Systematic evaluation of the induction of efficient neutralizing antibodies by recombinant multicomponent subunit vaccines against monkeypox virus.

Mpox (formerly known as monkeypox), which has symptoms similar to smallpox, is a zoonotic disease caused by the monkeypox virus (MPXV). From 1 January 2022 to 31 March 2024, 117 countries, territories, or areas reported 95,226 laboratory-confirmed cases of Mpox (including 185 deaths) to the World Health Organization. However, as there is no licensed specific MPXV vaccine available globally, the vaccines currently used for mpox prevention are mostly smallpox vaccines. Thus, the rapid development of safe and effective vaccines is urgently required. In the present study, the key MPXV proteins A35, B6R, E8L, A29, M1R, and H3L were expressed and prepared using a prokaryotic expression system (Escherichia coli) and a eukaryotic expression system (yeast), and the fusion antigens A35-A29 and A35-M1R were constructed based on the dimerization characteristics of the A35 protein. By combining the antigens with aluminum hydroxide and CpG adjuvants in different combinations, we developed nine multicomponent MPXV subunit vaccine candidates. Each antigen (10 μg) and fusion antigen (20 μg) were used to immunize the mice. The first two doses produced a mean titer of 10(Petersen et al., 2016 [5], and the third dose maintained the same potent antibody-specific response as the previous two immunizations. The protective activity of different antigen combinations was determined using the cell neutralization test of vaccinia virus (VACV), which showed that the subunit vaccine candidates with two to six components (MPXV6/5/4/3a/3b/Fa/2a) had good neutralizing activity, and antigens A35 and M1R could produce neutralizing antibodies against VACV. The neutralizing antibody titer of the fusion antigen MPXVFa (A35-M1R), detected 2 weeks after the second booster dose, was comparable with that of MPXV2a (A35 and M1R). The A35-M1R fusion protein not only provided a high level of protection as a protective antigen but also simplified the preparation of candidate antigens. In summary, we systematically investigated the different protective antigen candidates of MPXV that have been widely studied and provided critical insights into the key protective antigen composition for vaccines, thus establishing a technical and theoretical foundation for the development of MPXV subunit vaccines.