Principi Nicola, Fainardi Valentina, Esposito Susanna
Università degli Studi di Milano, 20122 Milano, Italy.
Pediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy.
Viruses. 2025 Aug 20;17(8):1140. doi: 10.3390/v17081140.
Human metapneumovirus (HMPV) is a major cause of acute respiratory tract infections, particularly in infants, young children, older adults, and immunocompromised individuals. Since its discovery in 2001, the virus has been recognized for its significant clinical and socioeconomic impact. Despite extensive research, no licensed vaccines or antiviral therapies are currently available for HMPV. This review aims to synthesize current knowledge on HMPV prevention and treatment, and to highlight promising avenues for future interventions. Several monoclonal antibodies (mAbs) targeting conserved epitopes of the HMPV fusion (F) protein have shown strong neutralizing activity in vitro and in animal models, although none have reached clinical trials. Vaccine development, including subunit, live attenuated, vector-based, and mRNA platforms, is progressing, with some candidates showing promise in adult populations. However, data in children, especially seronegative infants, remain limited. Antiviral research has explored repurposed drugs such as ribavirin and probenecid, along with novel agents like fusion inhibitors and T-cell-based immunotherapies, though none are yet approved. The development of safe, effective interventions-especially multivalent approaches targeting multiple respiratory viruses-remains a high priority. Continued research is essential to bridge the gap between preclinical promise and clinical application and to reduce the burden of HMPV infection worldwide.
人偏肺病毒（HMPV）是急性呼吸道感染的主要病因，尤其在婴儿、幼儿、老年人和免疫功能低下者中。自2001年被发现以来，该病毒因其重大的临床和社会经济影响而受到认可。尽管进行了广泛研究，但目前尚无针对HMPV的许可疫苗或抗病毒疗法。本综述旨在综合当前关于HMPV预防和治疗的知识，并突出未来干预的有前景途径。几种靶向HMPV融合（F）蛋白保守表位的单克隆抗体（mAb）在体外和动物模型中显示出强大的中和活性，尽管尚无一种进入临床试验。疫苗研发，包括亚单位、减毒活、载体和mRNA平台，正在取得进展，一些候选疫苗在成年人群中显示出前景。然而，儿童尤其是血清阴性婴儿的数据仍然有限。抗病毒研究探索了如利巴韦林和丙磺舒等 repurposed药物，以及融合抑制剂和基于T细胞的免疫疗法等新型药物，尽管尚无一种获得批准。开发安全、有效的干预措施，尤其是针对多种呼吸道病毒的多价方法，仍然是高度优先事项。持续研究对于弥合临床前前景与临床应用之间的差距以及减轻全球HMPV感染负担至关重要。
