Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Jan 11;35(3):496-502.
doi: 10.1016/j.vaccine.2016.09.026. Epub 2016 Sep 28.

Development and clinical applications of novel antibodies for prevention and treatment of respiratory syncytial virus infection

Asuncion Mejias  1 , Cristina Garcia-Maurino  2 , Rosa Rodriguez-Fernandez  3 , Mark E Peeples  2 , Octavio Ramilo  4
Affiliations
Review

Development and clinical applications of novel antibodies for prevention and treatment of respiratory syncytial virus infection

Asuncion Mejias et al. Vaccine. .

Abstract

Respiratory syncytial virus (RSV) remains a significant cause of morbidity and mortality in infants and young children, immunocompromised patients and the elderly. Despite the high disease burden, an effective and safe vaccine is lacking, although several candidates are currently in development. Current treatment for RSV infection remains largely supportive and RSV-specific options for prophylaxis are limited to palivizumab. In the past few years, novel therapeutic options including nanobodies, polyclonal and monoclonal antibodies have emerged and there are several products in preclinical and Phase-I, -II or -III clinical trials. The major target for antiviral drug development is the surface fusion (F) glycoprotein, which is crucial for the infectivity and pathogenesis of the virus. Solving the structures of the two conformations of the RSV F protein, the prefusion and postfusion forms, has revolutionized RSV research. It is now known that prefusion F is highly superior in inducing neutralizing antibodies. In this section we will review the stages of development and availability of different antibodies directed against RSV for the prevention and also for treatment of acute RSV infections. Some of these newer anti-RSV agents have shown enhanced potency, are being explored through alternative routes of administration, have improved pharmacokinetic profiles with an extended half-life, and may reduce design and manufacturing costs. Management strategies will require targeting not only high-risk populations (including adults or immunocompromised patients), but also previously healthy children who, in fact, represent the majority of children hospitalized with RSV infection. Following treated patients longitudinally is essential for determining the impact of these strategies on the acute disease as well as their possible long-term benefits on lung morbidity.

Keywords: Monoclonal antibodies; Nanobodies; RSV.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interests AM reports personal fees from Abbvie and Novartis, grants from Gilead and from Alios and grants and personal fees from Janssen. OR reports personal fees from HuMabs, Abbvie, Janssen, Medimmune and Regeneron, and grants from Janssen. MEP reports grants from Janssen, Medimmune, Abbott, Reviral and Agilvax. None of these fees or grants are related to the current work.

Figures

Figure 1
Figure 1. Anatomy of RSV
RSV is an enveloped, negative sense, single strand RNA virus whose genome contains 10 genes (15,222 nucleotides) encoding eleven proteins. Of the three transmembrane surface glycoproteins, the attachment (G) and fusion (F) proteins, are crucial for the infectivity and pathogenesis of the virus, and are the targets for neutralizing antibodies.
Figure 2
Figure 2. Refolding of the RSV F protein
The F glycoprotein is present in two forms, a metastable prefusion F (preF), the active form on the virion membrane, and the postfusion F (postF) after triggering, refolding and bringing the virus and target cell membrane together to initiate fusion and infection. It is not clear what causes the F protein to trigger.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375:1545–55. - PMC - PubMed
    1. Shay DK, Holman RC, Newman RD, Liu LL, Stout JW, Anderson LJ. Bronchiolitis-associated hospitalizations among US children, 1980–1996. Jama. 1999;282:1440–6. - PubMed
    1. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2095–128. - PMC - PubMed
    1. Walsh EE, Falsey AR. Respiratory syncytial virus infection in adult populations. Infectious disorders drug targets. 2012;12:98–102. - PubMed
    1. Campbell AP, Chien JW, Kuypers J, Englund JA, Wald A, Guthrie KA, et al. Respiratory virus pneumonia after hematopoietic cell transplantation (HCT): associations between viral load in bronchoalveolar lavage samples, viral RNA detection in serum samples, and clinical outcomes of HCT. J Infect Dis. 2010;201:1404–13. - PMC - PubMed

Publication types

MeSH terms