Mpox Virus: A holistic review of molecular pathogenesis, diagnostic advancements, and global response strategies
DOI:
https://doi.org/10.4025/actascibiolsci.v48i1.76252Palavras-chave:
Mpox; MPXV; diagnostics; pathogenesis; vaccines; biosensors; public health.Resumo
Mpox or Mpox virus (MPXV) has re-emerged as a global health concern, underscoring the importance of understanding its biology, improving diagnostic capacity, and developing effective therapeutic and preventive strategies. This review synthesizes current knowledge of MPXV pathogenesis, highlighting how the virus manipulates host immune responses and adapts through genetic variability. We discuss the spectrum of diagnostic tools, ranging from polymerase chain reaction (PCR) as the gold standard to rapid antigen-based assays and emerging biosensor platforms that enable sensitive and point-of-care detection. Advances in vaccine development and therapeutic repurposing are examined, alongside the challenges of equitable global access. Particular emphasis is placed on the integration of biosensing technologies with genomic surveillance to enhance outbreak preparedness. By bridging insights from virology, diagnostics, and public health, this review provides a comprehensive framework for strengthening global responses to MPXV and guiding future research toward pandemic readiness.
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Referências
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de Lima, L. F., Barbosa, P. P., Simeoni, C. L., de Paula, R. F. O., Proença-Modena, J. L., & de Araujo, W. R. (2023). Electrochemical paper-based nanobiosensor for rapid and sensitive detection of monkeypox virus. ACS Applied Materials & Interfaces, 15(50), 58079–58091. https://doi.org/10.1021/acsami.3c10730
De Pace, V., Bruzzone, B., Ricucci, V., Domnich, A., Guarona, G., Garzillo, G., Qosja, R., Ciccarese, G., Di Biagio, A., Orsi, A., & Icardi, G. (2024). Molecular diagnosis of human monkeypox virus during 2022–23 outbreak: Preliminary evaluation of novel real-time qualitative PCR assays. Microorganisms, 12(4), Article 664. https://doi.org/10.3390/microorganisms12040664
Debnath, J. P., Hossen, K., Sayed, S. B., Khandaker, M. S., Dev, P. C., Sarker, S., & Hossain, T. (2025). Identification of potential biomarkers for 2022 mpox virus infection: A transcriptomic network analysis and machine learning approach. Scientific Reports, 15(1), Article 2922. https://doi.org/10.1038/s41598-024-80519-7
Deng, Y., Navarro-Forero, S., & Yang, Z. (2025). Temporal expression classes and functions of vaccinia virus and mpox (monkeypox) virus genes. mBio, 16(4). https://doi.org/10.1128/mbio.03809-24
Ehmann, R., Mantke, O. D., McCulloch, E., Yousef, A., Ricketts, A., Staines, H., Bugert, J. J., Wölfel, R., & Niesters, H. G. (2024). International external quality assessment study for detection of monkeypox virus by PCR supporting laboratory preparedness during the 2022–2023 mpox outbreak and beyond. Journal of Clinical Virology, 175, Article 105741. https://doi.org/10.1016/j.jcv.2024.105741
Erster, O., Levy, I., Kabat, A., Mannasse, B., Levy, V., Assraf, H., Azar, R., Ben-Zvi, H., Bradenstein, R., & Bunder, O. (2023). A multi-laboratory evaluation of commercial monkeypox virus molecular tests. Microbiology Spectrum, 11(3), e00225-23. https://doi.org/10.1128/spectrum.00225-23
Grauâ€Echevarría, A., Blayaâ€Imbernón, D., Finello, M., Zafrilla, E. P., García, Ã. G., Leal, R. P., Labranderoâ€Hoyos, C., Magdalenoâ€Tapial, J., Díezâ€Recio, E., & Hernándezâ€Bel, P. (2025). Atypical mucocutaneous manifestations of mpox: A systematic review. The Journal of Dermatology, 52(2), 228–238. https://doi.org/10.1111/1346-8138.17513
Grifoni, A., Zhang, Y., Tarke, A., Sidney, J., Rubiro, P., Reina-Campos, M., Filaci, G., Dan, J. M., Scheuermann, R. H., & Sette, A. (2022). Defining antigen targets to dissect vaccinia virus and monkeypox virus-specific T cell responses in humans. Cell Host & Microbe, 30(12), 1662–1670. https://doi.org/10.1016/j.chom.2022.11.003
Han, C., Liu, Q., Luo, X., Zhao, J., Zhang, Z., He, J., Ge, F., Ding, W., Luo, Z., Jia, C., & Zhang, L. (2024). Development of a CRISPR/Cas12a-mediated aptasensor for mpox virus antigen detection. Biosensors and Bioelectronics, 257, Article 116313. https://doi.org/10.1016/j.bios.2024.116313
Huggett, J. F., O’Sullivan, D. M., Cowen, S., Cleveland, M. H., Davies, K., Harris, K., Moran-Gilad, J., Winter, A., Braybrook, J., & Messenger, M. (2024). Ensuring accuracy in the development and application of nucleic acid amplification tests (NAATs) for infectious disease. Molecular Aspects of Medicine, 97, Article 101275. https://doi.org/10.1016/j.mam.2024.101275
Jadhav, V., Paul, A., Trivedi, V., Bhatnagar, R., Bhalsinge, R., & Jadhav, S. V. (2025). Global epidemiology, viral evolution, and public health responses: A systematic review on mpox (1958–2024). Journal of Global Health, 15, Article 04061. https://doi.org/10.7189/jogh.15.04061
Karagoz, A., Tombuloglu, H., Alsaeed, M., Tombuloglu, G., AlRubaish, A. A., Mahmoud, A., Smajlović, S., Ćordić, S., Rabaan, A. A., & Alsuhaimi, E. (2023). Monkeypox (mpox) virus: Classification, origin, transmission, genome organization, antiviral drugs, and molecular diagnosis. Journal of Infection and Public Health, 16(4), 531–541. https://doi.org/10.1016/j.jiph.2023.02.003
Kataria, R., Kaur, S., & Kaundal, R. (2023). Deciphering the complete human-monkeypox virus interactome: Identifying immune responses and potential drug targets. Frontiers in Immunology, 14, Article 1116988. https://doi.org/10.3389/fimmu.2023.1116988
Lian, Z.-H., Yang, C.-H., Qiu, Y., & Ge, X.-Y. (2024). Evolutionary analysis and antiviral drug prediction of mpox virus. Microorganisms, 12(11), 2239. https://doi.org/10.3390/microorganisms12112239
Lin, Y., Guo, Z., Chen, J., Zhang, X., Zhou, L., Li, Y., & Zhang, Z. (2024). Development of a multiplex real-time PCR for the simultaneous detection of monkeypox virus clades I, II, and goatpox virus. Frontiers in Veterinary Science, 11, Article 1483653. https://doi.org/10.3389/fvets.2024.1483653
Liu, B. M., & Yang, Z. (2025). An urgent need for diagnostic tools to address global mpox public health emergencies. Journal of Clinical Microbiology, 63(7). https://doi.org/10.1128/jcm.01321-24
Liu, X., Yang, X., Wang, C., Liu, Q., Ding, Y., Xu, S., Wang, G., & Xiao, R. (2024). A nanogap-enhanced SERS nanotag–based lateral flow assay for ultrasensitive and simultaneous monitoring of SARS-CoV-2 S and NP antigens. Microchimica Acta, 191(2), Article 105. https://doi.org/10.1007/s00604-023-06126-x
Loganathan, T., Fletcher, J., Abraham, P., Kannangai, R., Chakraborty, C., El Allali, A., Alsamman, A. M., Zayed, H., & C, G. P. D. (2024). Expression analysis and mapping of viral–host protein interactions of Poxviridae suggests a lead candidate molecule targeting mpox. BMC Infectious Diseases, 24(1), Article 483. https://doi.org/10.1186/s12879-024-09332-x
Lv, X., Zhang, Z., Zhao, Y., Sun, X., Jiang, H., Zhang, S., Sun, X., Qiu, X., & Li, Y. (2023). Label-free detection of virus based on surface-enhanced Raman scattering. Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy, 302, Article 123087. https://doi.org/10.1016/j.saa.2023.123087
Mancon, A., Raccagni, A. R., Gagliardi, G., Moschese, D., Rizzo, A., Giacomelli, A., Cutrera, M., Salari, F., Bracchitta, F., Antinori, S., Gori, A., Rizzardini, G., Castagna, A., Gismondo, M. R., Nozza, S., & Mileto, D. (2024). Evaluation of analytical performance of the STANDARDâ„¢ M10 MPX/OPX assay for the simultaneous DNA detection and clade attribution of monkeypox virus. Emerging Microbes & Infections, 13(1). https://doi.org/10.1080/22221751.2024.2337666
Nayak, K., Daw, S., & Singha, P. (2024). The potential of systems biology to understand the tenets of host-pathogen interaction, toxicology, and aging. In Systems Biology Approaches: Prevention, Diagnosis, and Understanding Mechanisms of Complex Diseases (pp. 489–509). Springer. https://doi.org/10.1007/978-981-99-9462-5_19
Oduoye, M. O., Fatima, E., Muzammil, M. A., Dave, T., Irfan, H., Fariha, F., Marbell, A., Ubechu, S. C., Scott, G. Y., & Elebesunu, E. E. (2024). Impacts of the advancement in artificial intelligence on laboratory medicine in lowâ€and middleâ€income countries: Challenges and recommendations—A literature review. Health Science Reports, 7(1), Article e1794. https://doi.org/10.1002/hsr2.1794
Paniz-Mondolfi, A., Guerra, S., Muñoz, M., Luna, N., Hernandez, M. M., Patino, L. H., Reidy, J., Banu, R., Shrestha, P., Liggayu, B., Umeaku, A., Chen, F., Cao, L., Patel, A., Hanna, A., Li, S., Look, A., Pagani, N., Albrecht, R., … Ramírez, J. D. (2023). Evaluation and validation of an RT-PCR assay for specific detection of monkeypox virus (MPXV). Journal of Medical Virology, 95(1), Article e28247. https://doi.org/10.1002/jmv.28247
Paul, D., Saha, S., Basu, S., & Chakraborti, T. (2024). Computational analysis of pathogen-host interactome for fast and low-risk in-silico drug repurposing in emerging viral threats like mpox. Scientific Reports, 14(1), Article 18736. https://doi.org/10.1038/s41598-024-34812-w
Periel, E. A., Singh, A., & Jordan-Sciutto, K. (2023). Analysis of EIF2AK3 alternative splicing and its effect on PERK function in response to ER stress. Journal of NeuroVirology, 29(1), S1–S41. https://doi.org/10.1007/s13365-023-01132-z
Plebani, M., Nichols, J. H., Luppa, P. B., Greene, D., Sciacovelli, L., Shaw, J., Khan, A. I., Carraro, P., Freckmann, G., & Dimech, W. (2025). Point-of-care testing: State-of-the art and perspectives. Clinical Chemistry and Laboratory Medicine (CCLM), 63(1), 35–51. https://doi.org/10.1515/cclm-2024-0466
Rawat, S., Parul, Sharma, N., Sharma, B., Jain, U., & Thakur, V. (2025). Transmission, maintenance of infection, and consequences of disease. In Epidemiology and Environmental Hygiene in Veterinary Public Health (pp. 67–79). Academic Press. https://doi.org/10.1016/B978-0-443-16153-7.00005-3
Romero-Ramirez, A., Somasundaran, A., Kontogianni, K., Parkes, J., Hussain, Y., Gould, S., Williams, C. T., Wooding, D., Body, R., & Hardwick, H. E. (2025). Evaluation of the diagnostic accuracy of Xpert® Mpox and STANDARDâ„¢ M10 MPX/OPX for the detection of monkeypox virus. Journal of Infection, 90(2), Article 106413. https://doi.org/10.1016/j.jinf.2024.106413
Saghazadeh, A., & Rezaei, N. (2023). Insights on mpox virus infection immunopathogenesis. Reviews in Medical Virology, 33(2), Article e2426. https://doi.org/10.1002/rmv.2426
Savinkina, A., Kindrachuk, J., Bogoch, I. I., Rimoin, A. W., Hoff, N. A., Shaw, S. Y., Pitzer, V. E., Mbala-Kingebeni, P., & Gonsalves, G. S. (2024). Modelling vaccination approaches for mpox containment and mitigation in the Democratic Republic of the Congo. The Lancet Global Health, 12(12), e1936–e1944. https://doi.org/10.1016/S2214-109X(24)00366-9
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2026-04-02
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Mpox Virus: A holistic review of molecular pathogenesis, diagnostic advancements, and global response strategies. (2026). Acta Scientiarum. Biological Sciences, 48(1), e76252. https://doi.org/10.4025/actascibiolsci.v48i1.76252
