Background
Human respiratory syncytial virus (HRSV, referred to as RSV), also known as respiratory fusion virus, is a non-segmented negative sense single-stranded envelope RNA virus, belonging to the family Paramyxoviridae, genus Pneumovirus, and subfamily Pneumovirinae. Its 10 genes encode 11 proteins because two overlapping open reading frames in M2 mRNA produce two different matrix proteins, M2-1 and M2-2. The viral envelope contains three proteins, namely, G glycoprotein, fusion (F) glycoprotein and small hydrophobic (SH) protein. G protein plays a role in host cell attachment, F protein is responsible for fusion and cell entry, and SH protein is not necessary in both processes. RSV virus also includes five other structural proteins, namely, large (L) protein, nucleocapsid (N), phosphoprotein (P), matrix protein (M) and M2-1, as well as two non-structural proteins (NS1 and NS2). It is not clear whether M2-2 is also part of a mature assembled virion.
In temperate regions, RSV infections show a marked seasonal pattern. They usually begin in late fall or early winter and peak between mid-December and early February. Humans are the only hosts of RSV, and in particular, RSV is the leading cause of acute lower respiratory tract infection in children under 2 years of age worldwide, with 1 in 50 deaths in children 0-5 years of age and 1 in 28 deaths in children 1 month to 6 months of age attributable to RSV. RSV infection in childhood has also been shown to cause persistent or recurrent wheezing and asthma in later life, suggesting a possible link between the incidence of RSV and chronic disease.
At present, the main treatment of acute RSV infection is symptomatic supportive treatment, so the strategy for RSV focuses on prevention. The first type of prevention strategy is passive immunization with monoclonal antibodies or maternal vaccination during pregnancy, and the second is active immunization with a variety of vaccines designed for infants and adults. There are two different subtypes of RSV, RSV-A and RSV-B, which are mainly distinguished by the variation of G protein, while F protein is more conservative, so F protein has become the preferred target for vaccine and monoclonal antibody development. Candidate vaccines for RSV can be divided into live attenuated vaccine or chimeric vaccine. Vaccines based on protein, recombinant vector and nucleic acid are still under development.
Figure 1. Immunization Strategies for RSV
(Source: Gatt D, et al. 2023)
Alternative Names
Human respiratory syncytial virus monoclonal antibody
HRSV monoclonal antibody
RSV monoclonal antibody
References
- 1. Gatt D, et al. Prevention and Treatment Strategies for Respiratory Syncytial Virus (RSV). Pathogens. 2023 Jan 17;12(2):154.
- 2. Rezende W, et al. The RSV F p27 peptide: current knowledge, important questions. Front Microbiol. 2023 Jun 21;14:1219846.
References
Prevention and Treatment Strategies for Respiratory Syncytial Virus (RSV)
Pathogens
Authors: Gatt D, Martin I, AlFouzan R, Moraes TJ.
Abstract
Respiratory syncytial virus (RSV) is a leading cause of severe lower respiratory tract disease, especially in young children. Despite its global impact on healthcare, related to its high prevalence and its association with significant morbidity, the current therapy is still mostly supportive. Moreover, while more than 50 years have passed since the first trial of an RSV vaccine (which unfortunately caused enhanced RSV disease), no vaccine has been approved for RSV prevention. In the last two decades, our understanding of the pathogenesis and immunopathology of RSV have continued to evolve, leading to significant advancements in RSV prevention strategies. These include both the development of new potential vaccines and the successful implementation of passive immunization, which, together, will provide coverage from infancy to old age. In this review, we provide an update of the current treatment options for acute disease (RSV-specific and -non-specific) and different therapeutic approaches focusing on RSV prevention.
Development of mRNA vaccines against respiratory syncytial virus (RSV)
Cytokine Growth Factor Rev
Authors: Qiu X, Xu S, Lu Y, Luo Z, Yan Y, Wang C, Ji J
Abstract
Respiratory syncytial virus (RSV) is a single-stranded negative-sense RNA virus that is the primary etiologic pathogen of bronchitis and pneumonia in infants and the elderly. Currently, no preventative vaccine has been approved for RSV infection. However, advances in the characterization, and structural resolution, of the RSV surface fusion glycoprotein have revolutionized RSV vaccine development by providing a new target for preventive interventions. In general, six different approaches have been adopted in the development of preventative RSV therapeutics, namely, particle-based vaccines, vector-based vaccines, live-attenuated or chimeric vaccines, subunit vaccines, mRNA vaccines, and monoclonal antibodies. Among these preventive interventions, MVA-BN-RSV, RSVpreF3, RSVpreF, Ad26. RSV.preF, nirsevimab, clesrovimab and mRNA-1345 is being tested in phase 3 clinical trials, and displays the most promising in infant or elderly populations. Accompanied by the huge success of mRNA vaccines in COVID-19, mRNA vaccines have been rapidly developed, with many having entered clinical studies, in which they have demonstrated encouraging results and acceptable safety profiles. In fact, Moderna has received FDA approval, granting fast-track designation for an investigational single-dose mRNA-1345 vaccine against RSV in adults over 60 years of age. Hence, mRNA vaccines may represent a new, more successful, chapter in the continued battle to develop effective preventative measures against RSV. This review discusses the structure, life cycle, and brief history of RSV, while also presenting the current advancements in RSV preventatives, with a focus on the latest progress in RSV mRNA vaccine development. Finally, future prospects for this field are presented.
COA
Publication 
Loading ......
