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Updated: Sep 20, 2025
Generation, Amplification, and Titration of Recombinant Respiratory Syncytial Viruses
Published on: April 4, 2019
Respiratory syncytial virus: health burden, disease prevention, and treatment-recent progress and lessons learned
1Laboratory of Gene Technology, Department of Biosystems, KU Leuven, 3001 Leuven, Belgium.
Insights
New vaccines and antibody treatments now protect against Respiratory Syncytial Virus (RSV), a major cause of infant respiratory infections, after decades of research following an early vaccine failure.
Area of Science:
- Virology
- Immunology
- Vaccinology
Background:
- Respiratory Syncytial Virus (RSV) is a leading cause of severe lower respiratory tract infections in infants and a significant pathogen in older adults.
- Past prevention efforts, like a 1960s formalin-inactivated RSV vaccine, tragically led to enhanced disease, halting progress for decades.
- RSV poses a considerable global health burden, particularly in developing nations, necessitating effective prevention and treatment strategies.
Purpose of the Study:
- To review key research advancements in Respiratory Syncytial Virus (RSV) prevention and treatment.
- To highlight the development of new tools following the elucidation of the RSV F protein structure.
- To discuss the recent approval of RSV vaccines and ongoing antiviral drug development.
Main Methods:
- Review of historical and recent scientific literature on Respiratory Syncytial Virus (RSV).
- Focus on structure-based antigen engineering of the RSV F protein.
- Analysis of passive immunity approaches using monoclonal antibodies.
- Examination of antiviral drug development targeting viral processes.
Main Results:
- Recent breakthroughs have led to the approval of RSV vaccines in 2023 for maternal use and older adults.
- Passive immunization with monoclonal antibodies targeting the RSV F protein is now a key prevention tool.
- Antiviral therapies targeting RSV replication and fusion are under active development.
Conclusions:
- Decades of research, particularly structure-based antigen design, have overcome previous setbacks in RSV prevention.
- New vaccines and antibody therapies offer significant promise in reducing the global burden of RSV disease.
- Ongoing development of antiviral drugs is expected to further enhance control of RSV infections.
Abstract:
Respiratory syncytial virus (RSV), a negative-sense single-stranded RNA virus of the Pneumoviridae family, represents the most important pathogen of lower respiratory tract infections in young infants causing yearly epidemics. RSV is also an important respiratory viral pathogen for older subjects, which is second only to seasonal influenza virus infections. RSV represents a substantial public health burden with respect to morbidity and mortality, particularly in developing countries. Prevention and treatment options would therefore lessen the global disease burden. A formalin-inactivated RSV vaccine in the 1960s induced an enhanced disease upon exposure to natural RSV. After this tragical vaccine failure, it took nearly five decades of intensive research before prevention tools were approved by health authorities. The lead was taken by passive immunity approaches with injected monoclonal antibodies directed against the fusion protein F of RSV. The elucidation of the three-dimensional structure of the F protein revealed pre- and postfusion conformations. Subsequently, structure-based antigen engineering of the F protein paved the way for development of a prophylactic vaccine. In 2023, RSV vaccines were approved for maternal vaccination to protect young infants by placental transfer of antibodies and for vaccination in older subjects. Antiviral drugs that target the RSV fusion process, the RSV replicase, or the cytoplasmic viral factories are in development. Important research papers leading to these developments are reviewed here.
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