{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T21:29:46Z","timestamp":1777670986514,"version":"3.51.4"},"reference-count":50,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,9]],"date-time":"2022-08-09T00:00:00Z","timestamp":1660003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Biodefense Analysis and Countermeasure Center","award":["RSRD-05-00378"],"award-info":[{"award-number":["RSRD-05-00378"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>For over two decades, researchers have sought to improve smallpox vaccines and also develop therapies to ensure protection against smallpox or smallpox-like disease. The 2022 human monkeypox pandemic is a reminder that these efforts should persist. Advancing such therapies have involved animal models primarily using surrogate viruses such as monkeypox virus. The intravenous monkeypox model in macaques produces a disease that is clinically similar to the lesional phase of fulminant human monkeypox or smallpox. Two criticisms of the model have been the unnatural route of virus administration and the high dose required to induce severe disease. Here, we purified monkeypox virus with the goal of lowering the challenge dose by removing cellular and viral contaminants within the inoculum. We found that there are advantages to using unpurified material for intravenous exposures.<\/jats:p>","DOI":"10.3390\/v14081741","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T09:47:06Z","timestamp":1660124826000},"page":"1741","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Effect of Monkeypox Virus Preparation on the Lethality of the Intravenous Cynomolgus Macaque Model"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4656-5379","authenticated-orcid":false,"given":"Eric M.","family":"Mucker","sequence":"first","affiliation":[{"name":"Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josh D.","family":"Shamblin","sequence":"additional","affiliation":[{"name":"Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo Lynne","family":"Raymond","sequence":"additional","affiliation":[{"name":"Pathology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy A.","family":"Twenhafel","sequence":"additional","affiliation":[{"name":"Pathology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 21702, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5683-3250","authenticated-orcid":false,"given":"Robert F.","family":"Garry","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, School of Medicine, Tulane University, New Orleans, LA 70112, USA"},{"name":"Zalgen Labs, Frederick, MD 21703, USA"},{"name":"Global Virus Network (GVN), Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa E.","family":"Hensley","sequence":"additional","affiliation":[{"name":"Zoonotic and Emerging Disease Unit, United States Department of Agriculture, Manhattan, KS 66505, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Memariani, M., and Memariani, H. (2022). Multinational monkeypox outbreak: What do we know and what should we do?. Ir. J. Med. Sci.","DOI":"10.1007\/s11845-022-03052-4"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Bunge, E.M., Hoet, B., Chen, L., Lienert, F., Weidenthaler, H., Baer, L.R., and Steffen, R. (2022). The changing epidemiology of human monkeypox-A potential threat? A systematic review. PLoS Negl. Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010141"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Vaughan, A., Aarons, E., Astbury, J., Balasegaram, S., Beadsworth, M., Beck, C.R., Chand, M., O\u2019Connor, C., Dunning, J., and Ghebrehewet, S. (2018). Two cases of monkeypox imported to the United Kingdom, September 2018. Euro Surveill., 23.","DOI":"10.2807\/1560-7917.ES.2018.23.38.1800509"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1056\/NEJMoa032299","article-title":"The detection of monkeypox in humans in the Western Hemisphere","volume":"350","author":"Reed","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1099\/vir.0.005108-0","article-title":"A prairie dog animal model of systemic orthopoxvirus disease using West African and Congo Basin strains of monkeypox virus","volume":"90","author":"Hutson","year":"2009","journal-title":"J. Gen. Virol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Adler, H., Gould, S., Hine, P., Snell, L.B., Wong, W., Houlihan, C.F., Osborne, J.C., Rampling, T., Beadsworth, M.B., and Duncan, C.J. (2022). Clinical features and management of human monkeypox: A retrospective observational study in the UK. Lancet Infect. Dis.","DOI":"10.1016\/S1473-3099(22)00228-6"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"129","DOI":"10.2217\/fvl.12.130","article-title":"A review of experimental and natural infections of animals with monkeypox virus between 1958 and 2012","volume":"8","author":"Parker","year":"2013","journal-title":"Future Virol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.antiviral.2019.06.005","article-title":"The development and approval of tecoviromat (TPOXX((R))), the first antiviral against smallpox","volume":"168","author":"Merchlinsky","year":"2019","journal-title":"Antiviral Res."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Mucker, E.M., Chapman, J., Huzella, L.M., Huggins, J.W., Shamblin, J., Robinson, C.G., and Hensley, L.E. (2015). Susceptibility of Marmosets (Callithrix jacchus) to Monkeypox Virus: A Low Dose Prospective Model for Monkeypox and Smallpox Disease. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0131742"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Mucker, E.M., Wollen-Roberts, S.E., Kimmel, A., Shamblin, J., Sampey, D., and Hooper, J.W. (2018). Intranasal monkeypox marmoset model: Prophylactic antibody treatment provides benefit against severe monkeypox virus disease. PLoS Negl. Trop. Dis., 12.","DOI":"10.1371\/journal.pntd.0006581"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1099\/00221287-29-3-523","article-title":"Purification of pox viruses by density gradient centrifugation","volume":"29","author":"Zwartouw","year":"1962","journal-title":"J. Gen. Microbiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1093\/oxfordjournals.aje.a121326","article-title":"A study of intrafamilial transmission of smallpox","volume":"94","author":"Heiner","year":"1971","journal-title":"Am J Epidemiol"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1086\/374054","article-title":"Can postexposure vaccination against smallpox succeed?","volume":"36","author":"Mortimer","year":"2003","journal-title":"Clin. Infect. Dis."},{"key":"ref_14","first-page":"101","article-title":"Growing poxviruses and determining virus titer","volume":"269","author":"Kotwal","year":"2004","journal-title":"Methods Mol. Biol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.virol.2020.02.004","article-title":"Particle-specific neutralizing activity of a monoclonal antibody targeting the poxvirus A33 protein reveals differences between cell associated and extracellular enveloped virions","volume":"544","author":"Mucker","year":"2020","journal-title":"Virology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1902","DOI":"10.1093\/infdis\/jir663","article-title":"Evaluation of monkeypox disease progression by molecular imaging","volume":"204","author":"Dyall","year":"2011","journal-title":"J. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1038\/nature02331","article-title":"Immunogenicity of a highly attenuated MVA smallpox vaccine and protection against monkeypox","volume":"428","author":"Earl","year":"2004","journal-title":"Nature"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2620","DOI":"10.1128\/AAC.00021-09","article-title":"Nonhuman primates are protected from smallpox virus or monkeypox virus challenges by the antiviral drug ST-246","volume":"53","author":"Huggins","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1128\/AAC.01596-08","article-title":"ST-246 antiviral efficacy in a nonhuman primate monkeypox model: Determination of the minimal effective dose and human dose justification","volume":"53","author":"Jordan","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s12985-017-0880-8","article-title":"Validation of a pan-orthopox real-time PCR assay for the detection and quantification of viral genomes from nonhuman primate blood","volume":"14","author":"Mucker","year":"2017","journal-title":"Virol. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.1399-3089.2004.00186.x","article-title":"Reference values for clinical chemistry and clinical hematology parameters in cynomolgus monkeys","volume":"12","author":"Schuurman","year":"2005","journal-title":"Xenotransplantation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2787","DOI":"10.1016\/j.vaccine.2006.12.037","article-title":"Adjuvant-enhanced antibody responses to recombinant proteins correlates with protection of mice and monkeys to orthopoxvirus challenges","volume":"25","author":"Fogg","year":"2007","journal-title":"Vaccine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1128\/JVI.00984-08","article-title":"Coadministration of cidofovir and smallpox vaccine reduced vaccination side effects but interfered with vaccine-elicited immune responses and immunity to monkeypox","volume":"83","author":"Wei","year":"2009","journal-title":"J. Virol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.vaccine.2007.10.063","article-title":"Clonal vaccinia virus grown in cell culture fully protects monkeys from lethal monkeypox challenge","volume":"26","author":"Marriott","year":"2008","journal-title":"Vaccine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1093\/infdis\/jiq162","article-title":"Smallpox vaccine safety is dependent on T cells and not B cells","volume":"203","author":"Gordon","year":"2011","journal-title":"J. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"7081","DOI":"10.1016\/j.vaccine.2010.08.008","article-title":"Smallpox vaccine with integrated IL-15 demonstrates enhanced in vivo viral clearance in immunodeficient mice and confers long term protection against a lethal monkeypox challenge in cynomolgus monkeys","volume":"28","author":"Zielinski","year":"2010","journal-title":"Vaccine"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"9684","DOI":"10.1016\/j.vaccine.2011.09.135","article-title":"Attenuated NYCBH vaccinia virus deleted for the E3L gene confers partial protection against lethal monkeypox virus disease in cynomolgus macaques","volume":"29","author":"Denzler","year":"2011","journal-title":"Vaccine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1093\/infdis\/jiq017","article-title":"Multivalent smallpox DNA vaccine delivered by intradermal electroporation drives protective immunity in nonhuman primates against lethal monkeypox challenge","volume":"203","author":"Hirao","year":"2011","journal-title":"J. Infect. Dis."},{"key":"ref_29","first-page":"192","article-title":"Protection of Rhesus Monkeys against Monkeypox by Vaccinia Virus Immunization","volume":"25","author":"McConnell","year":"1964","journal-title":"Am. J. Vet. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.virol.2007.04.010","article-title":"DNA\/MVA HIV-1\/AIDS vaccine elicits long-lived vaccinia virus-specific immunity and confers protection against a lethal monkeypox challenge","volume":"366","author":"Nigam","year":"2007","journal-title":"Virology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1086\/427265","article-title":"Smallpox vaccine does not protect macaques with AIDS from a lethal monkeypox virus challenge","volume":"191","author":"Bray","year":"2005","journal-title":"J. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1038\/nm1261","article-title":"Smallpox vaccine-induced antibodies are necessary and sufficient for protection against monkeypox virus","volume":"11","author":"Golding","year":"2005","journal-title":"Nat. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2552","DOI":"10.4049\/jimmunol.177.4.2552","article-title":"Subunit recombinant vaccine protects against monkeypox","volume":"177","author":"Heraud","year":"2006","journal-title":"J. Immunol."},{"key":"ref_34","first-page":"1675","article-title":"Monkeypox: Experimental infection in chimpanzee (Pan satyrus) and immunization with vaccinia virus","volume":"29","author":"McConnell","year":"1968","journal-title":"Am. J. Vet. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.vaccine.2009.09.133","article-title":"Molecular smallpox vaccine delivered by alphavirus replicons elicits protective immunity in mice and non-human primates","volume":"28","author":"Hooper","year":"2009","journal-title":"Vaccine"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Golden, J.W., Josleyn, M., Mucker, E.M., Hung, C.F., Loudon, P.T., Wu, T.C., and Hooper, J.W. (2012). Side-by-side comparison of gene-based smallpox vaccine with MVA in nonhuman primates. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0042353"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"4433","DOI":"10.1128\/JVI.78.9.4433-4443.2004","article-title":"Smallpox DNA vaccine protects nonhuman primates against lethal monkeypox","volume":"78","author":"Hooper","year":"2004","journal-title":"J. Virol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"10889","DOI":"10.1073\/pnas.0804985105","article-title":"Rapid protection in a monkeypox model by a single injection of a replication-deficient vaccinia virus","volume":"105","author":"Earl","year":"2008","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.jcpa.2012.06.007","article-title":"Comparative pathology of smallpox and monkeypox in man and macaques","volume":"148","author":"Cann","year":"2013","journal-title":"J. Comp. Pathol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1177\/0300985810378649","article-title":"Animal models of orthopoxvirus infection","volume":"47","author":"Chapman","year":"2010","journal-title":"Vet. Pathol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Wahl-Jensen, V., Cann, J.A., Rubins, K.H., Huggins, J.W., Fisher, R.W., Johnson, A.J., de Kok-Mercado, F., Larsen, T., Raymond, J.L., and Hensley, L.E. (2011). Progression of pathogenic events in cynomolgus macaques infected with variola virus. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0024832"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/j.jacc.2003.11.053","article-title":"Smallpox vaccination and myopericarditis: A clinical review","volume":"43","author":"Cassimatis","year":"2004","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Centers for Disease Control and Prevention (2003). Smallpox vaccine adverse events among civilians\u2014United States, March 4\u201310, 2003. JAMA, 289, 1921\u20131922.","DOI":"10.1001\/jama.289.15.1921"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"3278","DOI":"10.1001\/jama.289.24.3278","article-title":"US military smallpox vaccination program experience","volume":"289","author":"Grabenstein","year":"2003","journal-title":"JAMA"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3283","DOI":"10.1001\/jama.289.24.3283","article-title":"Myopericarditis following smallpox vaccination among vaccinia-naive US military personnel","volume":"289","author":"Halsell","year":"2003","journal-title":"JAMA"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"S251","DOI":"10.1086\/524741","article-title":"Follow-up of cardiovascular adverse events after smallpox vaccination among civilians in the United States, 2003","volume":"46","author":"Sniadack","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2112","DOI":"10.1128\/JVI.01931-10","article-title":"Comparative analysis of monkeypox virus infection of cynomolgus macaques by the intravenous or intrabronchial inoculation route","volume":"85","author":"Johnson","year":"2011","journal-title":"J. Virol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"4999","DOI":"10.1128\/AAC.00678-09","article-title":"ST-246 inhibits in vivo poxvirus dissemination, virus shedding, and systemic disease manifestation","volume":"53","author":"Berhanu","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Rubins, K.H., Hensley, L.E., Relman, D.A., and Brown, P.O. (2011). Stunned silence: Gene expression programs in human cells infected with monkeypox or vaccinia virus. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0015615"},{"key":"ref_50","unstructured":"Mucker, E.M., Shamblin, J., Goff, A.J., Bell, T.M., Reed, C., Twenhafel, N., Chapman, J., Mattix, M., Alves, D., and Garry, R. (Viruses, 2022). Viruses, in review."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/8\/1741\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:06:08Z","timestamp":1760141168000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/8\/1741"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,9]]},"references-count":50,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["v14081741"],"URL":"https:\/\/doi.org\/10.3390\/v14081741","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,9]]}}}