title: Cytokine modulation correlates with severity of monkeypox disease in humans.
abstract: BACKGROUND
  Human monkeypox is a zoonotic disease endemic to parts of Africa. Similar to other orthopoxviruses, virus and host have considerable interactions through immunomodulation. These interactions likely drive the establishment of a productive infection and disease progression, resulting in the range of disease presentations and case fatality rates observed for members of the Orthopoxvirus genus.
  
  
  OBJECTIVE
  Much of our understanding about the immune response to orthopoxvirus infection comes from either in vitro or in vivo studies performed in small animals or non-human primates. Here, we conducted a detailed assessment of cytokine responses to monkeypox virus using serum from acutely ill humans collected during monkeypox active disease surveillance (2005-2007) in the Democratic Republic of the Congo.
  
  
  METHODS
  Nineteen serum samples that were from patients with confirmed monkeypox virus infections were selected for cytokine profiling. Cytokine profiling was performed on the Bio-Rad Bioplex 100 system using a 30-plex human cytokine panel.
  
  
  RESULTS
  Cytokine profiling revealed elevated cytokine concentrations in all samples. Overproduction of certain cytokines (interleukin [IL]-2R, IL-10, and granulocyte macrophage-colony stimulating factor were observed in patients with serious disease (defined as >250 lesions based on the World Health Organization scoring system).
  
  
  CONCLUSIONS
  The data suggest that cytokine modulation affects monkeypox disease severity in humans.
authors.affiliation: Virology Division, United States Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Johnston
authors.affiliation: Virology Division, United States Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA.
authors.forename: Joshua C
authors.initials: JC
authors.lastname: Johnson
authors.affiliation: Virology Division, United States Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA.
authors.forename: Spencer W
authors.initials: SW
authors.lastname: Stonier
authors.affiliation: Virology Division, United States Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA.
authors.forename: Kenny L
authors.initials: KL
authors.lastname: Lin
authors.affiliation: Department of Microbiology, Immunology, and Molecular Genetics, UCLA, 609 Charles E. Young Dr. East, 1602 Molecular Science Building, Los Angeles, CA 90095, USA.
authors.forename: Neville K
authors.initials: NK
authors.lastname: Kisalu
authors.affiliation: Virology Division, United States Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA.
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Hensley
authors.affiliation: Department of Epidemiology, UCLA School of Public Health, 650 Charles E. Young Dr. South, Los Angeles, CA 90024, USA. Electronic address: arimoin@ucla.edu.
authors.forename: Anne W
authors.initials: AW
authors.lastname: Rimoin
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D015023:Democratic Republic of the Congo; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D045908:Mpox, Monkeypox / Q000276:immunology* / Q000473:pathology*; D008993:Monkeypox virus / Q000276:immunology*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D016207:Cytokines
keywords: Cytokine; Cytokine storm; Monkeypox; Orthopoxvirus; Regulatory T cell