Modeling lesion transition dynamics to clinically characterize patients with clade I mpox in the Democratic Republic of the Congo

IF 14.6 1区医学 Q1 CELL BIOLOGY

Science Translational Medicine Pub Date : 2025-07-02 DOI:10.1126/scitranslmed.ads4773

Takara Nishiyama, Fuminari Miura, Yong Dam Jeong, Naotoshi Nakamura, Hyeongki Park, Masahiro Ishikane, Shotaro Yamamoto, Noriko Iwamoto, Michiyo Suzuki, Ayana Sakurai, Kazuyuki Aihara, Koichi Watashi, William S. Hart, Robin N. Thompson, Yasuhiro Yasutomi, Norio Ohmagari, Placide Mbala Kingebeni, John W. Huggins, Shingo Iwami, Phillip R. Pittman

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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.

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在刚果民主共和国，模拟病变转移动力学以临床表征进化支I型mpox患者

在全球暴发ii支m痘病毒（MPXV）的同时，刚果民主共和国（DRC）最近出现了携带I支MPXV的m痘病例的快速激增。2024年8月14日，世界卫生组织宣布该分支在非洲的持续跨界传播为国际关注的突发公共卫生事件。已知I支MPXV比IIb支更致命，但其临床特征和预后在患者之间存在差异。在这里，我们使用数学模型来量化进化支I型MPXV感染期间总病变计数的时间变化，使用的数据来自刚果民主共和国2007年至2011年的大量m痘患者。我们进一步分析了个体的临床数据，以探索高病变计数的预测性生物标志物。我们的分析表明，进化枝I型mpox患者可以根据病变严重程度分为两组，症状出现时外周血中的病毒载量可以作为这种分类的预测因子[曲线下面积(AUC) = 0.70]。我们的估计还表明，患者出现病变的时间跨度存在显著的个体异质性，从20天到65天不等。了解不同患者病变的严重程度和持续时间，正如我们的方法所描述的那样，可能有助于在正在进行的进化支I mpox暴发中制定更有针对性的治疗策略和控制措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Science Translational Medicine CELL BIOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL

CiteScore

26.70

自引率

1.20%

发文量

309

审稿时长

1.7 months

期刊介绍： Science Translational Medicine is an online journal that focuses on publishing research at the intersection of science, engineering, and medicine. The goal of the journal is to promote human health by providing a platform for researchers from various disciplines to communicate their latest advancements in biomedical, translational, and clinical research. The journal aims to address the slow translation of scientific knowledge into effective treatments and health measures. It publishes articles that fill the knowledge gaps between preclinical research and medical applications, with a focus on accelerating the translation of knowledge into new ways of preventing, diagnosing, and treating human diseases. The scope of Science Translational Medicine includes various areas such as cardiovascular disease, immunology/vaccines, metabolism/diabetes/obesity, neuroscience/neurology/psychiatry, cancer, infectious diseases, policy, behavior, bioengineering, chemical genomics/drug discovery, imaging, applied physical sciences, medical nanotechnology, drug delivery, biomarkers, gene therapy/regenerative medicine, toxicology and pharmacokinetics, data mining, cell culture, animal and human studies, medical informatics, and other interdisciplinary approaches to medicine. The target audience of the journal includes researchers and management in academia, government, and the biotechnology and pharmaceutical industries. It is also relevant to physician scientists, regulators, policy makers, investors, business developers, and funding agencies.