Last year, mpox infections flipped from being mostly restricted to hotspots in Africa to becoming a global health emergency. According to the World Health Organization (WHO) the unprecedented outbreak of mpox, previously known as monkeypox, recorded a cumulative total of 87,113 laboratory-confirmed cases, including 130 deaths from 1 January 2022 through 24 April 2023.
Fok-Moon Lum, an Investigator at the A*STAR Infectious Diseases Labs (ID Labs) said that the event sparked a flurry of research activity around the how and why of the virus’ unexpected rise. “Some of the major reasons for this spread could be attributed to waning smallpox immunity in the general population and the termination of the smallpox vaccination regime,” explained Lum.
In collaboration with teams at the National Centre for Infectious Diseases, Singapore, Lum and colleagues embarked on an in-depth review of studies in the field to help steer efforts to control the spread of mpox.
The researchers documented how the mpox virus affects host cells by interfering with cell signalling pathways and turning off the body’s protective immune mechanisms. They also identified an urgent need for defining immune biomarkers specific to mpox infections to help evaluate the efficacy of new vaccines. According to Lum, safe and effective vaccines are critical for shielding vulnerable populations such as pregnant women and children against the virus.
In addition, the team identified another gap in our understanding of the B.1 lineage, an emerging lineage of the Western African mpox strain that spread prolifically during the 2022 global outbreak. The researchers offered valuable insights on the evolution of this strain by comparing it to the genetics of SARS-CoV-2.
Unlike the genome of the COVID-causing virus which is RNA-based, mpox’s genetic material is encoded in DNA. Since DNA is more resistant to errors during replication in the host than RNA, mpox is less likely to produce mutant variants of increasing transmissibility.
Nonetheless, the team pointed to a series of genetic changes called single nucleotide polymorphisms present in the genome of the B.1 lineage, which can affect the function of the protein that the gene encodes, and explain its enhanced transmissibility and sudden worldwide spread. “As with other viruses, it is expected that the mpox virus will continue to mutate to obtain beneficial features for its own evolution and spread,” warned Lum.
Lum said that the group’s current interests lie in mapping host responses to active mpox infections. The team has collected samples from local patients and will leverage on the ID Labs’ repertoire of advanced immunological tools to help answer lingering questions in the field.
“This is extremely important as the mpox virus has accrued an arsenal of genes encoding for proteins that are capable of subverting the host immune responses,” said Lum.
The A*STAR-affiliated researchers contributing to this research are from the A*STAR Infectious Diseases Labs (ID Labs).
