Dynamics of Orthopoxvirus Stability Under Simulated Luminal Conditions of the Gastrointestinal Tract for Assessing the Feasibility of Oral Immunization.

BACKGROUND/OBJECTIVES: Mpox (formerly monkeypox) is a re-emerging global health threat. While current vaccines are injectable, oral vaccination offers a painless alternative, though the harsh gastrointestinal (GI) environment challenges live viral vaccines. This study evaluated the stability of orthopoxviruses under simulated GI conditions to assess the physicochemical feasibility of oral mpox immunization. METHODS: Attenuated and virulent strains of vaccinia, cowpox, and camelpox viruses were exposed to simulated gastric (pH 1.0-2.0 and 3.0-4.0 with pepsin) and intestinal (pH 7.0-7.5) conditions at 37 °C for 180 min. Viral titers were determined via cell culture assays. The physicochemical protective efficacy of enteric-coated capsules was evaluated using standard dissolution testing parameters. RESULTS: All orthopoxviruses were rapidly inactivated under highly acidic fasting conditions (pH 1.0-2.0). However, they exhibited high stability at pH 3.0-4.0 and 7.0-7.5, retaining approximately 20-30% of their initial infectivity after 180 min. Enteric-coated capsules successfully maintained shell integrity in simulated gastric fluids for over 3 h and dissolved completely under intestinal conditions within ~130 min, aligning with small intestine transit times. CONCLUSIONS: Orthopoxviruses possess sufficient intestinal stability to support the physicochemical feasibility of oral immunization, provided they are protected from gastric acidity. Enteric-coated capsules represent a highly suitable delivery system for the intestinal release of live orthopoxvirus-based candidates, warranting further in vivo preclinical evaluation.