Recent advances in Mpox across innate immunity, evasion, and clinical outcomes.

Recent mpox outbreaks have shown that disease severity cannot be explained by viral burden alone but is instead closely linked to the host immune response. This review synthesizes current evidence on the genomic diversity of monkeypox virus (MPXV), innate immune sensing, inflammatory pathways, immune evasion, and therapeutic strategies. We examine the key host determinants of disease outcome, including interferon signaling competence, inflammasome regulation, and natural killer cell function, together with the clinical manifestations seen in immunocompromised populations. By integrating molecular and clinical perspectives, this review helps explain the heterogeneity of mpox and informs the management of high-risk populations.