Upper and Lower Respiratory Tract Correlates of Protection Against RSV Following Vaccination of Non-Human Primates

Abstract

Respiratory syncytial virus (RSV) infection is a major cause of severe respiratory illness in both young infants and the elderly. While antibodies represent key correlates of protection, the antibody mechanisms remain poorly understood. Emerging data point to additional humoral Fc-mediated mechanisms of action beyond neutralization. Therefore, to map the humoral correlates of immunity against RSV, antibody responses were profiled in a highly controlled non-human primate challenge model. Six different vaccine platforms were tested in African Green Monkeys, which post-challenge, yielded distinct antibody profiles and viral loads in both upper and lower respiratory tracts. Machine learning was then used to determine antibody features associated with protection. Upper respiratory control involved virus specific IgA levels, neutralization, and complement whereas lower respiratory control involved Fc-mediated mechanisms. These data highlight a collaborative Fab and Fc protective signature, induced selectively by distinct vaccine platforms, and provides mechanistic insights for the rational development of vaccines.