By Tarun Sai LomteSep 8 2022Reviewed by Danielle Ellis, B.Sc. In a recent review published in Clinical Immunology, researchers reviewed the epidemiology, clinical character, treatment, and prevention of human monkeypox .
Host immune responses Orthopoxviruses elicit host immune responses through several DNA-sensing mechanisms such as interferon - γ inducible protein 17, DNA-dependent protein kinase, toll-like receptor 9 , and GMP-AMP synthase. DNA sensors activate the stimulator of IFN genes , activating nuclear factor -κB and IFN signaling pathways.
One study demonstrated that macaques depleted of T cells had survived a deadly dose of MPXV administered after vaccination, underscoring the pivotal role of serologic responses. Several mechanisms allow MPXV to escape from type I IFN responses. MPXV decreases the efficacy of viral clearance by downregulating chemokine receptors critical for migration and cytotoxicity of NK cells.
During the ongoing MPX outbreak, the viral incubation period is short, and skin lesions develop within 24 hours of contact with an infected subject in the absence of febrile prodrome. Polymerase chain reaction tests diagnose MPXV infection. Using samples from skin lesions is the most reliable method.
Vaccines Most anti-Orthopoxvirus vaccines are based on those against the vaccinia virus due to cross-reactive antibodies against Orthopoxviruses. Dryvax is a live vaccinia virus grown on calf skin; it was initially used before smallpox was eradicated. Dryvax has been linked to multiple adverse outcomes, which could rarely be fatal. As such, a second-generation ACAM2000 vaccine has been developed.
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