Immunopathogenesis of poxvirus infections: Forecasting the impending storm

Marianne M. Stanford, Grant McFadden, Gunasegaran Karupiah, Geeta Chaudhri

Research output: Contribution to journalReview articlepeer-review

96 Scopus citations


Variola virus, the causative agent of smallpox, is a member of the poxvirus family and one of the most virulent human pathogens known. Although smallpox was eradicated almost 30 years ago, it is not understood why the mortality rates associated with the disease were high, why some patients recovered, and what constitutes an effective host response against infection. As variola virus infects only humans, our current understanding of poxvirus infections comes largely from historical clinical data from smallpox patients and from animal studies using closely related viruses such as ectromelia, myxoma and monkeypox. The outcome of an infection is determined by a complex interaction between the type of immune response mounted by the host and by evasion mechanisms that the virus has evolved to subvert it. Disease pathogenesis is also a function of both host and viral factors. Poxviruses are not only cytopathic, causing host tissue damage, but also encode an array of immunomodulatory molecules that affect the severity of disease. The ability of the host to control virus replication is therefore critical in limiting tissue damage. However, in addition to targeting virus, the immune response can inadvertently damage the host to such a degree that it causes illness and even death. There is growing evidence that many of the symptoms associated with serious poxvirus infections are a result of a 'cytokine storm' or sepsis and that this may be the underlying cause of pathology.

Original languageEnglish (US)
Pages (from-to)93-102
Number of pages10
JournalImmunology and Cell Biology
Issue number2
StatePublished - Feb 5 2007
Externally publishedYes


  • Host response
  • Immune evasion
  • Immunopathology
  • Poxvirus
  • Smallpox

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Cell Biology


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