2025-07-03 名古屋大学
<関連情報>
- https://www.nagoya-u.ac.jp/researchinfo/result/2025/07/post-847.html
- https://www.nagoya-u.ac.jp/researchinfo/result/upload_images/20250703_sci.pdf
- https://www.science.org/doi/10.1126/scitranslmed.ads4773
コンゴ民主共和国におけるクレードI型mpox患者の臨床的特徴を明らかにするための病変移行動態のモデル化 Modeling lesion transition dynamics to clinically characterize patients with clade I mpox in the Democratic Republic of the Congo
Takara Nishiyama, Fuminari Miura, Yong Dam Jeong, Naotoshi Nakamura, […] , and Phillip R. Pittman
Science Translational Medicine Published:2 Jul 2025
DOI:https://doi.org/10.1126/scitranslmed.ads4773
Editor’s summary
Clade I mpox virus (MPVX) infections are associated with more severe disease and greater fatality than clade II infections, but a substantial amount of heterogeneity is nonetheless observed in clade I clinical presentations for reasons that are unclear. Nishiyama et al. used historical longitudinal data from patients infected with clade I MPVX in the Democratic Republic of Congo to examine clade-specific parameters of disease progression. They found that patients can be classified into two groups on the basis of their number of lesions and lesion duration and also report that early viral load is predictive of disease severity. This study may serve as a valuable resource for managing the current mpox public health emergency. —Catherine Charneski
Abstract
Coinciding with the global outbreak of clade IIb mpox virus (MPXV), the Democratic Republic of the Congo (DRC) recently experienced a rapid surge in mpox cases with clade I MPXV. On 14 August 2024, the World Health Organization declared the continued cross-border spread of this clade in Africa a public health emergency of international concern (PHEIC). Clade I MPXV is known to be more fatal than clade IIb, but its clinical characteristics and prognosis differ between patients. Here, we used mathematical modeling to quantify temporal changes in total lesion counts during clade I MPXV infections, using data from a large cohort of patients with mpox in the DRC from 2007 to 2011. We further analyzed individuals’ clinical data to explore predictive biomarkers of high lesion counts. Our analysis indicates that patients with clade I mpox can be stratified into two groups according to lesion severity and that viral load in peripheral blood at symptom onset may serve as a predictor for this classification [area under the curve (AUC) = 0.70]. Our estimates also suggest substantial individual heterogeneity in the time period during which patients have lesions, ranging from 20 to 65 days. Understanding the severity and duration of lesions in different patients, as characterized by our approach, may contribute to more tailored treatment strategies and control measures in ongoing clade I mpox outbreaks.
