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Bell TM, Facemire P, Bearss JJ, Raymond JL, Chapman J, Zeng X, Shamblin JD, Williams JA, Grosenbach DW, Hruby DE, Damon IK, Goff AJ, Mucker EM. Smallpox lesion characterization in placebo-treated and tecovirimat-treated macaques using traditional and novel methods. PLoS Pathog 2024; 20:e1012007. [PMID: 38386661 PMCID: PMC10883539 DOI: 10.1371/journal.ppat.1012007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
Smallpox was the most rampant infectious disease killer of the 20th century, yet much remains unknown about the pathogenesis of the variola virus. Using archived tissue from a study conducted at the Centers for Disease Control and Prevention we characterized pathology in 18 cynomolgus macaques intravenously infected with the Harper strain of variola virus. Six macaques were placebo-treated controls, six were tecovirimat-treated beginning at 2 days post-infection, and six were tecovirimat-treated beginning at 4 days post-infection. All macaques were treated daily until day 17. Archived tissues were interrogated using immunohistochemistry, in situ hybridization, immunofluorescence, and electron microscopy. Gross lesions in three placebo-treated animals that succumbed to infection primarily consisted of cutaneous vesicles, pustules, or crusts with lymphadenopathy. The only gross lesions noted at the conclusion of the study in the three surviving placebo-treated and the Day 4 treated animals consisted of resolving cutaneous pox lesions. No gross lesions attributable to poxviral infection were present in the Day 2 treated macaques. Histologic lesions in three placebo-treated macaques that succumbed to infection consisted of proliferative and necrotizing dermatitis with intracytoplasmic inclusion bodies and lymphoid depletion. The only notable histologic lesion in the Day 4 treated macaques was resolving dermatitis; no notable lesions were seen in the Day 2 treated macaques. Variola virus was detected in all three placebo-treated animals that succumbed to infection prior to the study's conclusion by all utilized methods (IHC, ISH, IFA, EM). None of the three placebo-treated animals that survived to the end of the study nor the animals in the two tecovirimat treatment groups showed evidence of variola virus by these methods. Our findings further characterize variola lesions in the macaque model and describe new molecular methods for variola detection.
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Affiliation(s)
- Todd M. Bell
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Paul Facemire
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Jeremy J. Bearss
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Jo Lynne Raymond
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Jennifer Chapman
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Xiankun Zeng
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Joshua D. Shamblin
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Janice A. Williams
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | | | - Dennis E. Hruby
- SIGA Technologies, Inc., Corvallis, Oregon, United States of America
| | - Inger K. Damon
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention (CDC) Atlanta, Georgia, United States of America
| | - Arthur J. Goff
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
| | - Eric M. Mucker
- U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland, United States of America
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Davis I, Payne JM, Olguin VL, Sanders MP, Clements T, Stefan CP, Williams JA, Hooper JW, Huggins JW, Mucker EM, Ricks KM. Development of a specific MPXV antigen detection immunodiagnostic assay. Front Microbiol 2023; 14:1243523. [PMID: 37744911 PMCID: PMC10516133 DOI: 10.3389/fmicb.2023.1243523] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/14/2023] [Indexed: 09/26/2023] Open
Abstract
Human monkeypox (mpox) has recently become a global public health emergency; however, assays that detect mpox infection are not widely available, largely due to cross-reactivity within the Orthopoxvirus genus. Immunoassay development was largely confined to researchers who focus on biothreats and endemic areas (Central and West Africa) until the 2022 outbreak. As was noted in the COVID-19 pandemic, antigen detection assays, integrated with molecular assays, are necessary to help curb the spread of disease. Antigen-detecting immunoassays offer the advantage of providing results ranging from within min to h and in lateral flow formats; they can be deployed for point-of-care, home, or field use. This study reports the development of an mpox-specific antigen detection immunoassay developed on a multiplexed, magnetic-bead-based platform utilizing reagents from all research sectors (commercial, academic, and governmental). Two semi-quantitative assays were developed in parallel and standardized with infectious mpox virus (MPXV) cell culture fluid and MPXV-positive non-human primate (NHP) sera samples. These assays could detect viral antigens in serum, were highly specific toward MPXV as compared to other infectious orthopoxviruses (vaccinia virus, cowpox virus, and camelpox virus), and exhibited a correlation with quantitative PCR results from an NHP study. Access to a toolbox of assays for mpox detection will be key for identifying cases and ensuring proper treatment, as MPXV is currently a global traveler.
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Affiliation(s)
- Ian Davis
- Diagnostic Systems Division, United States Army Medical Research Institute of Diseases, Frederick, MD, United States
| | - Jackie M. Payne
- Diagnostic Systems Division, United States Army Medical Research Institute of Diseases, Frederick, MD, United States
| | - Victoria L. Olguin
- Diagnostic Systems Division, United States Army Medical Research Institute of Diseases, Frederick, MD, United States
| | - Madison P. Sanders
- Diagnostic Systems Division, United States Army Medical Research Institute of Diseases, Frederick, MD, United States
| | - Tamara Clements
- Diagnostic Systems Division, United States Army Medical Research Institute of Diseases, Frederick, MD, United States
| | - Christopher P. Stefan
- Diagnostic Systems Division, United States Army Medical Research Institute of Diseases, Frederick, MD, United States
| | - Janice A. Williams
- Pathology Division, United States Army Medical Research Institute of Diseases, Frederick, MD, United States
| | - Jay W. Hooper
- Virology Division, United States Army Medical Research Institute of Diseases, Frederick, MD, United States
| | - John W. Huggins
- Virology Division, United States Army Medical Research Institute of Diseases, Frederick, MD, United States
| | - Eric M. Mucker
- Virology Division, United States Army Medical Research Institute of Diseases, Frederick, MD, United States
| | - Keersten M. Ricks
- Diagnostic Systems Division, United States Army Medical Research Institute of Diseases, Frederick, MD, United States
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Chen S, Li X, Zhang L, Ren L. What should we do about monkeypox? Animal Model Exp Med 2022; 5:482-484. [PMID: 36149253 PMCID: PMC9610136 DOI: 10.1002/ame2.12275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Si Chen
- College of Animal Sciences, Key Lab for Zoonoses Research, Ministry of Education, Jilin University, Changchun, China
| | - Xue Li
- College of Animal Sciences, Key Lab for Zoonoses Research, Ministry of Education, Jilin University, Changchun, China
| | - Liying Zhang
- College of Animal Sciences, Key Lab for Zoonoses Research, Ministry of Education, Jilin University, Changchun, China
| | - Linzhu Ren
- College of Animal Sciences, Key Lab for Zoonoses Research, Ministry of Education, Jilin University, Changchun, China
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Mucker EM, Shamblin JD, Goff AJ, Bell TM, Reed C, Twenhafel NA, Chapman J, Mattix M, Alves D, Garry RF, Hensley LE. Evaluation of Virulence in Cynomolgus Macaques Using a Virus Preparation Enriched for the Extracellular Form of Monkeypox Virus. Viruses 2022; 14:v14091993. [PMID: 36146799 PMCID: PMC9505131 DOI: 10.3390/v14091993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
The 2022 global human monkeypox outbreak emphasizes the importance of maintaining poxvirus research, including enriching a basic understanding of animal models for developing and advancing therapeutics and vaccines. Intravenous administration of monkeypox virus in macaques is arguably one of the best animal models for evaluating the efficacy of medical countermeasures. Here we addressed one criticism of the model, a requirement for a high-titer administration of virus, as well as improving our understanding of monkeypox virus pathogenesis. To do so, we infected macaques with a challenge dose containing a characterized inoculum enriched for the extracellular form of monkeypox virus. Although there were some differences between diseases caused by the enriched preparation compared with a relatively similar unpurified preparation, we were unable to reduce the viral input with the enriched preparation and maintain severe disease. We found that inherent factors contained within the serum of nonhuman primate blood affect the stability of the monkeypox extracellular virions. As a first step to study a role of the extracellular form in transmission, we also showed the presence of this form in the oropharyngeal swabs from nonhuman primates exposed to monkeypox virus.
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Affiliation(s)
- Eric M. Mucker
- United States Army Medical Research Institute of Infectious Diseases, Virology Division, Fort Detrick, Frederick, MD 21702, USA
- Correspondence:
| | - Josh D. Shamblin
- United States Army Medical Research Institute of Infectious Diseases, Virology Division, Fort Detrick, Frederick, MD 21702, USA
| | - Arthur J. Goff
- United States Army Medical Research Institute of Infectious Diseases, Virology Division, Fort Detrick, Frederick, MD 21702, USA
| | - Todd M. Bell
- United States Army Medical Research Institute of Infectious Diseases, Pathology Division, Fort Detrick, Frederick, MD 21702, USA
| | - Christopher Reed
- United States Army Medical Research Institute of Infectious Diseases, Pathology Division, Fort Detrick, Frederick, MD 21702, USA
| | - Nancy A. Twenhafel
- United States Army Medical Research Institute of Infectious Diseases, Pathology Division, Fort Detrick, Frederick, MD 21702, USA
| | - Jennifer Chapman
- United States Army Medical Research Institute of Infectious Diseases, Pathology Division, Fort Detrick, Frederick, MD 21702, USA
| | - Marc Mattix
- United States Army Medical Research Institute of Infectious Diseases, Pathology Division, Fort Detrick, Frederick, MD 21702, USA
| | - Derron Alves
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Infectious Disease Pathogenesis Section, Rockville, MD 20852, USA
| | - Robert F. Garry
- Department of Microbiology and Immunology, School of Medicine, Tulane University, New Orleans, LA 70112, USA
- Zalgen Labs, Frederick, MD 21703, USA
- Global Virus Network (GVN), Baltimore, MD 21201, USA
| | - Lisa E. Hensley
- United States Department of Agriculture, Zoonotic and Emerging Disease Unit, Manhattan, KS 66505, USA
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Abstract
Introduction Monkeypox virus is a zoonotic double-stranded DNA poxvirus in the genus Orthopoxvirus, family Poxviridae. Until recently, monkeypox was found primarily in Central and West Africa, where the virus had split into Congo Basin and West African clades. Areas Covered On 6 May 2022, monkeypox was detected in the United Kingdom and the virus has now been detected in every continent except Antarctica. The current outbreak represents the first documentation of widespread community transmission outside of Africa. Expert Opinion On 23 July 2022, the World Health Organization declared monkeypox a public health emergency of international concern and issued a series of guidance and recommendations for governments, health professionals and the public. This manuscript reviews what is known about monkeypox virus, with a focus on recent diagnostics and epidemiologic advances, and explores how recent advances in our understanding of the virus will be used to combat the expanding outbreak.
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Effect of Monkeypox Virus Preparation on the Lethality of the Intravenous Cynomolgus Macaque Model. Viruses 2022; 14:v14081741. [PMID: 36016363 PMCID: PMC9413320 DOI: 10.3390/v14081741] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 02/05/2023] Open
Abstract
For over two decades, researchers have sought to improve smallpox vaccines and also develop therapies to ensure protection against smallpox or smallpox-like disease. The 2022 human monkeypox pandemic is a reminder that these efforts should persist. Advancing such therapies have involved animal models primarily using surrogate viruses such as monkeypox virus. The intravenous monkeypox model in macaques produces a disease that is clinically similar to the lesional phase of fulminant human monkeypox or smallpox. Two criticisms of the model have been the unnatural route of virus administration and the high dose required to induce severe disease. Here, we purified monkeypox virus with the goal of lowering the challenge dose by removing cellular and viral contaminants within the inoculum. We found that there are advantages to using unpurified material for intravenous exposures.
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