Kumar Rukmini, Chow Carson C, Bartels John D, Clermont Gilles, Vodovotz Yoram
Department of Physics, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
Shock. 2008 Jan;29(1):104-11. doi: 10.1097/SHK.0b013e318067da56.
Bacillus anthracis (anthrax) can trigger an acute inflammatory response that results in multisystem organ failure and death. Previously, we developed a mathematical model of acute inflammation after gram-negative infection that had been matched qualitatively to literature data. We modified the properties of the invading bacteria in that model to those specific to B. anthracis and simulated the host response to anthrax infection. We simulated treatment strategies against anthrax in a genetically diverse population including the following: (1) antibiotic treatment initiated at various time points, (2) antiprotective antigen vaccine, and (3) a combination of antibiotics and vaccine. In agreement with studies in mice, our simulations showed that antibiotics only improve survival if administered early in the course of anthrax infection. Vaccination that leads to the formation of antibodies to protective antigen is anti-inflammatory and beneficial in averting shock and improving survival. However, antibodies to protective antigen alone are predicted not to be universally protective against anthrax infection. Rather, our simulations suggest that an optimal strategy would require both vaccination and antibiotic administration.
炭疽芽孢杆菌（炭疽）可引发急性炎症反应，导致多系统器官衰竭和死亡。此前，我们建立了革兰氏阴性菌感染后急性炎症的数学模型，该模型在性质上已与文献数据相匹配。我们将该模型中入侵细菌的特性修改为炭疽芽孢杆菌特有的特性，并模拟了宿主对炭疽感染的反应。我们在一个基因多样化的群体中模拟了针对炭疽的治疗策略，包括以下几种：（1）在不同时间点开始使用抗生素治疗，（2）抗保护性抗原疫苗，以及（3）抗生素和疫苗联合使用。与小鼠研究结果一致，我们的模拟结果表明，抗生素只有在炭疽感染病程早期给药才能提高存活率。导致形成保护性抗原抗体的疫苗接种具有抗炎作用，有助于避免休克并提高存活率。然而，仅保护性抗原抗体预计并不能对炭疽感染起到普遍的保护作用。相反，我们的模拟结果表明，最佳策略需要同时进行疫苗接种和抗生素给药。
