{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T04:34:13Z","timestamp":1741754053144,"version":"3.38.0"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"3-4","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,27]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Anthrax, caused by the bacterium Bacillus anthracis, stands as a formidable threat with both natural and bioterrorism-related implications. Its ability to afflict a wide range of hosts, including humans and animals, coupled with its potential use as a bioweapon, underscores the critical importance of understanding and advancing our capabilities to combat this infectious disease. In this context, exploring futuristic approaches becomes imperative, as they hold the promise of not only addressing current challenges but also ushering in a new era in anthrax management. This review delves into strategies to mitigate the impact of anthrax on global health and security, envisioning a future where our arsenal against anthrax is characterized by precision and adaptability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>This article highlights the significant potential of anthrax as a bioweapon, while also highlighting current knowledge and strategies developed against this deadly pathogen. We have performed an extensive research and literature review in concordance with the criteria outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A search strategy was conducted by using numerous keywords on various academic databases, yielding an initial set of 546 records along with 80 supplementary articles. The search included research papers, review papers, perspectives, clinical guidelines, and scientific blogs. The primary and secondary screening of the articles were conducted by 2 independent reviewers along with a third reviewer mitigating any discrepancies and biases encountered during the process. A set of inclusion and exclusion criteria were formulated, and a PICO framework was adapted based on which multiple records were analyzed and considered for the review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 53 articles were selected after completing a comprehensive systematic literature review. This review proposes novel approaches and scientific analysis of the complexities surrounding anthrax in the context of bioterrorism, highlighting the emerging technologies and strategies employed for bioterrorism mitigation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The upcoming advancements in anthrax research will be based on cutting-edge technologies and innovative approaches that demonstrate great potential for prevention, detection, and treatment. These advancements may include the incorporation of synthetic biology techniques such as precise manipulation of biological components, nanoscale diagnostics, and Clustered regularly interspaced short palindromic repeats-based technologies, which could revolutionize our ability to combat anthrax on a molecular level. As these progressive methodologies continue to evolve, the integration of these technologies has the potential to redefine our strategies against anthrax, providing more accurate, personalized, and adaptable approaches to address the challenges posed by this infectious threat.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usae535","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T20:18:27Z","timestamp":1733861907000},"page":"e569-e579","source":"Crossref","is-referenced-by-count":0,"title":["From Spores to Suffering: Understanding the Role of Anthrax in Bioterrorism"],"prefix":"10.1093","volume":"190","author":[{"given":"Ratnesh Singh","family":"Kanwar","sequence":"first","affiliation":[{"name":"Division of Clinical Research and Medical Management (CRMM), Institute of Nuclear Medicine & Allied Sciences (INMAS), DRDO , Delhi 110054,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirtida","family":"Gambhir","sequence":"additional","affiliation":[{"name":"Division of Clinical Research and Medical Management (CRMM), Institute of Nuclear Medicine & Allied Sciences (INMAS), DRDO , Delhi 110054,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9746-3900","authenticated-orcid":false,"given":"Tanishka","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Division of Clinical Research and Medical Management (CRMM), Institute of Nuclear Medicine & Allied Sciences (INMAS), DRDO , Delhi 110054,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akash","family":"Godiwal","sequence":"additional","affiliation":[{"name":"Translational Health Science and Technology Institute, NCR Biotech Science Cluster 3rd Milestone , Faridabad, Haryana 121001,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuntal","family":"Bhadra","sequence":"additional","affiliation":[{"name":"Division of Clinical Research and Medical Management (CRMM), Institute of Nuclear Medicine & Allied Sciences (INMAS), DRDO , Delhi 110054,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"2025031111144322600_R1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2023.1215773","article-title":"Anthrax revisited: how assessing the unpredictable can improve biosecurity","volume":"11","author":"Sabra","year":"2023","journal-title":"Front Bioeng Biotechnol"},{"author":"Centers for Disease Control and Prevention (CDC)","key":"2025031111144322600_R2","article-title":"History of anthrax"},{"key":"2025031111144322600_R3","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/978-3-030-03053-7_13","volume-title":"Defense Against Biological Attacks: Volume I","author":"Berger","year":"2019"},{"issue":"6","key":"2025031111144322600_R4","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.4269\/ajtmh.22-0341","article-title":"Beyond the unknown: a broad framing for preparedness for emerging infectious threats","volume":"107","author":"Christofferson","year":"2022","journal-title":"Am J Trop Med Hyg"},{"issue":"3","key":"2025031111144322600_R5","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.36800","article-title":"The history of anthrax weaponization in the Soviet Union","volume":"15","author":"Nikolakakis","year":"2023","journal-title":"Cureus"},{"issue":"1","key":"2025031111144322600_R6","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.jobb.2021.11.003","article-title":"Development of and prospects for the biological weapons convention","volume":"4","author":"Huigang","year":"2022","journal-title":"J Biosaf Biosecurity"},{"issue":"12","key":"2025031111144322600_R7","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8121864","article-title":"The Bacillus anthracis cell envelope: composition, physiological role, and clinical relevance","volume":"8","author":"Chateau","year":"2020","journal-title":"Microorganisms"},{"issue":"6","key":"2025031111144322600_R8","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13061056","article-title":"Human anthrax: update of the diagnosis and treatment","volume":"13","author":"Doganay","year":"2023","journal-title":"Diagnostics"},{"issue":"1","key":"2025031111144322600_R9","doi-asserted-by":"publisher","first-page":"10","DOI":"10.2174\/1574891X10666150408162354","article-title":"Human anthrax as a re-emerging disease","volume":"10","author":"Doganay","year":"2015","journal-title":"Recent Pat Antiinfect Drug Discov"},{"issue":"9","key":"2025031111144322600_R10","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1007\/s13213-018-1361-z","article-title":"Biomarkers of bacterial spore germination","volume":"68","author":"Tehri","year":"2018","journal-title":"Ann Microbiol"},{"issue":"1","key":"2025031111144322600_R11","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1146\/annurev-micro-091014-104523","article-title":"Anthrax pathogenesis","volume":"69","author":"Moayeri","year":"2015","journal-title":"Annu Rev Microbiol"},{"issue":"6","key":"2025031111144322600_R12","doi-asserted-by":"publisher","DOI":"10.1016\/J.TIM.2014.02.012","article-title":"Anthrax lethal and edema toxins in anthrax pathogenesis","volume":"22","author":"Liu","year":"2014","journal-title":"Trends Microbiol"},{"key":"2025031111144322600_R13","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00462","article-title":"Bacillus anthracis poly-\u03b3-D-glutamate capsule inhibits opsonic phagocytosis by impeding complement activation","volume":"11","author":"Sharma","year":"2020","journal-title":"Front Immunol"},{"issue":"3","key":"2025031111144322600_R14","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1128\/microbiolspec.GPP3-0032-2018","article-title":"The Bacillus cereus group: Bacillus species with pathogenic potential","volume":"7","author":"Ehling-Schulz","year":"2019","journal-title":"Microbiol Spectr"},{"article-title":"Anthrax","volume-title":"StatPearls","author":"Simonsen","key":"2025031111144322600_R15"},{"article-title":"Anthrax","volume-title":"MSD Manual Professional Edition","author":"Bush","key":"2025031111144322600_R16"},{"author":"Centers for Disease Control and Prevention","key":"2025031111144322600_R17","article-title":"Specimens for anthrax diagnosis by clinical presentation"},{"issue":"15","key":"2025031111144322600_R18","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13152490","article-title":"Alternate antimicrobial therapies and their companion tests","volume":"13","author":"Kalpana","year":"2023","journal-title":"Diagnostics"},{"issue":"22","key":"2025031111144322600_R19","doi-asserted-by":"publisher","DOI":"10.3390\/IJMS222212224\/S1","article-title":"Ultrasensitive detection of Bacillus anthracis by real-time PCR targeting a polymorphism in multi-copy 16s rRNA genes and their transcripts","volume":"22","author":"Braun","year":"2021","journal-title":"Int J Mol Sci"},{"issue":"12","key":"2025031111144322600_R20","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01376-15","article-title":"Efficacy of single and combined antibiotic treatments of anthrax in rabbits","volume":"59","author":"Weiss","year":"2015","journal-title":"Antimicrob Agents Chemother"},{"issue":"Suppl 3","key":"2025031111144322600_R21","doi-asserted-by":"publisher","first-page":"S373","DOI":"10.1093\/cid\/ciac520","article-title":"Systematic review of in vitro antimicrobial susceptibility testing for Bacillus anthracis, 1947-2019","volume":"75","author":"Maxson","year":"2022","journal-title":"Clin Infect Dis"},{"issue":"5","key":"2025031111144322600_R22","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens9050370","article-title":"Current status and trends in prophylaxis and management of anthrax disease","volume":"9","author":"Savransky","year":"2020","journal-title":"Pathogens"},{"issue":"3","key":"2025031111144322600_R23","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1517\/17460441.2014.877884","article-title":"Designing inhibitors of anthrax toxin","volume":"9","author":"Nestorovich","year":"2014","journal-title":"Expert Opin Drug Discov"},{"issue":"3","key":"2025031111144322600_R24","doi-asserted-by":"publisher","DOI":"10.3390\/toxins14030172","article-title":"Antibodies against anthrax toxins: a long way from benchlab to the bedside","volume":"14","author":"Avril","year":"2022","journal-title":"Toxins"},{"issue":"1","key":"2025031111144322600_R25","doi-asserted-by":"publisher","DOI":"10.1186\/s13036-018-0138-z","article-title":"Inhibition of bacterial toxin recognition of membrane components as an anti-virulence strategy","volume":"13","author":"Krueger","year":"2019","journal-title":"J Biol Eng"},{"issue":"5","key":"2025031111144322600_R26","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8050651","article-title":"Current state of anthrax vaccines and key R&D gaps moving forward","volume":"8","author":"Clark","year":"2020","journal-title":"Microorganisms"},{"issue":"1","key":"2025031111144322600_R27","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2023.2191741","article-title":"Inhalable vaccine of bacterial culture supernatant extract mediates protection against fatal pulmonary anthrax","volume":"12","author":"Zhai","year":"2023","journal-title":"Emerg Microbes Infect"},{"issue":"2","key":"2025031111144322600_R28","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines12020159","article-title":"Anthrax vaccines in the twenty-first century","volume":"12","author":"Georgopoulos","year":"2024","journal-title":"Vaccines"},{"issue":"1","key":"2025031111144322600_R29","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8010125","article-title":"Detection and identification of Bacillus anthracis: from conventional to molecular microbiology methods","volume":"8","author":"Zasada","year":"2020","journal-title":"Microorganisms"},{"issue":"S1","key":"2025031111144322600_R30","doi-asserted-by":"publisher","first-page":"283","DOI":"10.3233\/THC-236024","article-title":"Study on the detection of anthrax by ICP-MS based on gold nanoparticle labeling","volume":"31","author":"Xu","year":"2023","journal-title":"Technol Health Care"},{"issue":"1","key":"2025031111144322600_R31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11051-013-2151-y","article-title":"Lanthanide-functionalized silver nanoparticles for detection of an anthrax biomarker and test paper fabrication","volume":"16","author":"Tan","year":"2014","journal-title":"J Nanopart Res"},{"key":"2025031111144322600_R32","doi-asserted-by":"publisher","DOI":"10.1016\/j.cej.2020.12740","article-title":"AIE-based Tb3+ complex self-assembled nanoprobe for ratiometric fluorescence detection of anthrax spore biomarker in water solution and actual spore samples","volume":"413","author":"Su","year":"2021","journal-title":"Chem Eng J"},{"key":"2025031111144322600_R33","doi-asserted-by":"publisher","DOI":"10.3389\/fchem.2022.1057241","article-title":"Corrigendum: contactless and robust dielectric microspheres-assisted surface-enhanced Raman scattering sensitivity improvement for anthrax biomarker detection","volume":"10","author":"Ge","year":"2022","journal-title":"Front Chem"},{"key":"2025031111144322600_R34","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1016\/j.talanta.2018.08.071","article-title":"Anthrax biomarker: an ultrasensitive fluorescent ratiometry of dipicolinic acid by using terbium(III)-modified carbon dots","volume":"191","author":"Liu","year":"2019","journal-title":"Talanta"},{"key":"2025031111144322600_R35","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.ab.2017.12.007","article-title":"Validated MALDI-TOF-MS method for anthrax lethal factor provides early diagnosis and evaluation of therapeutics","volume":"543","author":"Gallegos-Candela","year":"2018","journal-title":"Anal Biochem"},{"issue":"2","key":"2025031111144322600_R36","doi-asserted-by":"publisher","first-page":"358","DOI":"10.3201\/eid2602.191351","article-title":"Rapid nanopore whole-genome sequencing for anthrax emergency preparedness","volume":"26","author":"McLaughlin","year":"2020","journal-title":"Emerg Infect Dis"},{"issue":"4","key":"2025031111144322600_R37","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics14040806","article-title":"Designing stable Bacillus anthracis antigens with a view to recombinant anthrax vaccine development","volume":"14","author":"Ryabchevskaya","year":"2022","journal-title":"Pharmaceutics"},{"key":"2025031111144322600_R38","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2022.1003969","article-title":"New formulation of a recombinant anthrax vaccine stabilised with structurally modified plant viruses","volume":"13","author":"Granovskiy","year":"2022","journal-title":"Front Microbiol"},{"issue":"3","key":"2025031111144322600_R39","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1177\/1091581819848722","article-title":"Repeat-dose toxicity study of a lyophilized recombinant protective antigen-based anthrax vaccine adjuvanted with CpG 7909","volume":"38","author":"Savransky","year":"2019","journal-title":"Int J Toxicol"},{"article-title":"VELOCITY: an anthrax vaccine clinical study","volume-title":"ClinicalTrials.gov identifier: NCT03877926","author":"Emergent BioSolutions","key":"2025031111144322600_R40"},{"issue":"5","key":"2025031111144322600_R41","doi-asserted-by":"publisher","DOI":"10.4172\/2157-2526.1000350","article-title":"Anthrax bioterrorism threat assessment preparedness and response strategies","volume":"14","author":"Franzen","year":"2023","journal-title":"J Bioterr Biodef"},{"issue":"Suppl 3","key":"2025031111144322600_R42","doi-asserted-by":"publisher","first-page":"S339","DOI":"10.1093\/cid\/ciac567","article-title":"Responding to the threat posed by anthrax: updated evidence to improve preparedness","volume":"75","author":"Honein","year":"2022","journal-title":"Clin Infect Dis"},{"issue":"8","key":"2025031111144322600_R43","doi-asserted-by":"publisher","DOI":"10.3390\/polym14081599","article-title":"Recent trends in protective textiles against biological threats: a focus on biological warfare agents","volume":"14","author":"Antunes","year":"2022","journal-title":"Polymers"},{"article-title":"Anthrax\u2014control and prevention","volume-title":"Safety and Health Topics","author":"Occupational Safety and Health Administration (OSHA)","key":"2025031111144322600_R44"},{"author":"UMN University Health & Safety","key":"2025031111144322600_R45","article-title":"Decontamination of biohazards and infectious agents"},{"key":"2025031111144322600_R46","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1016\/B978-1-4557-4801-3.00015-1","volume-title":"Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases","author":"Borio","year":"2015","edition":"8th"},{"issue":"8","key":"2025031111144322600_R47","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1016\/S1473-3099(21)00382-0","article-title":"Biodefence research two decades on: worth the investment?","volume":"21","author":"Long","year":"2021","journal-title":"Lancet Infect Dis"},{"article-title":"AI makes anthrax bioterror detection easier","volume-title":"IEEE Spectrum","author":"Hsu","key":"2025031111144322600_R48"},{"issue":"3","key":"2025031111144322600_R49","doi-asserted-by":"publisher","DOI":"10.1007\/S10462-021-10058-4","article-title":"Machine learning in drug discovery: a review","volume":"55","author":"Dara","year":"2022","journal-title":"Artif Intell Rev"},{"issue":"24","key":"2025031111144322600_R50","doi-asserted-by":"publisher","first-page":"4451","DOI":"10.1021\/acs.accounts.1c00407","article-title":"Biosensors for the detection of Bacillus anthracis","volume":"54","author":"Wang","year":"2021","journal-title":"Acc Chem Res"},{"issue":"1","key":"2025031111144322600_R51","doi-asserted-by":"publisher","DOI":"10.1007\/S12275-022-00005-5","article-title":"Recent advances in CRISPR-CAS technologies for synthetic biology","volume":"61","author":"Jeong","year":"2023","journal-title":"J Microbiol"},{"issue":"15","key":"2025031111144322600_R52","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15153837","article-title":"Precision medicine: disease subtyping and tailored treatment","volume":"15","author":"Wang","year":"2023","journal-title":"Cancers (Basel)"},{"issue":"5","key":"2025031111144322600_R53","doi-asserted-by":"publisher","DOI":"10.1016\/J.JSPS.2022.02.011","article-title":"Role of site-directed mutagenesis and adjuvants in the stability and potency of anthrax protective antigen","volume":"30","author":"Dahhas","year":"2022","journal-title":"Saudi Pharm J"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/3-4\/e569\/60958755\/usae535.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/3-4\/e569\/60958755\/usae535.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T11:15:23Z","timestamp":1741691723000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/190\/3-4\/e569\/7917172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,5]]},"references-count":53,"journal-issue":{"issue":"3-4","published-online":{"date-parts":[[2024,12,5]]},"published-print":{"date-parts":[[2025,2,27]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usae535","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"type":"print","value":"0026-4075"},{"type":"electronic","value":"1930-613X"}],"subject":[],"published-other":{"date-parts":[[2025,3]]},"published":{"date-parts":[[2024,12,5]]}}}