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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Correlates of Protection Against Respiratory Syncytial Virus Infection in Infancy
Bahaa Abu-Raya1,2, Frederic Reicherz3,4, Pascal M Lavoie3,4
1BC Children's Hospital Research Institute, Vancouver, Canada. baburaya@bcchr.ubc.ca.
Insights
Maternal immunization against respiratory syncytial virus (RSV) can protect infants. However, studies on immune correlates of protection (COP) in newborns show inconsistent results, necessitating standardized methods for future vaccine development.
Area of Science:
- Immunology
- Vaccinology
- Pediatrics
Background:
- Respiratory syncytial virus (RSV) poses a significant health risk, causing high morbidity and mortality in young infants.
- Maternal immunization during pregnancy is a promising strategy to protect infants from severe RSV disease.
- Identifying correlates of protection (COP) is crucial for developing effective maternal RSV vaccines and designing clinical trials.
Purpose of the Study:
- To review existing literature on immunological correlates of protection (COP) between infant immune responses at birth and clinical RSV outcomes.
- To identify inconsistencies and challenges in current research on maternal RSV vaccine COP.
- To provide recommendations for future research directions in this field.
Main Methods:
- Literature review of studies investigating immunological measures at birth and their correlation with infant RSV disease or hospitalization.
- Analysis of findings from less than a dozen relevant studies.
- Identification of factors contributing to inconsistent results across studies.
Main Results:
- Existing studies investigating immunological COP for RSV disease in infants have yielded inconsistent findings.
- Variability in study designs, inclusion/exclusion criteria, antibody neutralization assays, and outcome measures likely contribute to these inconsistencies.
- Limited research exists, with fewer than a dozen studies reporting on immunological COP for RSV.
Conclusions:
- Standardization of immunological measures and outcome assessments is essential for future RSV vaccine research.
- Expanding the scope of functional RSV immune measures beyond antibody neutralization is recommended.
- Future studies should carefully consider infant age and the seasonality of RSV infection to improve the reliability of COP findings.
Abstract:
The highest morbidity and mortality from respiratory syncytial virus (RSV) infection occurs in young infants. Immunization of expectant mothers during pregnancy has the potential to substantially reduce the burden of RSV disease in a majority of infants. Correlates of protection (COP) are important in guiding the development of maternal RSV vaccines and the design of maternal RSV vaccine trials, as immune response to candidate vaccines should mirror protective RSV immunity at birth. Here, we review the literature reporting correlations between RSV immune measures at birth and clinical RSV outcomes during infancy. Less than a dozen studies have investigated immunological COP with RSV disease or related hospitalization, yielding inconsistent findings overall. The differences in findings between studies could be due to differences in inclusion/exclusion criteria (e.g., the inclusion of older infants who may benefit less from maternal antibodies or infants followed during inter-seasonal periods where RSV is absent), differences in semi-quantitative RSV antibody neutralization assays, or differences in RSV outcome measures such as the sensititivity/specificity of diagnostic tests. Future research in this field should seek to standardize RSV immunological measures and outcomes, expand the breadth of functional RSV measures beyond antibody neutralization, and consider infants' age and seasonality of RSV infection.
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