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Título

MONKEYPOX VIRUS OCULAR MANIFESTATION AND IMMUNE RESPONSES KEY POINTS

Resumo

Introduction: Members of the Poxviridae family display unique viral characteristics, including DNA cleavage sites, surface epitopes, and polypeptides. The core region of the MPXV genome, coding for essential viral structural and enzymatic proteins, shares 96.3% of its sequence with the smallpox virus, the prototype species of Poxviridae. By the 1980s, a worldwide effort had successfully eradicated wild-type smallpox virus. MPXV infection begins with a prodromal stage, followed by a characteristic eruption. The dermatitis lesions typically start as macular, then progress to papular, and eventually become vesicular and pustular. Methods: We performed a narrative semi‐systematic review to publish the paper “Monkeypox Virus Immune Evasion and Eye Manifestation: Beyond Eyelid Implications” in the journal “Viruses”. This review aimed to propose and characterise several ocular manifestations and complications of Monkeypox virus as well as their respective pathophysiology. The search terms, used both separately and in combination, included: ‘monkeypox virus eye disease’, ‘monkeypox virus ocular manifestation’, ‘MPV pathophysiology’. Only articles published in English were included in this study. Conclusion: Common external ocular manifestations of MPV typically involve a generalized pustular rash, keratitis, discharges, and dried secretions related to conjunctival pustules, photophobia, and lacrimation. Orthopoxviruses can evade host immune responses by secreting proteins that antagonize the functions of host IFNγ, CC and CXC chemokines, IL-1β, and the complement system. One of the most important transcription factors downstream of pattern recognition receptors binding is IRF3, which controls the expression of the crucial antiviral molecules IFNα and IFNβ. We strongly recommend that ophthalmologists include MPXV as part of their differential diagnosis when they encounter similar cases presenting with ophthalmic manifestations such as conjunctivitis, blepharitis, or corneal lesions. Furthermore, because non-vaccinated individuals are more likely to exhibit these symptoms, it is recommended that healthcare administrators prioritize smallpox vaccination for at-risk groups, including very young children, pregnant women, older adults, and immunocompromised individuals, especially those in close contact with MPXV cases.

Referências Bibliográficas

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