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Global Transmission, Prevention, Control, and Treatment of Mpox Virus in 2025: A Comprehensive Review from Infection
Quan Quan1, Nan Wu1,2,3, Ying-Hua Luo4
1Department of Biochemistry and Molecular Biology, College of Life Science and Biotechnology, Heilongjiang Bayi Agricultural University, Daqing 163319, China.
Abstract:
The World Health Organization (WHO) declared the mpox (MPX) outbreak a public health emergency of international concern (PHEIC) on 23 July 2022, and 14 August 2024, respectively, underscoring the confirmed and concerning global spread of the disease. A gap exists in our fundamental understanding of the mpox virus (MPXV), despite its genetic relatedness to the variola virus (VARV). This knowledge deficit is evident in the performance of current medical countermeasures; vaccines and antiviral therapies adapted from smallpox programs demonstrate only partial efficacy and are constrained by issues of safety and suboptimal effectiveness against MPXV. In this context, the development of MPX-specific vaccines and antiviral drugs has become a critical priority in the global effort to combat MPX. However, MPXV employs multiple strategies to evade host immune responses, such as producing specific and poxvirus homologous proteins that suppress both innate immunity (including the six principal innate immune signaling pathways and antiviral strategies, notably the interferon [IFN] pathway) and adaptive immunity, thereby complicating vaccine and drug development. Insights from research on vaccinia virus (VACV) and VARV may inform the investigation of MPXV pathogenesis and immune evasion mechanisms. Drawing on relevant scientific literature, this review systematically examines key aspects of MPX infection, pathogenicity, and immune evasion, as well as the coordination between innate and adaptive immune responses. Furthermore, this review elucidates the current application and deployment landscape of the three principal therapeutics and three major vaccines for MPX, aiming to provide a theoretical foundation for future research and development of vaccines and targeted antiviral agents.
Insights
Mpox (MPX) is spreading globally, but understanding of the mpox virus (MPXV) and its immune evasion is limited. This review examines MPX infection, immune responses, and current countermeasures to guide future vaccine and antiviral development.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- The global mpox (MPX) outbreak, declared a public health emergency, highlights gaps in understanding the mpox virus (MPXV).
- Current medical countermeasures adapted from smallpox are only partially effective and have safety concerns.
- MPXV employs immune evasion strategies, complicating the development of MPX-specific treatments.
Purpose of the Study:
- To systematically review MPX infection, pathogenicity, and immune evasion mechanisms.
- To analyze the interplay between innate and adaptive immune responses in MPX.
- To elucidate the current landscape of MPX therapeutics and vaccines for future R&D.
Main Methods:
- Systematic review of scientific literature on MPX, vaccinia virus (VACV), and variola virus (VARV).
- Examination of MPXV pathogenesis and immune evasion strategies.
- Analysis of current vaccine and antiviral therapies for MPX.
Main Results:
- MPXV utilizes diverse strategies to suppress innate and adaptive immunity, including the interferon pathway.
- Existing vaccines and antivirals show limited efficacy and safety profiles against MPX.
- Insights from VACV and VARV research can inform MPXV studies.
Conclusions:
- A deeper understanding of MPXV pathogenesis and immune evasion is crucial for developing effective MPX-specific countermeasures.
- Targeted vaccine and antiviral development is a priority to combat the global mpox outbreak.
- This review provides a foundation for future research in MPX therapeutics and vaccines.
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