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Monkeypox is a zoonotic viral disease caused by monkeypox virus (MONKEYPOX virus) (MPXV), a positive pox virus that belongs to the pox virus family
summary
References: Lum, FM.
, Torres-Ruesta, A.
, Tay, M.
Z.
et al.
Monkeypox: disease epidemiology, host immunity and clinical interventions.
Nat Rev Immunol (2022).
Figure 1: Geographical distribution of confirmed and suspected monkeypox cases during outbreaks between May and August 2022
Phylogenetically, MPXV can be divided into two distinct branches – Central Africa (also commonly known as the Congo Basin) and West AfricaClinical features of MPXV infection
The incubation period for MPXV infection is 5 to 21 days, and common symptoms include fever (between 38.
Disease severity can be classified using lesion counts, as higher lesion counts are associated
Lesions usually go through 4 stages – macular, papule, blister, and pustular – and then shed into scabs
Intrinsic immune response to MXV
Innate immune cells often serve as the first line of defense after an active viral infection, but these cells also serve as targets for some viruses
In humans infected with MPXV, the role of many innate immune cells— including monocytes/macrophages, neutrophils, natural killer cells, conventional dendritic cells, plasma cell-like dendritic cells, and innate immune lymphocytes — is unknown
In reported cases of human MMXV infection, many cytokines were elevated after infection (independent of disease severity) – including IL-1β, IL-1RA, IL-2R, IL-4, IL-5, IL-6, IL-8, IL-13, IL-15, IL-17, CCL2, and CCL5
B cell and antibody protection
Currently, 14 MXV proteins have been shown to be recognized by cross-reactive VACV-induced immunoglobulins from human vaccines
T cell immunity
CD4+ T cells, particularly follicular helper T cells, play a role
MPXV immune evasion
Positive pox viruses have accumulated a large number of genes that code for proteins that interfere with host cell signaling pathways
Figure 3: Immune evasion of MPXV
vaccine
Smallpox vaccines are known to have cross-protective activity
In unvaccinated individuals, post-exposure vaccination is effective in preventing disease and reducing disease severity
Third-generation attenuated vaccines, such as JYNNEOS, have better safety profiles than earlier vaccines
treat
Several therapeutics developed for smallpox can be used for monkeypox, but their effectiveness against monkeypox is based on preclinical evidence with little supporting clinical data
summary
Immunotherapy and prevention strategies are important public health tools
References: Lum, FM.
, Torres-Ruesta, A.
, Tay, M.
Z.
et al.
Monkeypox: disease epidemiology, host immunity and clinical interventions.
Nat Rev Immunol (2022).