# No Distinct Cytokine, Chemokine, and Growth Factor Blood Profile Associated With Monkeypox Virus Clade IIb Infected Patients

## TL;DR

The study found no distinct blood cytokine profiles in monkeypox patients infected with Clade IIb, suggesting limited clinical use of these markers.

## Contribution

The study is the first to analyze cytokine profiles in Clade IIb monkeypox patients using a 65-plex panel.

## Key findings

- No strong cytokine profiles distinguished Clade IIb mpox patients from healthy controls.
- Some cytokines, chemokines, and growth factors were elevated or suppressed in patients.
- HIV-positive patients showed changes in specific cytokine levels compared to pre-outbreak samples.

## Abstract

Previous studies indicated Clade I monkeypox virus infection to be associated with marked elevation of proinflammatory cytokines. This remains unexplored for Clade II‐associated disease, which has different clinical manifestations and prognosis. We used a 65‐plex cytokine, chemokine, and growth factor (CCG) panel to analyze serum samples of 100 male acute Clade IIb mpox patients and 26 healthy controls in Belgium. Cluster analyses revealed no strong or distinct CCG profiles distinguishing mpox patients from controls but suggested trends in certain cytokine modulation. Individual CCG analyses found elevated levels of cytokines (MIF, CD30, IL2R, IL18, APRIL, and TNFRII), chemokines (CCL4, CCL8, CCL22, CCL24, CXCL9, CXCL10, CXCL11, CXCL12, and CXCL13), and growth factors (HGF and VEGFA) in patients, while CCL11 and CXCL5 were significantly suppressed. We detected no differences in key proinflammatory cytokines, IL‐1α, IL‐1β, IL‐6, IL‐8 or anti‐inflammatory cytokines, IL‐4, IL‐10, IL‐13. In patients living with HIV, comparison with pre‐outbreak samples showed an increase in CXCL13 and a decrease in CXCL5, CCL2, CCL24, HGF, SCF, and TWEAK. The absence of discriminatory CCG profiles in Clade IIb mpox patients compared to healthy controls suggests there may be limited clinical applications of those markers.