Pathogenesis and sepsis caused by organisms potentially utilized as biologic weapons: opportunities for targeted intervention.

The microorganisms potentially utilized as biologic weapons have a variety of pathogenic mechanisms that lead to overwhelming infection, septic shock and death. Although many of these organisms have unique pathogenic attributes, the development of generic therapies for common pathways would be exceedingly useful as countermeasures. This review will examine the features of pathogenesis leading to sepsis for key biologic threat agents (causative agents of anthrax, plague, tularemia, smallpox and viral hemorrhagic fevers), and highlight current and future therapeutic targets. For some of the biologic threat agents, such as anthrax, substantial research has yielded a number of targeted sites for intervention. For other organisms, further elucidation of the mechanisms of pathogenesis and septic shock is needed to direct therapeutic exploration.