Rivera Claudia A, Gómez Roberto S, Díaz Rodrigo A, Céspedes Pablo F, Espinoza Janyra A, González Pablo A, Riedel Claudia A, Bueno Susan M, Kalergis Alexis M
a Millennium Institute of Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas , Pontificia Universidad Católica de Chile , Santiago , Chile.
b Millennium Institute on Immunology and Immunotherapy, Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas y Facultad de Medicina , Universidad Andrés Bello , Santiago , Chile.
Expert Opin Investig Drugs. 2015;24(12):1613-30. doi: 10.1517/13543784.2015.1099626. Epub 2015 Oct 12.
Human respiratory syncytial virus (hRSV) is the leading cause of acute lower respiratory tract infections worldwide in infants, as well as an important pathogen affecting the elderly and immunocompromised individuals. Despite more than a half a century of research, no licensed vaccines are available and only palivizumab has been approved to use in humans, mostly recommended or limited to high risk infants. Therefore, novel therapeutic and preventive drugs need to be developed to fight this major human pathogen.
This review discusses current therapeutic approaches in preclinical and clinical stages, aimed at controlling or preventing hRSV infection. These methods include passive immunization, experimental drugs, vaccine candidates and maternal immunization.
Based on the results of various immunization strategies and therapeutic approaches, it is likely that the most effective strategy against hRSV will be a prophylactic tool aimed at developing a strong antiviral T-cell response capable of both, promoting the generation of hRSV-specific high affinity antibodies and leading the protective immunity required to prevent the disease caused by this virus. Alternatively, if prophylactic strategies fail, antiviral drugs and novel passive immunity strategies could significantly contribute to reducing hospitalization rates in susceptible individuals.
人类呼吸道合胞病毒(hRSV)是全球范围内婴儿急性下呼吸道感染的主要病因,也是影响老年人和免疫功能低下个体的重要病原体。尽管经过了半个多世纪的研究,但目前尚无获批的疫苗,仅有帕利珠单抗被批准用于人类,主要推荐用于或限于高危婴儿。因此,需要研发新型治疗和预防药物来对抗这种主要的人类病原体。
本综述讨论了临床前和临床阶段旨在控制或预防hRSV感染的当前治疗方法。这些方法包括被动免疫、实验性药物、候选疫苗和母体免疫。
基于各种免疫策略和治疗方法的结果,对抗hRSV最有效的策略可能是一种预防性工具,旨在产生强大的抗病毒T细胞反应,既能促进产生hRSV特异性高亲和力抗体,又能引发预防该病毒所致疾病所需的保护性免疫。另外,如果预防策略失败,抗病毒药物和新型被动免疫策略可显著有助于降低易感个体的住院率。