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Shah BM, Modi P. Breaking Barriers: Current Advances and Future Directions in Mpox Therapy. Curr Drug Targets 2024; 25:62-76. [PMID: 38151842 DOI: 10.2174/0113894501281263231218070841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Mpox, a newly discovered zoonotic infection, can be transmitted from animal to human and between humans. Serological and genomic studies are used to identify the virus. OBJECTIVE Currently, there are no proven effective treatments for Mpox. Also, the safety and efficacy of intravenous vaccinia immune globulin, oral Tecovirimat (an inhibitor of intracellular viral release), and oral Brincidofovir (a DNA polymerase inhibitor) against the Mpox virus are uncertain, highlighting the need for more effective and safe treatments. As a result, drug repurposing has emerged as a promising strategy to identify previously licensed drugs that can be repurposed to treat Mpox. RESULTS Various approaches have been employed to identify previously approved drugs that can target specific Mpox virus proteins, including thymidylate kinase, D9 decapping enzyme, E8 protein, Topoisomerase1, p37, envelope proteins (D13, A26, and H3), F13 protein, virus's main cysteine proteases, and DNA polymerase. CONCLUSION In this summary, we provide an overview of potential drugs that could be used to treat Mpox and discuss the underlying biological processes of their actions.
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Affiliation(s)
- Bhumi M Shah
- Department of Pharmaceutical Chemistry, L.J. Institute of Pharmacy, L.J. University, Ahmedabad, Gujarat 382210, India
| | - Palmi Modi
- Department of Pharmaceutical Chemistry, L.J. Institute of Pharmacy, L.J. University, Ahmedabad, Gujarat 382210, India
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Khan G, Perveen N. The 2022 monkeypox outbreak 1 year on: The 5 Ws. Rev Med Virol 2024; 34:e2489. [PMID: 37930054 DOI: 10.1002/rmv.2489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023]
Abstract
In May 2022, World Health Organization (WHO) reported an outbreak of Mpox in several European countries which were previously Mpox free. Mpox (formerly known as monkeypox) is a zoonotic viral disease endemic in Central and West Africa. The sudden emergence of Mpox outside Africa and its subsequent rapid spread lead the WHO to declare the outbreak as Public Health Emergency of International Concern. By 15 May 2023, a total of 87,704 confirmed cases and 140 deaths had been reported from 111 countries and territories worldwide. Looking back on this outbreak 1 year later, several important questions have arisen. Here, we address these questions using the classic 5 Ws: What, When, Where, Who and Why? We discuss these questions to understand how this outbreak emerged and how it was effectively managed. We outline what needs to be done to prevent, or at least minimise, outbreaks due to emerging and re-emerging viral infections.
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Affiliation(s)
- Gulfaraz Khan
- Department of Microbiology & Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Nighat Perveen
- Department of Biology, College of Science, United Arab Emirates University, Al-Ain, United Arab Emirates
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Ahmed SK, Abdulqadir SO, Omar RM, Hussein S, Qurbani K, Mohamed MG, Abubaker Blbas HT, Fahrni ML, Lazzarino AI. Knowledge, Attitudes, and Willingness of Healthcare Workers in Iraq's Kurdistan Region to Vaccinate against Human Monkeypox: A Nationwide Cross-Sectional Study. Vaccines (Basel) 2023; 11:1734. [PMID: 38140139 PMCID: PMC10747727 DOI: 10.3390/vaccines11121734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023] Open
Abstract
Although human monkeypox infections had not been recorded in the Kurdistan region of Iraq as of August 2023, the rapid growth of cases worldwide and the detection of monkeypox in neighboring Middle Eastern nations call for careful planning and timely response measures. Educating and empowering frontline healthcare workers (HCWs) so that they can act to curb the spread of monkeypox infections are core elements of primary prevention and protecting public health. Therefore, this study aimed to assess HCWs' knowledge and attitudes about monkeypox and their willingness to vaccinate against monkeypox. By employing a convenience sampling method, an online survey was disseminated via Google Forms between 1 November 2022 and 15 January 2023. The researchers utilized regression analyses to ascertain the factors associated with the three parameters: knowledge, attitude, and the willingness to vaccinate. A total of 637 HCWs were included in the analysis (ages ranged between 21 and 51 years). The mean overall scores were 8.18 of a max score of 16 (SD 3.37), 3.4 of 5 (SD 1.37), and 2.41 of 5 (SD 1.25) for knowledge, attitude, and willingness to vaccinate, respectively. A multivariate logistic regression analysis demonstrated that HCWs who had heard about monkeypox before 2022 rather than later had a higher level of knowledge (AOR: 4.85; 95% CI: 2.81-8.36; p < 0.001). In addition, those who had newly joined the workforce or had less than 1 year experience in practice had more positive attitudes about curbing monkeypox (AOR: 0.35; 95% CI: 0.20-0.59; p < 0.01) than those who practiced for longer. No significant predictors of willingness to vaccinate against monkeypox were identified. The research revealed that HCWs exhibited a relatively low level of monkeypox knowledge. They also had poor attitudes towards monkeypox vaccination and were therefore reluctant to receive the vaccines. Imparting knowledge about the infectious disease can cultivate better awareness and attitudes among HCWs as to their roles in mitigating the spread of an epidemic in the foreseeable future.
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Affiliation(s)
- Sirwan Khalid Ahmed
- Department of Adult Nursing, College of Nursing, University of Raparin, Rania, Sulaymaniyah 46012, Iraq;
- Ministry of Health, General Directorate of Health-Raparin, Rania, Sulaymaniyah 46012, Iraq
| | - Salar Omer Abdulqadir
- Department of Psychiatric and Mental Health Nursing, College of Nursing, University of Raparin, Rania, Sulaymaniyah 46012, Iraq
| | - Rukhsar Muhammad Omar
- Department of Kindergarten, College of Basic Education, University of Raparin, Rania, Sulaymaniyah 46012, Iraq
| | - Safin Hussein
- Department of Biology, College of Science, University of Raparin, Rania, Sulaymaniyah 46012, Iraq
| | - Karzan Qurbani
- Department of Biology, College of Science, University of Raparin, Rania, Sulaymaniyah 46012, Iraq
| | - Mona Gamal Mohamed
- Department of Adult Nursing, RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khaimah 72603, United Arab Emirates
| | | | - Mathumalar Loganathan Fahrni
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Puncak Alam Campus, Selangor Branch, Puncak Alam 42300, Malaysia
| | - Antonio Ivan Lazzarino
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London W2 1PG, UK
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Ramírez-Amador V, Figueroa-Ramos A, Valencia-Mayoral P, Mayo-Rangel A, Anaya-Saavedra G. Clinicopathological and molecular approaches to the diagnosis of oral lesions in Mpox: Case report. Int J STD AIDS 2023; 34:990-993. [PMID: 37464736 DOI: 10.1177/09564624231190422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Mpox virus infection (MPXV) has recently been recognized as a public health emergency by the World Health Organization. While several studies have described the clinical characteristics of MPXV-oral lesions, there remains a dearth of information regarding the histological and ultrastructural oral findings. A 24-year-old HIV-positive man presented with a shallow ulcer, covered by a fibrinoid membrane, and surrounded by an erythematous halo in the hard and soft palate. The clinical appearance of the lesion raised suspicion of a viral infection; thus, the diagnosis was based on histological and electronic microscopy findings and confirmed by RT-PCR testing in the skin specimen. This case report aims to offer comprehensive insights into the clinical, histopathological, and ultrastructural features of oral lesions caused by MPXV in an individual with HIV. This report provides valuable information about the characteristics of MPXV infection in the oral mucosa, particularly in people living with HIV.
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Affiliation(s)
- Velia Ramírez-Amador
- Oral Pathology and Medicine Postgraduate Program, Metropolitan Autonomous University, Mexico City, Mexico
| | - Alexia Figueroa-Ramos
- Oral Pathology and Medicine Postgraduate Program, Metropolitan Autonomous University, Mexico City, Mexico
| | | | - Angélica Mayo-Rangel
- Pathology Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Gabriela Anaya-Saavedra
- Oral Pathology and Medicine Postgraduate Program, Metropolitan Autonomous University, Mexico City, Mexico
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Bruno G, Buccoliero GB. Antivirals against Monkeypox (Mpox) in Humans: An Updated Narrative Review. Life (Basel) 2023; 13:1969. [PMID: 37895350 PMCID: PMC10608433 DOI: 10.3390/life13101969] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
As of 29 August 2023, a total of 89,596 confirmed cases of Mpox (monkeypox) have been documented across 114 countries worldwide, with 157 reported fatalities. The Mpox outbreak that transpired in 2022 predominantly affected young men who have sex with men (MSM). While most cases exhibited a mild clinical course, individuals with compromised immune systems, particularly those living with HIV infection and possessing a CD4 count below 200 cells/mm3, experienced a more severe clinical trajectory marked by heightened morbidity and mortality. The approach to managing Mpox is primarily symptomatic and supportive. However, in instances characterized by severe or complicated manifestations, the utilization of antiviral medications becomes necessary. Despite tecovirimat's lack of official approval by the FDA for treating Mpox in humans, a wealth of positive clinical experiences exists, pending the outcomes of ongoing clinical trials. Brincidofovir and cidofovir have also been administered in select cases due to the unavailability of tecovirimat. Within the scope of this narrative review, our objective was to delve into the clinical attributes of Mpox and explore observational studies that shed light on the utilization of these antiviral agents.
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Affiliation(s)
- Giuseppe Bruno
- Infectious Diseases Unit, San Giuseppe Moscati Hospital, Azienda Sanitaria Locale Taranto, 74121 Taranto, Italy;
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Khan A, Shahab M, Nasir F, Waheed Y, Alshammari A, Mohammad A, Zichen G, Li R, Wei DQ. Exploring the Traditional Chinese Medicine (TCM) database chemical space to target I7L protease from monkeypox virus using molecular screening and simulation approaches. SAR AND QSAR IN ENVIRONMENTAL RESEARCH 2023; 34:689-708. [PMID: 37675795 DOI: 10.1080/1062936x.2023.2250723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/16/2023] [Indexed: 09/08/2023]
Abstract
In the current study, we used molecular screening and simulation approaches to target I7L protease from monkeypox virus (mpox) from the Traditional Chinese Medicines (TCM) database. Using molecular screening, only four hits TCM27763, TCM33057, TCM34450 and TCM31564 demonstrated better pharmacological potential than TTP6171 (control). Binding of these molecules targeted Trp168, Asn171, Arg196, Cys237, Ser240, Trp242, Glu325, Ser326, and Cys328 residues and may affect the function of I7L protease in in vitro assay. Moreover, molecular simulation revealed stable dynamics, tighter structural packing and less flexible behaviour for all the complexes. We further reported that the average hydrogen bonds in TCM27763, TCM33057, TCM34450 and TCM31564I7L complexes remained higher than the control drug. Finally, the BF energy results revealed -62.60 ± 0.65 for the controlI7L complex, for the TCM27763I7L complex -71.92 ± 0.70 kcal/mol, for the TCM33057I7L complex the BF energy was -70.94 ± 0.70 kcal/mol, for the TCM34450I7L the BF energy was -69.94 ± 0.85 kcal/mol while for the TCM31564I7L complex the BF energy was calculated to be -69.16 ± 0.80 kcal/mol. Although, we used stateoftheart computational methods, these are theoretical insights that need further experimental validation.
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Affiliation(s)
- A Khan
- Department of Bioinformatics and Biological Statistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, P.R. China
- Zhongjing Research and Industrialization Institute of Chinese Medicine, Zhongguancun Scientific Park, Nayang, P.R. China
- School of Medical and Life Sciences, Sunway University, Sunway City, Malaysia
| | - M Shahab
- State Key Laboratory of Chemical Resources Engineering, Beijing University of Chemical Technology, Beijing, China
| | - F Nasir
- Amna Inayat Medical College, Lahore, Pakistan
| | - Y Waheed
- Office of Research, Innovation, and Commercialization (ORIC), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad, Pakistan
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - A Alshammari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - A Mohammad
- Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Dasman, Kuwait
| | - G Zichen
- Zhiyuan College, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - R Li
- Department of Flowers, college of Horticulture, China Agriculture University, Beijing, P.R. China
| | - D Q Wei
- Department of Bioinformatics and Biological Statistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, P.R. China
- Zhongjing Research and Industrialization Institute of Chinese Medicine, Zhongguancun Scientific Park, Nayang, P.R. China
- Peng Cheng Laboratory, Vanke Cloud City, Shenzhen, P.R China
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