Fig. 4.

Manipulation of the host immune response by the monkeypox virus. MPXV can escape from the protein kinase R pathway through reduction of mRNA synthesis and ablation of type-I interferon mediating protein kinase R phosphorylation. MPXV can also reduce the production of inflammatory mediators by interfering with phosphorylation of the MAPK/ERK1/2 pathways. It suppresses cell apoptosis by increasing phosphorylation of the ATK pathway. MPXV can prevent natural killer cells from killing virus-infected cells and secreting inflammatory cytokines. MPXV can also interfere with the adaptive immune response by hindering T cell receptor trans-signaling.