Emerging strategies for monkeypox: antigen and antibody applications in diagnostics, vaccines, and treatments

Monkeypox, a zoonotic illness caused by monkeypox virus (MPXV), has been declared a public health emergency of international concern by the World Health Organization (WHO) on 2 separate occasions. The rapid spread and widespread transmission are closely associated with various proteins involved in the MPXV lifecycle, particularly surface antigen proteins found in mature virion (MV) and enveloped virion (EV), such as A29L, M1R, B6R, and A35R. These antigens are highly conserved in monkeypox virus (MPXV) and vaccinia virus (VACV), possessing cross-protective capabilities that can trigger broad immune protection against multiple orthopoxviruses, including MPXV. Vaccines based on DNA, mRNA, and recombinant proteins, targeting these antigens effectively address the current lack of specific monkeypox vaccines by triggering strong immune responses and ensuring the prevention of monkeypox. Compared to traditional vaccines, multi-epitope vaccines designed using computational tools such as reverse vaccinology and immunoinformatics offer lower development costs and faster validation processes. These multi-epitope vaccines also provide adaptability to mutations in MPXV strains. Additionally, these antigens and corresponding antibodies are useful for diagnosis and therapeutic monitoring, supporting early detection and offering novel treatments for cases resistant to existing antiviral drugs. This review provides a brief summary of recent progress and emerging trends in monkeypox detection, vaccine development, and antibody-based therapy targeting these antigens, offering new insights for monkeypox prevention and control.