Abstract
Respiratory syncytial virus (RSV) represents the main cause of acute respiratory tract infections in children worldwide and is the leading cause of hospitalization in infants. RSV infection is a self-limiting condition and does not require antibiotics. However hospitalized infants with clinical bronchiolitis often receive antibiotics for fear of bacteria coinfection, especially when chest radiography is performed due to similar radiographic appearance of infiltrate and atelectasis. This may lead to unnecessary antibiotic prescription, additional cost, and increased risk of development of resistance. Despite the considerable burden of RSV bronchiolitis, to date, only symptomatic treatment is available, and there are no commercially available vaccines. The only licensed passive immunoprophylaxis is palivizumab. The high cost of this monoclonal antibody (mAb) has led to limiting its prescription only for high-risk children: infants with chronic lung disease, congenital heart disease, neuromuscular disorders, immunodeficiencies, and extreme preterm birth. Nevertheless, it has been shown that the majority of hospitalized RSV-infected children do not fully meet the criteria for immune prophylaxis. While waiting for an effective vaccine, passive immune prophylaxis in children is mandatory. There are a growing number of RSV passive immunization candidates under development intended for RSV prevention in all infants. In this review, we describe the state-of-the-art of palivizumab’s usage and summarize the clinical and preclinical trials regarding the development of mAbs with a better cost-effectiveness ratio.
Highlights
We retrace the history of the passive Respiratory syncytial virus (RSV) prophylaxis, describe the state-of-the-art of the use of palivizumab, and summarize the clinical and preclinical trials regarding the development of new monoclonal antibody (mAb)
After its promising results in neutralizing RSV in cotton rats and healthy volunteers, SB209763/RSHZ19 showed lower clinical efficacy when it was directly compared to another IgG1 mAb, MEDI-493 in infants at risk for severe RSV
Since the documented risk of adverse events associated with RSV-IGIV, mAbs have been the milestones of passive RSV prophylaxis
Summary
Respiratory syncytial virus (RSV) is a non-segmented, single-stranded, negative-sense. RSV encodes 11 proteins, of which the proteins of the lipid envelope are involved in the mechanisms of viral attachment and, subsequently, in the infection and development of the respiratory disease (Figure 1). Histopathological findings include necrosis of respiratory tract cells, proliferation of the bronchiolar epithelium, and. 2021, 22, 3703 necrosis of respiratory tract cells, proliferation of the bronchiolar epithelium, and infiltration of monocytes, T-cells, and neutrophils between vessels and small airways [4]. F proteins are mostly involved in the pathogenesis of thevessels infection theairways. F protein responsible entry of mediates the virus the intoadhesion the cells to and in the insertion of viral. Innate immunity is firstly involved against virus in inflammation and subsequent destruction.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
