https://www.selleckchem.com/products/azd4547.html 3.6%, p  less then  0.001) and all-cause death (7.8% vs. 0%, p = 0.007). In a multivariate Cox proportional hazards regression analysis, presence of the ARC-HBR criteria [hazard ratio (HR) 4.15, 95% confidence interval (CI) 1.25-13.80, p = 0.020], body mass index (HR 1.13, 95% CI 1.01-1.27, p = 0.042), diabetes mellitus (HR 2.70, 95% CI 1.28-5.69, p = 0.009), hyperlipidemia (HR 0.41, 95% CI 0.21-0.80, p = 0.009), and infrapopliteal lesions (HR 3.51, 95% CI 1.63-7.56, p = 0.001) were independent predictors of the primary composite outcome. Approximately 70% of Japanese patients undergoing EVT met the ARC-HBR criteria, and its presence was strongly associated with adverse outcomes within 12 months of EVT.Caseous lymphadenitis (CLA) is an infectious chronic disease responsible for economic losses in sheep and goat breeding worldwide. CLA has no effective treatment, evidencing the vaccination schedule as the best control strategy. Although some commercial vaccines have been available, none of them provides total protection, which is sometimes insufficient and does not reach the same efficiency when compared in sheep and goats. They also have questionable safety levels and side effects. In light of this, several experimental vaccines are in development in order to improve safety, reproducibility, and protective immune response against the etiologic agent of CLA, Corynebacterium pseudotuberculosis. In this review, we discussed aspects as antigen, adjuvant, routes of administration, protection level, and animal models used in CLA vaccine development, as well the challenges and future perspectives. KEY POINTS Caseous lymphadenitis (CLA) does not have an appropriate commercial vaccine. Different experimental vaccines are in development aiming to protect against Corynebacterium pseudotuberculosis. An ideal vaccine for CLA is necessary for the disease control.Bioremediation of toxic metal ions using bacterial strains is a promi