Anthrax prevention and treatment: Utility of therapy combining antibiotic plus vaccine Anthrax prevention and treatment: Utility of therapy combining antibiotic plus vaccine

Expert Opinion on Biological Therapy

Volumn 9, Issue 12, 2009, Pages 1477-1486

  Klinman, Dennis M ^a   Yamamoto, Masaki ^a   Tross, Debra ^a   Tomaru, Koji ^a  

^a NATIONAL CANCER INSTITUTE   (United States)

Author keywords

Adjuvant; Anthrax; Vaccine

Indexed keywords

ALUMINUM POTASSIUM SULFATE; ANTHRAX TOXIN; ANTHRAX VACCINE; ANTHRAX VACCINE ADSORBED; ANTHRAX VACCINE PRECIPITATED; ANTIBIOTIC AGENT; CHOLERA TOXIN; CIPROFLOXACIN; CPG OLIGODEOXYNUCLEOTIDE; DALBAVANCIN; DNA VACCINE; DOXYCYCLINE; ERYTHROMYCIN; FORMALDEHYDE; IMMUNOGLOBULIN G; IMMUNOLOGICAL ADJUVANT; LIVE VACCINE; NEUTRALIZING ANTIBODY; POLOXAMER; POLY(GAMMA DEXTRO GLUTAMIC ACID); PROBIOTIC AGENT; PROTECTIVE ANTIGEN ANTIBODY; RECOMBINANT PROTECTIVE ANTIGEN; TETRACYCLINE; UNCLASSIFIED DRUG;

ADJUVANT THERAPY; ANTHRAX; ANTIBIOTIC THERAPY; ANTIBODY PRODUCTION; ANTIBODY TITER; BACTERIAL SPORE; CLINICAL TRIAL; COMBINATION CHEMOTHERAPY; DOSE RESPONSE; DRUG EFFICACY; DRUG SAFETY; HUMAN; IMMUNOGENICITY; IMMUNOREACTIVITY; INFECTION PREVENTION; LACTOBACILLUS CASEI; MONOTHERAPY; NONHUMAN; PATIENT COMPLIANCE; REVIEW; SALMONELLA; SINGLE DRUG DOSE; VACCINATION; VACCINE PRODUCTION;

ADJUVANTS, IMMUNOLOGIC; ANIMALS; ANTHRAX; ANTHRAX VACCINES; ANTI-BACTERIAL AGENTS; DRUG APPROVAL; DRUG THERAPY, COMBINATION; HUMANS; TREATMENT OUTCOME; VACCINES, ATTENUATED; VACCINES, SYNTHETIC;

EID: 70450186151     PISSN: 14712598     EISSN: None     Source Type: Journal    
DOI: 10.1517/14712590903307347     Document Type: Review

References (186)

1. Hanna P. Anthrax pathogenesis and host response. Curr Top Microbiol Immunol 1998;225:13-35
2. Carter KC. Koch's postulates in realtion to the work of Jacob Henle and Edwin Klebs. Med Hist 1985;29:353-374
3. Lane HC, Montagne JL, Fauci AS. Bioterrorism: A clear and present danger. Nat Med 2001;7:1271-1273
4. Friedlander AM, Brachman PS. Anthrax. In: Plotkin SA, Mortimer EA, editors, Vaccines. Philadelphia, PA: WB Saunders; 1998. p. 729-739
5. Friedlander AM, Welkos SL, Pitt ML, et al. Postexposure prophylaxis against experimental inhalation anthrax. J Infect Dis 1993;167:1239-1243
6. Henderson DW, Peacock S, Belton FC. Observations on the prophylaxis of experimental pulmonary anthrax in the monkey. J Hyg 1956;54:28-36
7. Glassman HN. Industrial inhalation anthrax: Discussion. Bateriol Rev 1966;30:657-659
8. Gochenours WS Jr, Sawyer WD, Henderson JE, et al. On the recognition and therapy of simian woolsorter's disease. J Hyg (Lond) 1963;61:317-322
9. Tournier JN, Ulrich RG, Quesnel-Hellmann A, et al. Anthrax, toxins and vaccines: A 125-year journey targeting bacillus anthracis. Expert Rev Anti Infect Ther 2009;7:219-236
10. Jernigan DB, Raghunathan PL, Bell BP, et al. Investigation of bioterrorism-related anthrax, United States, 2001: Epidemiologic findings. Emerg Infect Dis 2002;8:1019-1028
11. Baillie LW. Past, imminent and future human medical countermeasures for anthrax. J Appl Microbiol 2006;101:594-606
12. Geison GL. The Private Science of Louis Pasteur. Princeton, NJ: Princeton University Press; 1995
13. Webb GF. Being prepared: Modeling the response to an anthrax attack. Ann Intern Med 2005;142:667-668
14. Grabenstein JD. Vaccines: Countering anthrax: Vaccines and immunoglobulins. Clin Infect Dis 2008;46:129-136
15. Inglesby TV, O'Toole T, Henderson DA, et al. Anthrax as a biological weapon, 2002: updated recommendations for management. JAMA 2002;287:2236-2252
16. Little SF. Anthrax vaccines: A development update. BioDrugs 2005;19:233-245
17. Smith H, Keppie J. Observations on experimetnal anthrax; demonstration of a specific lethal factor produced in vivo by bacillus anthracis. Nature 1954;173:869-870
18. Occupational health guidelines for remediation workers at Bacillus anthracis-contaminated sites-United States, 2001-2002. MMWR Morb Mortal Wkly Rep 2002;51:786-789
19. Stern EJ, Uhde KB, Shadomy SV, et al. Conference report on public health and clinical guidelines for anthrax. Emerg Infect Dis 2008;14. Available from: http://www.cdc.gov/EID/content/14/4/ 07-0969.htm [Last accessed 5 September 2009]
20. Shepard CW, Soriano-Gabarro M, Zell ER, et al. Antimicrobial postexposure prophylaxis for anthrax: Adverse events and adherence. Emerg Infect Dis 2002;8:1124-1132
21. Jefferds MD, Laserson K, Fry AM, et al. Adherence to antimicrobial inhalational anthrax prophylaxis among postal workers, Washington DC, 2001. Emerg Infect Dis 2002;8:1138-1144
22. Pittman PR, Leitman SF, Oro JG, et al. Protective antigen and toxin neutralization antibody patterns in anthrax vaccinees undergoing serial plasmapheresis. Clin Diagn Lab Immunol 2005;12:713-721
23. Stepanov AV, Marinin LI, Pomerantsev AP, et al. Development of novel vaccines against anthrax in man. J Biotechnol 1996;44:155-160
24. Casadevall A. Passive antibody administration (immediate immunity) as a specific defense against biological weapons. Emerg Infect Dis 2002;8:833-841
25. Kelly CD, O'Loughlin C, Gelder FB, et al. Rapid generation of an anthrax immunotherapeutic from goats using a novel non-toxic muramyl dipeptide adjuvant. J Immune Based Ther Vaccines 2007;5:11. Published online 22 October 2007, doi:10.1186/1476-8518-5-11
26. Vitale L, Blanset D, Lowy I, et al. Prophylaxis and therapy of inhalational anthrax by a novel monoclonal antibody to protective antigen that mimics vaccine-induced immunity. Infect Immun 2006;74:5840-5847
27. Herrmann JE, Wang S, Zhang C, et al. Passive immunotherapy of Bacillus anthracis pulmonary infection in mice with antisera produced by DNA immunization. Vaccine 2006;24:5872-5880
28. Klinman DM, Xie H, Little SF, et al. CpG oligonucleotides improve the protective immune response induced by the anthrax vaccination of rhesus macaques. Vaccine 2004;22:2881-2886
29. Klinman DM, Tross D. A single-dose combination therapy that both prevents and treats anthrax infection. Vaccine 2009;13:1811-1817
30. Vietri NJ, Purcell BK, Lawler JV, et al. Short-course postexposure antibiotic prophylaxis combined with vaccination protects against experimental inhalational anthrax. Proc Natl Acad Sci USA 2006;103:7813-7816
31. Ivins BE, Welkos SL. Recent advances in the development of an improved, human anthrax vaccine. Eur J Epidemiol 1988;4:12-19
32. Brachman PS, Gold H, Plotkin SA, et al. Field evaluation of a human anthrax vaccine. Am J Public Health 1962;52:632-645
33. Turnbull PC. Anthrax vaccines: Past, present and future. Vaccine 1991;9:533-539
34. Whiting GC, Rijpkema S, Adams T, et al. Characterisation of adsorbed anthrax vaccine by two-dimensional gel electrophoresis1. Vaccine 2004;22:4245-4251
35. Mogridge J, Cunningham K, Lacy DB, et al. The lethal and edema factors of anthrax toxin bind only to oligomeric forms of the protective antigen3. Proc Natl Acad Sci USA 2002;99:7045-7048
36. Chowdhury K, Light SE, Garon CF, et al. A cloned polyoma DNA fragment representing the 5¢ half of the early gene region is oncogenic. J Virol 1980;36:566-574
37. Little SF, Ivins BE. Molecular pathogenesis of Bacillus anthracis infection. Microbes Infect 1999;1:131-139
38. Welkos S, Little S, Friedlander A, et al. The role of antibodies to Bacillus anthracis and anthrax toxin components in inhibiting the early stages of infection by anthrax spores. Microbiology 2001;147:1677-1685 (Pubitemid 32544833)
39. Welkos SL, Friedlander AM. Comparative safety and efficacy against Bacillus anthracis of protective antigen and live vaccines in mice. Microb Pathog 1988;5:127-139
40. Fellows PF, Linscott MK, Ivins BE, et al. Efficacy of a human anthrax vaccine in guinea pigs, rabbits, and rhesus macaques against challenge by bacillus anthracis isolates of diverse geographical origin. Vaccine 2001;19:3241-3247
41. Baillie L. The development of new vaccines against bacillus anthracis. J Appl Microbiol 2001;91:609-613
42. Pittman PR, Gibbs PH, Cannon TL, et al. Anthrax vaccine: Short-term safety experience in humans. Vaccine 2001;20:972-978
43. Ready T. US soldiers refuse to fall in line with anthrax vaccination scheme. Nat Med 2004;10:112
44. Geier DA, Geier MR. Anthrax vaccination and joint related adverse reactions in light of biological warfare scenarios. Clin Exp Rheumatol 2002;20:217-220
45. Wasserman GM, Grabenstein JD, Pittman PR, et al. Analysis of adverse events after anthrax immunization in US Army medical personnel. J Occup Environ Med 2003;45:222-233
46. Pittman PR, Kim-Ahn G, Pifat DY, et al. Anthrax vaccine: Immunogenicity and safety of a dose-reduction, route-change comparison study in humans. Vaccine 2002;20:1412-1420
47. Enstone JE, Wale MC, Nguyen-Van-Tam JS, et al. Adverse medical events in British service personnel following anthrax vaccination. Vaccine 2003;21:1348-1354
48. Lange JL, Lesikar SE, Rubertone MV, et al. Comprehensive systematic surveillance for adverse effects of anthrax vaccine adsorbed, US Armed Forces, 1998-2000. Vaccine 2003;21:1620-1628
49. Pittman PR, Norris SL, Barrera Oro JG, et al. Patterns of antibody response in humans to the anthrax vaccine adsorbed (AVA) primary (six-dose) series. Vaccine 2006;24:3654-3660
50. Marano N, Plikaytis BD, Martin SW, et al. Effects of a reduced dose schedule and intramuscular administration of anthrax vaccine adsorbed on immunogenicity and safety at 7 months: A randomized trial. J Am Med Assoc 2008;300:1532-1543
51. Little SF, Ivins BE, Webster WM, et al. Duration of protection of rabbits after vaccination with bacillus anthracis recombinant protective antigen vaccine. Vaccine 2006;24:2530-2536
52. Ivins BE, Welkos SL. Cloning and expression of the bacillus anthracis protective antigen gene in bacillus subtilis. Infect Immun 1986;54:537-542
53. Gorse GJ, Keitel W, Keyserling H, et al. Immunogenicity and tolerance of ascending doses of a recombinant protective antigen (rPA102) anthrax vaccine: A randomized, double-blinded, controlled, multicenter trial. Vaccine 2006;24:5950-5959
54. Weiss MM, Weiss PD, Weiss JB. Anthrax vaccine and public health policy. Am J Public Health 2007;97:1945-1951
55. Campbell JD, Clement KH, Wasserman SS, et al. Safety, reactogenicity and immunogenicity of a recombinant protective antigen anthrax vaccine given to healthy adults. Hum Vaccine 2007;3:205-211
56. Abboud N, Casadevall A. Immunogenicity of bacillus anthracis protective antigen domains and efficacy of elicited antibody responses depend on host genetic background. Clin Vaccine Immunol 2008;15:1115-1123
57. Coulson NM, Fulop M, Titball RW. Bacillus anthracis protective antigen, expressed in salmonella typhimurium SL 3261, affords protection against anthrax spore challenge. Vaccine 1994;12:1395-1401
58. Ivins BE, Pitt ML, Fellows PF, et al. Comparative efficacy of experimental anthrax vaccine candidates against inhalation anthrax in rhesus macaques. Vaccine 1998;16:1141-1148
59. Little SF, Ivins BE, Webster WM, et al. Effect of aluminum hydroxide adjuvant and formaldehyde in the formulation of rPA anthrax vaccine. Vaccine 2007;25:2771-2777
60. Coeshott CM, Smithson SL, Verderber E, et al. Pluronic F127-based systemic vaccine delivery systems. Vaccine 2004;22:2396-2405
61. Xie H, Gursel I, Ivins BE, et al. CpG oligodeoxynucleotides adsorbed onto polylactide-co-glycolide microparticles improve the immunogenicity and protective activity of the licensed anthrax vaccine. Infect Immun 2005;73:828-833
62. Klinman DM, Xie H, Ivins BE. CpG oligonucleotides improve the protective immune response induced by the licensed anthrax vaccine. Ann NY Acad Sci 2006;1082:137-150
63. Rynkiewicz D, Rathkopf M, Ransom J, et al. Marked enhancement of antibody response to anthrax vaccine adsorbed with CpG 7909 in healthy volunteers. ICAAC abstract LB-25. 2005
64. Baillie L, Townend T, Walker N, et al. Characterization of the human immune response to the UK anthrax vaccine. FEMS Immunol Med Microbiol 2004;42:267-270
65. Stanley JL, Smith H. The three factors of anthrax toxin: Their immunogenicity and lack of demonstrable enzymic activity. J Gen Microbiol 1963;31:329-337
66. Singh Y, Ivins BE, Leppla SH. Study of immunization against anthrax with the purified recombinant protective antigen of bacillus anthracis. Infect Immun 1998;66:3447-3448
67. Brossier F, Weber-Levy M, Mock M, et al. Protective antigen-mediated antibody response against a heterologous protein produced in vivo by bacillus anthracis. Infect Immun 2000;68:5731-5734
68. Price BM, Liner AL, Park S, et al. Protection against anthrax lethal toxin challenge by genetic immunization with a plasmid encoding the lethal factor protein. Infect Immun 2001;69:4509-4515
69. Brossier F, Levy M, Mock M. Anthrax spores make an essential contribution to vaccine efficacy. Infect Immun 2002;70:661-664
70. Brahmbhatt TN, Darnell SC, Carvalho HM, et al. Recombinant exosporium protein BclA of bacillus anthracis is effective as a booster for mice primed with suboptimal amounts of protective antigen. Infect Immun 2007;75:5240-5247
71. Gauthier YP, Tournier JN, Paucod JC, et al. Efficacy of a vaccine based on protective antigen and killed spores against experimental inhalational anthrax. Infect Immun 2009;77:1197-1207
72. Casares S, Inaba K, Brumeanu TD, et al. Antigen presentation by dendritic cells after immunization with DNA encoding a major histocompatibility complex class II-restricted viral epitope. J Exp Med 1997;186:1481-1486
73. Meselson M, Guillemin J, Hugh-Jones M, et al. The Sverdlovsk anthrax outbreak of 1979. Science 1994;266:1202-1208
74. Brookmeyer R, Johnson E, Bollinger R. Modeling the optimum duration of antibiotic prophylaxis in an anthrax outbreak. Proc Natl Acad Sci USA 2003;100:10129-10132
75. Fowler RA, Sanders GD, Bravata DM, et al. Cost-effectiveness of defending against bioterrorism: A comparison of vaccination and antibiotic prophylaxis against anthrax. Ann Intern Med 2005;142:601-610
76. Schmitt B, Dobrez D, Parada JP, et al. Responding to a small-scale bioterrorist anthrax attack: Cost-effectiveness analysis comparing preattack vaccination with postattack antibiotic treatment and vaccination. Arch Intern Med 2007;167:655-662
77. Altboum Z, Gozes Y, Barnea A, et al. Postexposure prophylaxis against anthrax: Evaluation of various treatment regimens in intranasally infected guinea pigs. Infect Immun 2002;70:6231-6241
78. Klinman DM, Currie D, Lee G, et al. Systemic but not mucosal immunity induced by AVA prevents inhalational anthrax. Microbes Infect 2007;9:1478-1483
79. Langford MJ, Myers RC. Difficulties associated with the development and licensing of vaccines for protection against bio-warfare and bio-terrorism. Dev Biol (Basel) 2002;110:107-112
80. Food Drug Administration, HHS. New drug and biological drug products; evidence needed to demonstrate effectiveness of new drugs when human efficacy studies are not ethical or feasible. Fed Regist 2002;67:37988-37998
81. Weiss S, Kobiler D, Levy H, et al. Immunological correlates for protection against intranasal challenge of bacillus anthracis spores conferred by a protective antigen-based vaccine in rabbits. Infect Immun 2006;74:394-398
82. Reuveny S, White MD, Adar YY, et al. Search for correlates of protective immunity conferred by anthrax vaccine. Infect Immun 2001;69:2888-2893
83. Little SF, Ivins BE, Fellows PF, et al. Defining a serological correlate of protection in rabbits for a recombinant anthrax vaccine. Vaccine 2004;22:422-430
84. Little SF, Webster WM, Norris SL, et al. Evaluation of an anti-rPA IgG ELISA for measuring the antibody response in mice. Biologicals 2004;32:62-69
85. Little SF, Webster WM, Ivins BE, et al. Development of an in vitro-based potency assay for anthrax vaccine. Vaccine 2004;22:2843-2852
86. Pombo M, Berthold I, Gingrich E, et al. Validation of an anti-PA-ELISA for the potency testing of anthrax vaccine in mice. Biologicals 2004;32:157-163
87. Tross D, Klinman DM. Effect of CpG oligonucleotides on vaccine-induced B cell memory. J Immunol 2008;181:5785-5790
88. Barnard JP, Friedlander AM. Vaccination against anthrax with attenuated recombinant strains of bacillus anthracis that produce protective antigen. Infect Immun 1999;67:562-567
89. Aloni-Grinstein R, Gat O, Altboum Z, et al. Oral spore vaccine based on live attenuated nontoxinogenic bacillus anthracis expressing recombinant mutant protective antigen. Infect Immun 2005;73:4043-4053
90. Little SF, Knudson GB. Comparative efficacy of bacillus anthracis live spore vaccine and protective antigen vaccine against anthrax in the guinea pig. Infect Immun 1986;52:509-12
91. Coulson NM, Fulop M, Titball RW. Bacillus anthracis protective antigen, expressed in salmonella typhimurium SL 3261, affords protection against anthrax spore challenge. Vaccine 1994;12:1395-1401
92. Ivins BE, Pitt ML, Fellows PF, et al. Comparative efficacy of experimental anthrax vaccine candidates against inhalation anthrax in rhesus macaques. Vaccine 1998;16:1141-1148
93. Little SF, Ivins BE, Webster WM, et al. Effect of aluminum hydroxide adjuvant and formaldehyde in the formulation of rPA anthrax vaccine. Vaccine 2007;25:2771-2777
94. Coeshott CM, Smithson SL, Verderber E, et al. Pluronic F127-based systemic vaccine delivery systems. Vaccine 2004;22:2396-2405
95. Xie H, Gursel I, Ivins BE, et al. CpG oligodeoxynucleotides adsorbed onto polylactide-co-glycolide microparticles improve the immunogenicity and protective activity of the licensed anthrax vaccine. Infect Immun 2005;73:828-833
96. Klinman DM, Xie H, Ivins BE. CpG oligonucleotides improve the protective immune response induced by the licensed anthrax vaccine. Ann NY Acad Sci 2006;1082:137-150
97. Rynkiewicz D, Rathkopf M, Ransom J, et al. Marked enhancement of antibody response to anthrax vaccine adsorbed with CpG 7909 in healthy volunteers. ICAAC abstract LB-25. 2005
98. Baillie L, Townend T, Walker N, et al. Characterization of the human immune response to the UK anthrax vaccine. FEMS Immunol Med Microbiol 2004;42:267-270
99. Stanley JL, Smith H. The three factors of anthrax toxin: Their immunogenicity and lack of demonstrable enzymic activity. J Gen Microbiol 1963;31:329-337
100. Singh Y, Ivins BE, Leppla SH. Study of immunization against anthrax with the purified recombinant protective antigen of bacillus anthracis. Infect Immun 1998;66:3447-3448
101. Brossier F, Weber-Levy M, Mock M, et al. Protective antigen-mediated antibody response against a heterologous protein produced in vivo by bacillus anthracis. Infect Immun 2000;68:5731-5734
102. Price BM, Liner AL, Park S, et al. Protection against anthrax lethal toxin challenge by genetic immunization with a plasmid encoding the lethal factor protein. Infect Immun 2001;69:4509-4515
103. Brossier F, Levy M, Mock M. Anthrax spores make an essential contribution to vaccine efficacy. Infect Immun 2002;70:661-664
104. Brahmbhatt TN, Darnell SC, Carvalho HM, et al. Recombinant exosporium protein BclA of bacillus anthracis is effective as a booster for mice primed with suboptimal amounts of protective antigen. Infect Immun 2007;75:5240-5247
105. Gauthier YP, Tournier JN, Paucod JC, et al. Efficacy of a vaccine based on protective antigen and killed spores against experimental inhalational anthrax. Infect Immun 2009;77:1197-1207
106. Casares S, Inaba K, Brumeanu TD, et al. Antigen presentation by dendritic cells after immunization with DNA encoding a major histocompatibility complex class II-restricted viral epitope. J Exp Med 1997;186:1481-1486
107. Meselson M, Guillemin J, Hugh-Jones M, et al. The Sverdlovsk anthrax outbreak of 1979. Science 1994;266:1202-1208
108. Brookmeyer R, Johnson E, Bollinger R. Modeling the optimum duration of antibiotic prophylaxis in an anthrax outbreak. Proc Natl Acad Sci USA 2003;100:10129-10132
109. Fowler RA, Sanders GD, Bravata DM, et al. Cost-effectiveness of defending against bioterrorism: A comparison of vaccination and antibiotic prophylaxis against anthrax. Ann Intern Med 2005;142:601-610
110. Schmitt B, Dobrez D, Parada JP, et al. Responding to a small-scale bioterrorist anthrax attack: Cost-effectiveness analysis comparing preattack vaccination with postattack antibiotic treatment and vaccination. Arch Intern Med 2007;167:655-662
111. Altboum Z, Gozes Y, Barnea A, et al. Postexposure prophylaxis against anthrax: Evaluation of various treatment regimens in intranasally infected guinea pigs. Infect Immun 2002;70:6231-6241
112. Klinman DM, Currie D, Lee G, et al. Systemic but not mucosal immunity induced by AVA prevents inhalational anthrax. Microbes Infect 2007;9:1478-1483
113. Langford MJ, Myers RC. Difficulties associated with the development and licensing of vaccines for protection against bio-warfare and bio-terrorism. Dev Biol (Basel) 2002;110:107-112
114. Food Drug Administration, HHS. New drug and biological drug products; evidence needed to demonstrate effectiveness of new drugs when human efficacy studies are not ethical or feasible. Fed Regist 2002;67:37988-37998
115. Weiss S, Kobiler D, Levy H, et al. Immunological correlates for protection against intranasal challenge of bacillus anthracis spores conferred by a protective antigen-based vaccine in rabbits. Infect Immun 2006;74:394-398
116. Reuveny S, White MD, Adar YY, et al. Search for correlates of protective immunity conferred by anthrax vaccine. Infect Immun 2001;69:2888-2893
117. Little SF, Ivins BE, Fellows PF, et al. Defining a serological correlate of protection in rabbits for a recombinant anthrax vaccine. Vaccine 2004;22:422-430
118. Little SF, Webster WM, Norris SL, et al. Evaluation of an anti-rPA IgG ELISA for measuring the antibody response in mice. Biologicals 2004;32:62-69
119. Little SF, Webster WM, Ivins BE, et al. Development of an in vitro-based potency assay for anthrax vaccine. Vaccine 2004;22:2843-2852
120. Pombo M, Berthold I, Gingrich E, et al. Validation of an anti-PA-ELISA for the potency testing of anthrax vaccine in mice. Biologicals 2004;32:157-163
121. Tross D, Klinman DM. Effect of CpG oligonucleotides on vaccine-induced B cell memory. J Immunol 2008;181:5785-5790
122. Barnard JP, Friedlander AM. Vaccination against anthrax with attenuated recombinant strains of bacillus anthracis that produce protective antigen. Infect Immun 1999;67:562-567
123. Aloni-Grinstein R, Gat O, Altboum Z, et al. Oral spore vaccine based on live attenuated nontoxinogenic bacillus anthracis expressing recombinant mutant protective antigen. Infect Immun 2005;73:4043-4053
124. Little SF, Knudson GB. Comparative efficacy of bacillus anthracis live spore vaccine and protective antigen vaccine against anthrax in the guinea pig. Infect Immun 1986;52:509-512
125. Gu M, Leppla SH, Klinman DM. Protection against anthrax toxin by vaccination with a DNA plasmid encoding anthrax protective antigen. Vaccine 1999;17:340-344
126. Galloway DR, Baillie L. DNA vaccines against anthrax. Expert Opin Biol Ther 2004;4:1661-1667
127. Garmory HS, Titball RW, Griffin KF, et al. Salmonella enterica serovar typhimurium expressing a chromosomally integrated copy of the bacillus anthracis protective antigen gene protects mice against an anthrax spore challenge. Infect Immun 2003;71:3831-3836
128. Garmory HS, Brown KA, Titball RW. Salmonella vaccines for use in humans: Present and future perspectives. FEMS Microbiol Rev 2002;26:339-353
129. Galen JE, Zhao L, Chinchilla M, et al. Adaptation of the endogenous Salmonella enterica serovar Typhi clyA-encoded hemolysin for antigen export enhances the immunogenicity of anthrax protective antigen domain 4 expressed by the attenuated live-vector vaccine strain CVD 908-htrA. Infect Immun 2004;72:7096-7106
130. Zegers ND, Kluter E, van Der SH, et al. Expression of the protective antigen of bacillus anthracis by lactobacillus casei: Towards the development of an oral vaccine against anthrax. J Appl Microbiol 1999;87:309-314
131. Aziz MA, Singh S, Anand KP, et al. Expression of protective antigen in transgenic plants: A step towards edible vaccine against anthrax. Biochem Biophys Res Commun 2002;299:345-351
132. Mikszta JA, Sullivan VJ, Dean C, et al. Protective immunization against inhalational anthrax: A comparison of minimally invasive delivery platforms. J Infect Dis 2005;191:278-288
133. Flick-Smith HC, Eyles JE, Hebdon R, et al. Mucosal or parenteral administration of microsphere-associated bacillus anthracis protective antigen protects against anthrax infection in mice. Infect Immun 2002;70:2022-2028
134. Gaur R, Gupta PK, Banerjea AC, et al. Effect of nasal immunization with protective antigen of Bacillus anthracis on protective immune response against anthrax toxin. Vaccine 2002;20:2836-2839
135. Sloat BR, Cui Z. Strong mucosal and systemic immunities induced by nasal immunization with anthrax protective antigen protein incorporated in liposome-protamine-DNA particles. Pharm Res 2006;23:262-269 (Pubitemid 43237857)
136. Kenney RT, Yu J, Guebre-Xabier M, et al. Induction of protective immunity against lethal anthrax challenge with a patch. J Infect Dis 2004;190:774-782
137. Matyas GR, Friedlander AM, Glenn GM, et al. Needle-free skin patch vaccination method for anthrax. Infect Immun 2004;72:1181-1183
138. Schneerson R, Kubler-Kielb J, Liu TY, et al. Poly(gamma-D-glutamic acid) protein conjugates induce IgG antibodies in mice to the capsule of bacillus anthracis: A potential addition to the anthrax vaccine. Proc Natl Acad Sci USA 2003;100:8945-8950
139. Hahn UK, Boehm R, Beyer W. DNA vaccination against anthrax in mice-combination of anti-spore and anti-toxin components. Vaccine 2006;24:4569-4571 (Pubitemid 43776776)
140. Boyaka PN, Tafaro A, Fischer R, et al. Effective mucosal immunity to anthrax: Neutralizing antibodies and Th cell responses following nasal immunization with protective antigen. J Immunol 2003;170:5636-5643
141. Hermanson G, Whitlow V, Parker S, et al. A cationic lipid-formulated plasmid DNA vaccine confers sustained antibody-mediated protection against aerosolized anthrax spores. Proc Natl Acad Sci USA 2004;101:13601-13606
142. Steichen C, Chen P, Kearney JF, et al. Identification of the immunodominant protein and other proteins of the bacillus anthracis exosporium. J Bacteriol 2003;185:1903-1910
143. Maurer PH. Antigenicity of polypeptides XIII. Immunological studies with synthetic polymers containing only D- or D- and L-alpha-amino acids. J Exp Med 1965;121:339-349
144. Cohen S, Mendelson I, Altboum Z, et al. Attenuated nontoxinogenic and nonencapsulated recombinant bacillus anthracis spore vaccines protect against anthrax. Infect Immun 2000;68:4549-4558
145. Glomski IJ, Corre JP, Mock M, et al. Noncapsulated toxinogenic bacillus anthracis presents a specific growth and dissemination pattern in naive and protective antigen-immune mice. Infect Immun 2007;75:4754-4761
146. Chabot DJ, Scorpio A, Tobery SA, et al. Anthrax capsule vaccine protects against experimental infection. Vaccine 2004;23:43-47
147. Wang TT, Fellows PF, Leighton TJ, et al. Induction of opsonic antibodies to the gamma-D-glutamic acid capsule of bacillus anthracis by immunization with a synthetic peptide-carrier protein conjugate. FEMS Immunol Med Microbiol 2004;40:231-237
148. Rhie GE, Roehrl MH, Mourez M, et al. A dually active anthrax vaccine that confers protection against both bacilli and toxins. Proc Natl Acad Sci USA 2003;100:10925-10930
149. Bourgogne A, Drysdale M, Hilsenbeck SG, et al. Global effects of virulence gene regulators in a Bacillus anthracis strain with both virulence plasmids. Infect Immun 2003;71:2736-2743
150. Huang CM, Foster KW, DeSilva TS, et al. Identification of Bacillus anthracis proteins associated with germination and early outgrowth by proteomic profiling of anthrax spores. Proteomics 2004;4:2653-2661
151. Huang CM, Elmets CA, Tang DC, et al. Proteomics reveals that proteins expressed during the early stage of bacillus anthracis infection are potential targets for the development of vaccines and drugs. Genomics Proteomics Bioinformatics 2004;2:143-151
152. Wang J, Ying T, Wang H, et al. 2-D reference map of Bacillus anthracis vaccine strain A16R proteins. Proteomics 2005;5:4488-4495
153. Rosovitz MJ, Schuck P, Varughese M, et al. Alanine-scanning mutations in domain 4 of anthrax toxin protective antigen reveal residues important for binding to the cellular receptor and to a neutralizing monoclonal antibody. J Biol Chem 2003;278:30936-30944
154. Hoffmaster AR, Ravel J, Rasko DA, et al. Identification of anthrax toxin genes in a bacillus cereus associated with an illness resembling inhalation anthrax. Proc Natl Acad Sci USA 2004;101:8449-8454
155. Karginov VA, Robinson TM, Riemenschneider J, et al. Treatment of anthrax infection with combination of ciprofloxacin and antibodies to protective antigen of bacillus anthracis. FEMS Immunol Med Microbiol 2004;40:71-491.
156. Gu M, Leppla SH, Klinman DM. Protection against anthrax toxin by vaccination with a DNA plasmid encoding anthrax protective antigen. Vaccine 1999;17:340-344
157. Galloway DR, Baillie L. DNA vaccines against anthrax. Expert Opin Biol Ther 2004;4:1661-1667
158. Garmory HS, Titball RW, Griffin KF, et al. Salmonella enterica serovar typhimurium expressing a chromosomally integrated copy of the bacillus anthracis protective antigen gene protects mice against an anthrax spore challenge. Infect Immun 2003;71:3831-3836
159. Garmory HS, Brown KA, Titball RW. Salmonella vaccines for use in humans: Present and future perspectives. FEMS Microbiol Rev 2002;26:339-353
160. Galen JE, Zhao L, Chinchilla M, et al. Adaptation of the endogenous Salmonella enterica serovar Typhi clyA-encoded hemolysin for antigen export enhances the immunogenicity of anthrax protective antigen domain 4 expressed by the attenuated live-vector vaccine strain CVD 908-htrA. Infect Immun 2004;72:7096-7106
161. Zegers ND, Kluter E, van Der SH, et al. Expression of the protective antigen of bacillus anthracis by lactobacillus casei: Towards the development of an oral vaccine against anthrax. J Appl Microbiol 1999;87:309-314
162. Aziz MA, Singh S, Anand KP, et al. Expression of protective antigen in transgenic plants: A step towards edible vaccine against anthrax. Biochem Biophys Res Commun 2002;299:345-351
163. Mikszta JA, Sullivan VJ, Dean C, et al. Protective immunization against inhalational anthrax: A comparison of minimally invasive delivery platforms. J Infect Dis 2005;191:278-288
164. Flick-Smith HC, Eyles JE, Hebdon R, et al. Mucosal or parenteral administration of microsphere-associated bacillus anthracis protective antigen protects against anthrax infection in mice. Infect Immun 2002;70:2022-2028
165. Gaur R, Gupta PK, Banerjea AC, et al. Effect of nasal immunization with protective antigen of Bacillus anthracis on protective immune response against anthrax toxin. Vaccine 2002;20:2836-2839
166. Sloat BR, Cui Z. Strong mucosal and systemic immunities induced by nasal immunization with anthrax protective antigen protein incorporated in liposome-protamine-DNA particles. Pharm Res 2006;23:262-269 (Pubitemid 43237857)
167. Kenney RT, Yu J, Guebre-Xabier M, et al. Induction of protective immunity against lethal anthrax challenge with a patch. J Infect Dis 2004;190:774-782
168. Matyas GR, Friedlander AM, Glenn GM, et al. Needle-free skin patch vaccination method for anthrax. Infect Immun 2004;72:1181-1183
169. Schneerson R, Kubler-Kielb J, Liu TY, et al. Poly(gamma-D-glutamic acid) protein conjugates induce IgG antibodies in mice to the capsule of bacillus anthracis: A potential addition to the anthrax vaccine. Proc Natl Acad Sci USA 2003;100:8945-8950
170. Hahn UK, Boehm R, Beyer W. DNA vaccination against anthrax in mice-combination of anti-spore and anti-toxin components. Vaccine 2006;24:4569-4571 (Pubitemid 43776776)
171. Boyaka PN, Tafaro A, Fischer R, et al. Effective mucosal immunity to anthrax: Neutralizing antibodies and Th cell responses following nasal immunization with protective antigen. J Immunol 2003;170:5636-5643
172. Hermanson G, Whitlow V, Parker S, et al. A cationic lipid-formulated plasmid DNA vaccine confers sustained antibody-mediated protection against aerosolized anthrax spores. Proc Natl Acad Sci USA 2004;101:13601-13606
173. Steichen C, Chen P, Kearney JF, et al. Identification of the immunodominant protein and other proteins of the bacillus anthracis exosporium. J Bacteriol 2003;185:1903-1910
174. Maurer PH. Antigenicity of polypeptides XIII. Immunological studies with synthetic polymers containing only D- or D- and L-alpha-amino acids. J Exp Med 1965;121:339-349
175. Cohen S, Mendelson I, Altboum Z, et al. Attenuated nontoxinogenic and nonencapsulated recombinant bacillus anthracis spore vaccines protect against anthrax. Infect Immun 2000;68:4549-4558
176. Glomski IJ, Corre JP, Mock M, et al. Noncapsulated toxinogenic bacillus anthracis presents a specific growth and dissemination pattern in naive and protective antigen-immune mice. Infect Immun 2007;75:4754-4761
177. Chabot DJ, Scorpio A, Tobery SA, et al. Anthrax capsule vaccine protects against experimental infection. Vaccine 2004;23:43-47
178. Wang TT, Fellows PF, Leighton TJ, et al. Induction of opsonic antibodies to the gamma-D-glutamic acid capsule of bacillus anthracis by immunization with a synthetic peptide-carrier protein conjugate. FEMS Immunol Med Microbiol 2004;40:231-237
179. Rhie GE, Roehrl MH, Mourez M, et al. A dually active anthrax vaccine that confers protection against both bacilli and toxins. Proc Natl Acad Sci USA 2003;100:10925-10930
180. Bourgogne A, Drysdale M, Hilsenbeck SG, et al. Global effects of virulence gene regulators in a Bacillus anthracis strain with both virulence plasmids. Infect Immun 2003;71:2736-2743
181. Huang CM, Foster KW, DeSilva TS, et al. Identification of Bacillus
182. Huang CM, Elmets CA, Tang DC, et al. Proteomics reveals that proteins expressed during the early stage of bacillus anthracis infection are potential targets for the development of vaccines and drugs. Genomics Proteomics Bioinformatics 2004;2:143-151
183. Wang J, Ying T, Wang H, et al. 2-D reference map of Bacillus anthracis vaccine strain A16R proteins. Proteomics 2005;5:4488-4495
184. Rosovitz MJ, Schuck P, Varughese M, et al. Alanine-scanning mutations in domain 4 of anthrax toxin protective antigen reveal residues important for binding to the cellular receptor and to a neutralizing monoclonal antibody. J Biol Chem 2003;278:30936-30944
185. Hoffmaster AR, Ravel J, Rasko DA, et al. Identification of anthrax toxin genes in a bacillus cereus associated with an illness resembling inhalation anthrax. Proc Natl Acad Sci USA 2004;101:8449-8454
186. Karginov VA, Robinson TM, Riemenschneider J, et al. Treatment of anthrax infection with combination of ciprofloxacin and antibodies to protective antigen of bacillus anthracis. FEMS Immunol Med Microbiol 2004;40:71-74