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An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay
Published on: January 26, 2019
Ongoing developments in RSV prophylaxis: a clinician's analysis
Fariba Rezaee1, Debra T Linfield1, Terri J Harford1
1Pediatric Research Center and Pediatric Institute, Cleveland Clinic Children's, United States; Pathobiology Department, Lerner Research Institute, United States.
Insights
Respiratory syncytial virus (RSV) causes significant infant hospitalizations and adult illness. Current prophylaxis is limited, necessitating new vaccine development to overcome challenges and improve prevention.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- Respiratory syncytial virus (RSV) is a leading cause of infant hospitalization and a significant cause of morbidity in the elderly and immunocompromised.
- RSV infections can lead to long-term respiratory issues, including recurrent wheezing and asthma diagnoses.
- Despite decades of research, effective pharmacological treatments are lacking, with supportive care remaining the primary management strategy.
Purpose of the Study:
- To review current prophylactic options for RSV.
- To summarize the status of ongoing RSV vaccine clinical trials.
- To discuss various vaccine development strategies and identify major hurdles.
Main Methods:
- Literature review of existing RSV prophylactic measures.
- Analysis of current RSV vaccine development pipelines (preclinical to Phase III).
- Discussion of diverse vaccine strategies and developmental challenges.
Main Results:
- Palivizumab is the sole available RSV prophylaxis, with limited efficacy and high cost, restricting its use to high-risk infants.
- Multiple RSV vaccine candidates are in various stages of clinical development, employing diverse strategies.
- Past vaccine trials, like the formalin-inactivated RSV vaccine, highlight the complexities and risks involved in RSV vaccine development.
Conclusions:
- There is an urgent need for effective RSV vaccines due to the virus's widespread impact.
- Ongoing clinical trials represent promising avenues for RSV prevention.
- Overcoming developmental hurdles is crucial for achieving a safe and broadly effective RSV vaccine.
Abstract:
Respiratory syncytial virus (RSV) is the most common respiratory pathogen in infants and young children worldwide. Lower respiratory tract infection due to RSV is one of the most common causes of hospitalization for infants, especially those born premature or with chronic lung or heart disease. Furthermore, RSV infection is an important cause of morbidity in adults, particularly in the elderly and immunocompromised individuals. The acute phase of this infection is often followed by episodes of wheezing that recur for months or years and usually lead to a physician diagnosis of asthma. RSV was discovered more than 50 years ago, and despite extensive research to identify pharmacological therapies, the most effective management of this infection remains supportive care. The trial of a formalin-inactivated RSV vaccine in the 1960s resulted in priming the severe illness upon natural infection. Currently, Palivizumab is the only available option for RSV prophylaxis, and because of restricted clinical benefits and high costs, it has been limited to a group of high-risk infants. There are several ongoing trials in preclinical, Phase-I, Phase-II, or Phase-III clinical stages for RSV vaccine development based on various strategies. Here we review the existing available prophylactic options, the current stages of RSV vaccine clinical trials, different strategies, and major hurdles in the development of an effective RSV vaccine.
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