[Immunoprophylaxis of respiratory infections]

Anti-infective antibody-based immunotherapy has gained renewed interest since the crisis of antibiotic resistance and because there is no therapy against various viral infections. The immunoprophylaxis of respiratory infections aims to utilize the ability of local antibodies to neutralize inhaled micro-organisms and their cytopathic products. Immunoglobulins for intravenous use (i.v.i.g.) have a wide spectrum of specificities. Hyperimmune i.v.i.g. containing high titers of specific antibodies have demonstrated efficacy in clinical trials, notably against the respiratory syncytial virus. Monoclonal antibodies have the advantage to be homogenous and specific for one selected epitope and several studies have demonstrated their efficacy to neutralize several infectious agents. Moreover, antibodies can be administered topically and are effective at lower doses than those needed for systemic administration. The mechanism of action could be the agglutination of bacteria or viruses at the epithelial surfaces of the respiratory tract inhibiting the early steps of the infectious process. Thanks to new technologies of humanized monoclonal antibodies, immunotherapy offers real promising perspectives for prophylactic and therapeutic therapies against a variety of current or emerging infectious diseases.