New Method Treats Deadly Infectious Disease Beyond the “Point of No Return”

University of Pittsburgh researchers discovered that a mix of growth factors can rescue cells from late-stage anthrax damage by reactivating key survival pathways, offering hope for treatments beyond the current therapeutic window.

Anthrax, an infectious disease caused by the bacterium Bacillus anthracis, is often treatable in its early stages. However, once it progresses past the “point of no return” after just a few days, patients are almost certainly doomed.

In a new Nature Microbiology study, University of Pittsburgh researchers show that a cocktail of growth factors reversed would-be lethal cell damage in mice with anthrax, suggesting that this approach could be adapted for use in patients beyond the brink.

“While only a few people die from anthrax in the United States each year, there is always the concern that the bacterium could be released on a large scale as a bioweapon,” said senior author Shihui Liu, M.D., Ph.D., associate professor of medicine at the Pitt School of Medicine and member of the Aging Institute, a joint venture of Pitt and UPMC. “Because the early symptoms of anthrax are non-specific and flu-like, the disease often isn’t diagnosed until it’s too late for current treatments to help. We need new approaches to treat this later stage of the disease.”

How Anthrax Works at the Cellular Level

When B. anthracis enters the body through inhalation, ingestion, injection, or contact with skin, it produces two proteins that combine to form a lethal toxin.

Early on, anthrax can be treated with antibiotics that eliminate the bacterium or antibodies that neutralize the lethal toxin before it enters cells. But once inside cells, the toxin inactivates members of a group of enzymes known as MEKs by cleaving off one of their ends, disrupting the important pathways they control and rapidly causing widespread cellular, tissue, and organ damage—and death.

To learn more about the roles of MEK-controlled pathways in anthrax toxicity, Liu and his team generated mice with modified MEKs that were resistant to being cleaved by lethal toxin. These included MEK1 and MEK2, which control a pathway called ERK involved in cellular division and survival, and MEK3 and MEK6, which regulate the p38 pathway that’s involved in stress-induced defense.

When exposed to lethal toxin or B. anthracis, mice with either modified MEK1/2 or MEK3/6 had much greater survival than normal animals, indicating that anthrax must inactivate both the ERK and p38 pathways to kill its host.

A Surprising Rescue with Growth Factors

In mice and human cells exposed to lethal toxin or B. anthracis, a combination of three growth factors —all individually approved as treatments for other conditions — reactivated the ERK pathway and brought them back from the point of no return.

“Because lethal toxin breaks MEK proteins by clipping off their ends, we thought that this cellular damage was irreversible,” said Liu. “So we were really surprised to find that specific growth factors were able to reactivate the ERK pathway and rescue the cell.”

Because different types of cells in the body may require different growth factors to activate ERK, the researchers are now working to optimize a treatment for anthrax in humans.

Reference: “ERK pathway reactivation prevents anthrax toxin lethality in mice” by Jie Liu, Zehua Zuo, Michael Ewing, Qing Cao, Liu Cao, Qi Li, Toren Finkel, Stephen H. Leppla and Shihui Liu, 28 March 2025, Nature Microbiology.
DOI: 10.1038/s41564-025-01977-x

This research was supported by NIAID (R01AI170574).