Mpox Infection and Endocrine Health: Bridging the Knowledge Gap
Abstract
1. Introduction
2. MPX and Thyroid Function
3. MPX and the Adrenals/Other Endocrine Glands
4. MPX and the Gonads: Clinical and Pathophysiological Considerations
5. Interaction of MPX with Hormonal Receptors and Hormonal Metabolism
6. Clinical Implications and Risks of Steroid Therapy in MPX
7. Conclusions
8. Limitations and Future Directions
8.1. Limitations
8.2. Future Research Directions
Author Contributions
Funding
Conflicts of Interest
Abbreviations
MPX | Mpox |
MPXV | Monkeypox virus |
HPA | Hypothalamic–pituitary–adrenal |
TSH | Thyrotropin |
T3 | Triiodothyronine |
T4 | Thyroxine |
AI | Adrenal insufficiency |
11β-HSD | 11β-hydroxysteroid dehydrogenase |
HPG | Hypothalamic-pituitary-gonadal |
MSM | Men who have sex with men |
GRs | Glucocorticoid receptors |
ARs | Androgen receptors |
ERs | Estrogen receptors |
GCs | Glucocorticoids |
3β-HSD | 3β-hydroxysteroid dehydrogenase |
STI | Sexually transmitted infection |
SGRMs | Selective glucocorticoid receptor modulators |
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Impact | Findings | Mechanisms | Clinical Implications |
---|---|---|---|
Thyroid | MPX linked to subacute thyroiditis, leading to thyrotoxicosis or hypothyroidism | Viral infiltration; immune-mediated damage | Symptoms: fever, weight loss, neck pain Treatment: corticosteroids, levothyroxine |
Adrenal | Viral infections have been implicated in adrenal insufficiency | Viral invasion; HPA axis dysregulation | Possible risk of adrenal insufficiency, requiring glucocorticoid therapy |
Reproductive (Men) | MPXV persistence in testes; may affect fertility, hormone production | Testicular inflammation; necrosis | Potential sperm quality reduction, hormonal imbalances Further research needed |
Hormonal Receptors | MPXV may alter steroid receptor activity | Modulation of glucocorticoid, androgen, and estrogen signaling/metabolism pathways | Possible sex-based differences in severity of MPX |
Steroid Therapy | Steroids help inflammation but may prolong MPXV viremia | Interaction with glucocorticoid receptors | Need for balance between benefit and harm needed; selective glucocorticoid receptor modulators (SGRMs) may help |
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Savvidis, C.; Rizzo, M.; Ilias, I. Mpox Infection and Endocrine Health: Bridging the Knowledge Gap. Medicina 2025, 61, 899. https://doi.org/10.3390/medicina61050899
Savvidis C, Rizzo M, Ilias I. Mpox Infection and Endocrine Health: Bridging the Knowledge Gap. Medicina. 2025; 61(5):899. https://doi.org/10.3390/medicina61050899
Chicago/Turabian StyleSavvidis, Christos, Manfredi Rizzo, and Ioannis Ilias. 2025. "Mpox Infection and Endocrine Health: Bridging the Knowledge Gap" Medicina 61, no. 5: 899. https://doi.org/10.3390/medicina61050899
APA StyleSavvidis, C., Rizzo, M., & Ilias, I. (2025). Mpox Infection and Endocrine Health: Bridging the Knowledge Gap. Medicina, 61(5), 899. https://doi.org/10.3390/medicina61050899