3 h (12.6 to 96.0)]. In Study-2, survival rate and time increased with HS and raxibacumab at 0 h (4/4) or 6 h after (3/3) beginning lethal and edema toxin compared to HS [0/5; 71.5 h (65 to 93)] (p = 0.01 averaged over raxibacumab groups).ConclusionsRaxibacumab augments HS and improves survival during shock with lethal and edema toxin.Electronic supplementary materialThe online version of this article (doi:10.1186/s40635-015-0043-4) contains supplementary material, which is available to authorized users.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC4473792&blobtype=pdf
Journal	Intensive Care Medicine Experimental [Intensive Care Med Exp]
Volume Number	3
DOI	10.1186/s40635-015-0043-4
PubMed Central reference number	PMC4473792
Issue Number	1
PubMed reference number	26097803
e-ISSN	2197425X
Language	English
Publisher	Springer International Publishing
Publisher Date	2015-02-28
Publisher Place	Gewerbestrasse 11, Cham, Ch 6330, Switzerland
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. © Remy et al.; licensee Springer. 2015
Subject Keyword	B. anthracis Edema toxin Lethal toxin Monoclonal antibody Protective antigen Raxibacumab
Content Type	Text
Resource Type	Article
Subject	Physiology (medical) Emergency Medicine Critical Care and Intensive Care Medicine

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Raxibacumab augments hemodynamic support and improves outcomes during shock with B. anthracis edema toxin alone or together with lethal toxin in canines.