Magnapera Alessia, Riccio Anna, Curcio Antonio, Tramontozzi Caterina, Piermatteo Lorenzo, D'Anna Stefano, Alcaro Stefano, Alteri Claudia, La Frazia Simone, Artese Anna, Salpini Romina, Svicher Valentina
Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy.
Department of Health Science, Magna Graecia University, 88100 Catanzaro, Italy.
Viruses. 2025 May 30;17(6):793. doi: 10.3390/v17060793.
Respiratory syncytial virus (RSV) is a leading cause of severe respiratory illness in infants, young children, as well as elderly and immunocompromised patients worldwide. RSV is classified into two major subtypes, RSV-A and RSV-B, and remains the most frequently detected pathogen in infants hospitalized with acute respiratory infections. Recent advances have brought both passive and active immunization strategies, including FDA-approved vaccines for older adults and pregnant women and new monoclonal antibodies (mAbs) for infant protection. Although significant progress has been made, the need remains for improved antiviral treatments, particularly for vulnerable infants and immunocompromised patients. Recent studies have identified multiple RSV mutations that confer resistance to current treatments. These mutations, detected in both in vitro studies and clinical isolates, often complicate therapeutic outcomes, underscoring the need for updated and effective management strategies. In this context, evaluating protein flexibility through tools like DisoMine provides insight into how specific mutations impact structural dynamics at binding sites, thus affecting ligand affinity. This review aims to synthesize these aspects, offering a comprehensive insight into ongoing efforts to counteract RSV and address the evolving challenge of drug resistance.
呼吸道合胞病毒（RSV）是全球范围内导致婴儿、幼儿以及老年人和免疫功能低下患者发生严重呼吸道疾病的主要原因。RSV分为两种主要亚型，即RSV-A和RSV-B，并且仍然是因急性呼吸道感染住院的婴儿中最常检测到的病原体。最近的进展带来了被动和主动免疫策略，包括美国食品药品监督管理局（FDA）批准的针对老年人和孕妇的疫苗以及用于保护婴儿的新型单克隆抗体（mAb）。尽管已经取得了重大进展，但仍需要改进抗病毒治疗方法，特别是针对易受感染的婴儿和免疫功能低下的患者。最近的研究已经确定了多种对当前治疗产生耐药性的RSV突变。这些在体外研究和临床分离株中均检测到的突变，常常使治疗结果复杂化，凸显了对更新的有效管理策略的需求。在这种背景下，通过DisoMine等工具评估蛋白质灵活性，能够深入了解特定突变如何影响结合位点的结构动力学，从而影响配体亲和力。本综述旨在综合这些方面，全面深入地了解为对抗RSV以及应对不断演变的耐药性挑战所做的持续努力。
