Monkeypox: A Review of Clinical Features, Diagnosis, and Treatment

Cheema, Asfand Yar; Ogedegbe, Oboseh J; Munir, Mishaal; Alugba, Gabriel; Ojo, Tioluwani K

doi:10.7759/cureus.26756

Cited by 60 publications

(105 citation statements)

References 12 publications

(30 reference statements)

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“…In May 2022, new outbreaks of monkeypox disease were identified in multiple countries worldwide. Interestingly, these affected countries were not endemic to MPXV and no recent travel history to endemic African countries was reported by infected individuals [7]. According to the monkeypox outbreak global map of centers for disease control and prevention (CDC), the total number of monkeypox cases is 31,799 and total deaths number is 12 as reported by 12 August 2022 [8].…”

Section: Introductionmentioning

confidence: 99%

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Computational Repurposing of FDA Approved Drugs Against Monkeypox Virus Cysteine Proteinase: A Molecular Docking and Dynamics Simulation Study.

Odhar¹

2022

Preprint

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Monkeypox is a zoonotic disease caused by a DNA virus known as Monkeypox virus. Generally, Monkeypox disease is considered a self-limiting condition with symptoms similar to that of smallpox disease. Most cases of Monkeypox are considered mild but some patients may suffer from serious complications. Due to the high similarity between Monkeypox virus and smallpox virus, therefore vaccines and antiviral therapies originally intended for use against smallpox can be effective also in Monkeypox infection cases. However, the level of cross-immunity against poxviruses had declined globally because of cessation of vaccination campaigns against smallpox decades ago. As a result, the recent outbreaks in 2022 of Monkeypox in multiple regions of the word have caused public health fears of a new pandemic potential. It is well-known that Monkeypox virus like other poxviruses replicates in the cytoplasm of infected cells by using a number of viral encoded proteins like cysteine proteinase. Generally, proteases enzymes play a critical role in viral replication cycle through catalysis of precursor polyproteins cleavage. Therefore, proteases enzymes like cysteine proteinase represent an attractive target to design novel antiviral drugs. Unfortunately, the cysteine proteinase enzyme of Monkeypox virus is still not yet crystallized and this can negatively impact efforts for structure-based drug design and screening. As such, we have chosen to computationally model the secondary and tertiary structures of Monkeypox cysteine proteinase by using the primary amino acids sequence of the enzyme. And after refinement and validation of the modelled protein, we have screened a library of 1,615 FDA approved drug molecules against Monkeypox cysteine proteinase by using AutoDock Vina. Then, the best hits were further assessed by molecular dynamics simulation for 20 nanoseconds. The aim of this in-silico study is to repurpose approved drugs as a potential inhibitor against Monkeypox cysteine proteinase. The findings of this in-silico study refer to the potential ability of the antibiotic Tetracycline to inhibit the cysteine proteinase of Monkeypox virus. However, the lack of crystallization data regarding this proteinase enzyme makes these findings not conclusive.

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Section: Introductionmentioning

confidence: 99%

“…Because of the similarity between MPXV and variola virus (smallpox), it is believed that anti-smallpox drugs like Tecovirimat and Brincidofovir are also effective against monkeypox disease. Also, vaccination against smallpox can provide cross-immunity against MPXV infection [7].…”

Section: Introductionmentioning

confidence: 99%

Computational Repurposing of FDA Approved Drugs Against Monkeypox Virus Cysteine Proteinase: A Molecular Docking and Dynamics Simulation Study.

Odhar¹

2022

Preprint

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“…Another important immune-modulating component that contributes to the higher virulence of this strain comes from a gene in the Congo Basin lineage that inhibits complement enzymes. However, contrary to what was previously believed, studies have shown that neither a decrease in major histocompatibility complex (MHC) expression nor a decrease in cellular transport is connected to MPX virulence (Cheema et al 2022).…”

Section: Vaccinationmentioning

confidence: 68%

“…There are 10 recognized species of Orthopoxviruses at present, including MPXV and variola (smallpox). However, despite being a DNA virus, MPXV does not replicate outside of the cytoplasm of infected cells (Cheema et al 2022;Harris 2022).…”

Section: Introductionmentioning

confidence: 99%

Monkeypox: An Update on Current Knowledge and Research Advances

Chandran¹,

Dhama

Aslam

et al. 2022

J Exp Bio & Ag Sci

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The resurgence of the disease in humans that is very similar to smallpox called monkeypox (MPX) disease, caused by the monkeypox virus (MPXV), is the dominant topic of discussion in the scientific and popular press around the world right now. This is taking place as the world celebrates the historic accomplishments made in the fight against the Coronavirus Disease (COVID-19) pandemic MPX is currently thought to pose a risk to the general public's health, particularly in areas with high rates of MPXV infection and close human-wild animal contact. Despite the rarity of MPX outbreaks, they are often caused by human-to-human transmission, especially in households and healthcare settings. Recent decades have seen recurrent outbreaks of the MPX after the smallpox disease was declared eliminated and the consequent cessation of smallpox vaccination programs. MPX has presently spread to several countries throughout the world and posed a global public health emergency, with nearly 45000 confirmed cases in 96 countries and locations, and 12 deaths as of August 24, 2022. Even though this viral illness is thought to be self-limiting, its consequences and feasible pandemic potential seriously jeopardize public health. The main approach to avoiding MPX is to adopt appropriate prevention and control measures, increase awareness of risk factors, and inform the public of the steps they may take to reduce viral exposure. Scientific studies are currently looking at the viability and suitability of the MPX vaccination. This article presents a general introduction to MPXV / MPX along with progress in diagnosis, treatment, vaccination, and prevention and control strategies for tackling this global health emergency.

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“…Detailed medical history is pivotal in diagnosis by including information on recent travel to endemic areas, previous smallpox immunization, and clinical picture. However, the gold standard for detecting MPX DNA is the real-time polymerase chain reaction (PCR) test owing to its sensitivity and accuracy; thus, the PCR test should be done before other diagnostic assays [ 26 ]. Specimens for diagnostic testing include the roof of vesicles' fluid and pustules of skin lesions and dry crusts [ 27 ].…”

Section: Reviewmentioning

confidence: 99%

From a Neglected Pathogen to a Public Health Emergency: Connecting the Dots in Monkeypox Emergence

Fahmy¹,

Shabata²,

Aktham³

2022

Cureus

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The recent unprecedented emergence of the monkeypox (MPX) outbreak rang an alarm bell creating a burden on global health. The virus historically spread in endemic regions of sub-Saharan Africa by animalhuman and human-human modes of transmission with an unknown modality. Currently, cases are occurring worldwide while risk factors, transmission, and outcomes of infection are still poorly defined. In addition, the likely genotypic mutation of MPX is an area of concern and requires further assessment. While licensed smallpox vaccinations are currently considered for early prevention after recent exposure, and antivirals are recommended for treating severe cases, there are no treatments available to treat MPX. This review provides general disease awareness and highlights recommendations for the containment of the virus.

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Monkeypox: A Review of Clinical Features, Diagnosis, and Treatment

Cited by 60 publications

References 12 publications

Computational Repurposing of FDA Approved Drugs Against Monkeypox Virus Cysteine Proteinase: A Molecular Docking and Dynamics Simulation Study.

Computational Repurposing of FDA Approved Drugs Against Monkeypox Virus Cysteine Proteinase: A Molecular Docking and Dynamics Simulation Study.

Monkeypox: An Update on Current Knowledge and Research Advances

From a Neglected Pathogen to a Public Health Emergency: Connecting the Dots in Monkeypox Emergence

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