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Loe MWC, Soenong H, Lee E, Li-Kim-Moy J, Williams PC, Yeo KT. Nirsevimab: Alleviating the burden of RSV morbidity in young children. J Paediatr Child Health 2024. [PMID: 39150043 DOI: 10.1111/jpc.16643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 08/17/2024]
Abstract
Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infections (LRTIs) and hospital admissions in early childhood. Recent advancements in novel preventive therapies, including extended half-life monoclonal antibodies and antenatal vaccination, have afforded new opportunities to significantly reduce the burden of this infection. Nirsevimab is a novel monoclonal antibody that provides sustained protection against RSV for at least 5 months among newborns and young children. It has received regulatory approval in numerous countries and is being implemented across various settings. Two pivotal Phase 3 trials (MELODY, HARMONIE) demonstrated significant reductions in RSV-associated LRTI hospitalisations following nirsevimab administration, with treatment efficacy of 62.1% and 83.2%. Emerging real-world data from early adopters of nirsevimab corroborates these findings. Studies from Spain, Luxembourg, France and the USA report effectiveness rates between 82% and 90% in preventing RSV-associated hospitalisations among infants entering their first RSV season. Current implementation strategies for nirsevimab have primarily focused on seasonal administration for all infants, aligned to local RSV seasons, and often include catch-up doses for those born before the season begins. Available cost-effectiveness analyses indicate that while nirsevimab offers significant potential public health benefits, its adoption must carefully consider economic factors such as treatment costs, implementation strategies tailored to local viral epidemiology, and logistics for vaccine delivery. Overall, nirsevimab presents a promising opportunity to alleviate the burden of severe RSV infections in young children. However, ongoing surveillance and refinements in implementation strategies are crucial to optimise its impact and ensure sustainability across diverse health-care settings.
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Affiliation(s)
- Marcus Wing Choy Loe
- Duke-NUS Medicine School, Singapore
- Department of Neonatology, KK Women's & Children's Hospital, Singapore
| | - Helen Soenong
- School of Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia
| | - Evelyn Lee
- Centre for Economic Impacts of Genomic Medicine, Macquarie University, Sydney, New South Wales, Australia
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
| | - Jean Li-Kim-Moy
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Phoebe Cm Williams
- School of Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Infectious Diseases, Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Kee Thai Yeo
- Duke-NUS Medicine School, Singapore
- Department of Neonatology, KK Women's & Children's Hospital, Singapore
- School of Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia
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Lin ZL, Xu X, Yang JJ, Lu LQ, Huang H, Hua XZ, Lu LD. Efficacy of budesonide/formoterol inhalation powder in treating viral pneumonia in children. World J Clin Cases 2024; 12:4469-4475. [PMID: 39070822 PMCID: PMC11235498 DOI: 10.12998/wjcc.v12.i21.4469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/09/2024] [Accepted: 05/21/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Respiratory viruses are increasingly detected in children with community-acquired pneumonia. Further strategies to limit antibiotic use in children with viral pneumonia are warranted. AIM To explore clinical efficacy of budesonide/formoterol inhalation powder for viral pneumonia in children and its impact on cellular immunity and inflammatory factor production. METHODS A total of 60 children with viral pneumonia were recruited: 30 receiving budesonide/formoterol inhalation powder and 30 conventional symptomatic treatment. Outcome measures included peripheral blood levels of inflammatory cytokines, CD4+, CD8+, Th1, Th2, Th17 and Treg, clinical efficacy, and incidence of adverse reactions. RESULTS Compared with the control group, the observation group showed a significant reduction in interleukin-6 and high-sensitivity C-reactive protein levels after treatment. Compared with the control group, the observation group showed a significant increase in CD4+/CD8+ and Th1/Th2 levels, and a decrease in Th17/Treg levels after treatment. The total effective rates in the observation group and the control group were 93.75% and 85.00%, respectively, which was a significant difference (P = 0.003). CONCLUSION Budesonide/formoterol inhalation powder significantly improved therapeutic efficacy for viral pneumonia in children. The mechanism of action may be related to downregulation of the inflammatory response and improved cellular immune function.
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Affiliation(s)
- Zi-Liang Lin
- Department of Pediatrics, Cangnan Hospital Affiliated to Wenzhou Medical University, Wenzhou 325800, Zhejiang Province, China
| | - Xu Xu
- Department of Pediatrics, Cangnan Hospital Affiliated to Wenzhou Medical University, Wenzhou 325800, Zhejiang Province, China
| | - Jiao-Jiao Yang
- Department of Pediatrics, Cangnan Hospital Affiliated to Wenzhou Medical University, Wenzhou 325800, Zhejiang Province, China
| | - Li-Qiang Lu
- Department of Pediatrics, Cangnan Hospital Affiliated to Wenzhou Medical University, Wenzhou 325800, Zhejiang Province, China
| | - Heng Huang
- Department of Pediatrics, Cangnan Hospital Affiliated to Wenzhou Medical University, Wenzhou 325800, Zhejiang Province, China
| | - Xiao-Zhen Hua
- Department of Pediatrics, Cangnan Hospital Affiliated to Wenzhou Medical University, Wenzhou 325800, Zhejiang Province, China
| | - Li-Dang Lu
- Department of Pediatrics, Cangnan Hospital Affiliated to Wenzhou Medical University, Wenzhou 325800, Zhejiang Province, China
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Ramirez KA, Mond J, Papenburg J, Boivin G, Gilbert BE, Falsey AR, Bagga B, DeVincenzo JP. In-vivo and human evidence for potential efficacy of therapeutic polyclonal RSV neutralizing antibodies for palivizumab-resistant RSV infections. Virology 2023; 586:115-121. [PMID: 37542818 DOI: 10.1016/j.virol.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Monoclonal antibody (palivizumab), intravenous immune globulin (IGIV), or respiratory syncytial virus (RSV)-polyclonal-hyperimmune-globulin (RSV-IG as Respigam®, RI-001, RI-002) are used with ribavirin in RSV-infected immunocompromised patients, with debated efficacy. Palivizumab-resistance (PR) can arise during treatment of persistent infections in this population. RSV-IG may confer benefit in PR-RSV infection. METHODS RSV-IG [RI-001] was provided for an immunocompromised infant with RSV-pneumonitis refractory to ribavirin and palivizumab. RSV-neutralizing antibody, respiratory RSV load (qPCR), and F-gene-sequence-detection of PR was determined. Prophylactic RSV-IG [RI-002] or palivizumab was administered in a cotton-rat model infected with wild-type and PR-RSV. Lung RSV load and neutralizing antibody were measured. RESULTS As protective RI-001-neutralizing antibody titers waned in the infant, a subpopulation of PR-escape mutants were detected with a fatal RSV-burden in the lungs. In PR-RSV-infected cotton rats, prophylactic RI-002 reduced RSV-load in the lungs (2.45 vs 0.28 log10 PFU/g lung-tissue reduction, respectively, p < 0.05) and provided protective RSV-neutralizing antibody. CONCLUSIONS RSV-IG and ribavirin use in immunocompromised patients requires further study.
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Affiliation(s)
- Kacy A Ramirez
- LeBonheur Children's Hospital, Memphis, TN, United States; Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States; St Jude Children's Research Hospital, Memphis, TN, United States.
| | - James Mond
- ADMA Biologics, Boca Raton FL, United States
| | - Jesse Papenburg
- McGill University Health Centre and Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Guy Boivin
- Research Center in Infectious Diseases and Centre Hospitalier Universitaire (CHU) of Quebec and Laval University, Quebec City, Quebec, Canada
| | | | - Ann R Falsey
- University of Rochester School of Medicine, Rochester, NY, United States
| | - Bindiya Bagga
- LeBonheur Children's Hospital, Memphis, TN, United States; Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States
| | - John P DeVincenzo
- LeBonheur Children's Hospital, Memphis, TN, United States; Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States; Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, Memphis, United States.
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Raguž MJ, Božić T, Nikše T. Is immunization with palivizumab really effective in high-risk children? JOURNAL OF MOTHER AND CHILD 2022; 26:87-92. [PMID: 36811495 PMCID: PMC10032334 DOI: 10.34763/jmotherandchild.20222601.d-22-00049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 01/12/2022] [Indexed: 02/24/2023]
Abstract
AIM The aim of this research is to determine the specific characteristics of the immunized children during a 15-year period and the readmissions to hospital due to potential infections of the respiratory tract. MATERIAL AND METHODS This retrospective cohort study was conducted in the period from October 2008 to March 2022. The test group consists of 222 infants who met the strict criteria for immunization. RESULTS The study observed 222 infants who were immunized with palivizumab during the 14-year period. 124 (55.9%) infants were preterm (< 32 weeks) and 69 (31.1%) were infants with congenital heart defects, whereas 29 (13.1%) exhibited other individual risk factors. 38 (17.1%) were re-admitted to the pulmonary ward. Upon re-admission, a quick test to diagnose for RSV infections was conducted and only one infant tested positive. RESULTS The conclusion of our 14-year study is that palivizumab prophylaxis has truly proven itself effective for infants at risk in our region during the research time period. Over the years, the immunization season has not changed and the number of doses hasremained the same, as have the indications for immunization. What has changed, however, is an increase in the number of immunized infants without a significant increase in the number of re-admissions to hospital on account of respiratory disorders.
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Affiliation(s)
- Marjana Jerković Raguž
- Department of Neonatology. Clinic for Children's Diseases, University Clinical Hospital Mostar. Bosnia and Herzegovina Serbia
| | - Tomica Božić
- Department of Cardiology. Clinic for Children's Diseases, University Clinical Hospital Mostar. Bosnia and Herzegovina Serbia
| | - Tamara Nikše
- Department of Pulmology. Clinic for Children's Diseases, University Clinical Hospital Mostar. Bosnia and Herzegovina Serbia
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Simões EAF, Forleo-Neto E, Geba GP, Kamal M, Yang F, Cicirello H, Houghton MR, Rideman R, Zhao Q, Benvin SL, Hawes A, Fuller ED, Wloga E, Pizarro JMN, Munoz FM, Rush SA, McLellan JS, Lipsich L, Stahl N, Yancopoulos GD, Weinreich DM, Kyratsous CA, Sivapalasingam S. Suptavumab for the Prevention of Medically Attended Respiratory Syncytial Virus Infection in Preterm Infants. Clin Infect Dis 2021; 73:e4400-e4408. [PMID: 32897368 PMCID: PMC8653633 DOI: 10.1093/cid/ciaa951] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/08/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major cause of childhood medically attended respiratory infection (MARI). METHODS We conducted a randomized, double-blind, placebo-controlled phase 3 trial in 1154 preterm infants of 1 or 2 doses of suptavumab, a human monoclonal antibody that can bind and block a conserved epitope on RSV A and B subtypes, for the prevention of RSV MARI. The primary endpoint was proportion of subjects with RSV-confirmed hospitalizations or outpatient lower respiratory tract infection (LRTI). RESULTS There were no significant differences between primary endpoint rates (8.1%, placebo; 7.7%, 1-dose; 9.3%, 2-dose). Suptavumab prevented RSV A infections (relative risks, .38; 95% confidence interval [CI], .14-1.05 in the 1-dose group and .39 [95% CI, .14-1.07] in the 2-dose group; nominal significance of combined suptavumab group vs placebo; P = .0499), while increasing the rate of RSV B infections (relative risk 1.36 [95% CI, .73-2.56] in the 1-dose group and 1.69 [95% CI, .92-3.08] in the 2-dose group; nominal significance of combined suptavumab group vs placebo; P = .12). Sequenced RSV isolates demonstrated no suptavumab epitope changes in RSV A isolates, while all RSV B isolates had 2-amino acid substitution in the suptavumab epitope that led to loss of neutralization activity. Treatment emergent adverse events were balanced across treatment groups. CONCLUSIONS Suptavumab did not reduce overall RSV hospitalizations or outpatient LRTI because of a newly circulating mutant strain of RSV B. Genetic variation in circulating RSV strains will continue to challenge prevention efforts. CLINICAL TRIALS REGISTRATION NCT02325791.
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Affiliation(s)
- Eric A F Simões
- Department of Pediatrics, University of Colorado School of Medicine, and The Children’s Hospital Colorado, Aurora, Colorado, USA
| | | | - Gregory P Geba
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Mohamed Kamal
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Feng Yang
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | | | | | - Ronald Rideman
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Qiong Zhao
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Sarah L Benvin
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Alicia Hawes
- Regeneron Genetics Center, Tarrytown, New York, USA
| | | | - Elzbieta Wloga
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Jose M Novoa Pizarro
- Facultad Medicina Universidad del Desarrollo/CAS, Hospital Padre Hurtado, Santiago, Chile
| | - Flor M Munoz
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Scott A Rush
- Department of Molecular Biosciences, University of Texas at Austin, Austin, Texas, USA
| | - Jason S McLellan
- Department of Molecular Biosciences, University of Texas at Austin, Austin, Texas, USA
| | - Leah Lipsich
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
| | - Neil Stahl
- Regeneron Pharmaceuticals, Inc, Tarrytown, New York, USA
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Viguria N, Navascués A, Juanbeltz R, Echeverría A, Ezpeleta C, Castilla J. Effectiveness of palivizumab in preventing respiratory syncytial virus infection in high-risk children. Hum Vaccin Immunother 2021; 17:1867-1872. [PMID: 33502928 PMCID: PMC8115746 DOI: 10.1080/21645515.2020.1843336] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/24/2020] [Indexed: 12/30/2022] Open
Abstract
To date, there is no consensus regarding palivizumab prophylaxis for respiratory syncytial virus infection. The purpose of this study is to assess the effectiveness of palivizumab prophylaxis to prevent respiratory syncytial virus-related infection consultations and hospitalizations in high-risk children <2 y. We studied children <2 y of age with risk factors who had indication of palivizumab prophylaxis over eight epidemic seasons (2011-2012 to 2018-2019) in Navarra, Spain. Children positives for respiratory syncytial virus by reverse-transcription polymerase chain reaction were compared to negative testers. Palivizumab was indicated in 1,214 children <2 y of age with risk factors during 2011-2012 to 2018-2019 seasons. A total of 142 high-risk children tested for respiratory syncytial virus were included in the study. From the 35 respiratory syncytial virus-positive confirmed cases, 20 (57%) had received palivizumab versus 82 (77%) from the 107 negative controls. The effectiveness of prophylactic palivizumab was 70% (95% CI, 19%-90%) in preventing confirmed clinical infection and 82% (95% CI, 29%-96%) in preventing hospitalized cases. Our results show that palivizumab is notably effective for preventing laboratory-confirmed cases of respiratory syncytial virus and hospitalization in high-risk children <2 y of age. For children who have received palivizumab, the risk of getting sick remains high; thus, other preventive measures are necessary.
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Affiliation(s)
- Natividad Viguria
- Department of Paediatrics, Complejo Hospitalario de Navarra – IdiSNA, Pamplona, Spain
| | - Ana Navascués
- Department of Clinical Microbiology, Complejo Hospitalario de Navarra – IdiSNA, Pamplona, Spain
| | - Regina Juanbeltz
- Department of Hospital Pharmacy, Complejo Hospitalario de Navarra – IdiSNA, Pamplona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Carmen Ezpeleta
- Department of Clinical Microbiology, Complejo Hospitalario de Navarra – IdiSNA, Pamplona, Spain
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Instituto de Salud Pública de Navarra-IdiSNA, Pamplona, Spain
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Global Molecular Epidemiology of Respiratory Syncytial Virus from the 2017-2018 INFORM-RSV Study. J Clin Microbiol 2020; 59:JCM.01828-20. [PMID: 33087438 PMCID: PMC7771447 DOI: 10.1128/jcm.01828-20] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/15/2020] [Indexed: 02/07/2023] Open
Abstract
Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection among infants and young children, resulting in annual epidemics worldwide. INFORM-RSV is a multiyear clinical study designed to describe the global molecular epidemiology of RSV in children under 5 years of age by monitoring temporal and geographical evolution of current circulating RSV strains, F protein antigenic sites, and their relationships with clinical features of RSV disease. During the pilot season (2017–2018), 410 RSV G-F gene sequences were obtained from 476 RSV-positive nasal samples collected from 8 countries (United Kingdom, Spain, The Netherlands, Finland, Japan, Brazil, South Africa, and Australia). Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection among infants and young children, resulting in annual epidemics worldwide. INFORM-RSV is a multiyear clinical study designed to describe the global molecular epidemiology of RSV in children under 5 years of age by monitoring temporal and geographical evolution of current circulating RSV strains, F protein antigenic sites, and their relationships with clinical features of RSV disease. During the pilot season (2017–2018), 410 RSV G-F gene sequences were obtained from 476 RSV-positive nasal samples collected from 8 countries (United Kingdom, Spain, The Netherlands, Finland, Japan, Brazil, South Africa, and Australia). RSV B (all BA9 genotype) predominated over RSV A (all ON1 genotype) globally (69.0% versus 31.0%) and in all countries except South Africa. Geographic clustering patterns highlighted wide transmission and continued evolution with viral spread. Most RSV strains were from infants of <1 year of age (81.2%), males (56.3%), and patients hospitalized for >24 h (70.5%), with no differences in subtype distribution. Compared to 2013 reference sequences, variations at F protein antigenic sites were observed for both RSV A and B strains, with high-frequency polymorphisms at antigenic site Ø (I206M/Q209R) and site V (L172Q/S173L/K191R) in RSV B strains. The INFORM-RSV 2017–2018 pilot season establishes an important molecular baseline of RSV strain distribution and sequence variability with which to track the emergence of new strains and provide an early warning system of neutralization escape variants that may impact transmission or the effectiveness of vaccines and MAbs under development.
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Choi SH, Park KS, Kim YJ. Analysis of respiratory syncytial virus fusion protein from clinical isolates of Korean children in palivizumab era, 2009–2015. J Infect Chemother 2019; 25:514-519. [DOI: 10.1016/j.jiac.2019.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 02/07/2019] [Accepted: 02/20/2019] [Indexed: 02/07/2023]
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Krivitskaya VZ, Sintsova KS, Petrova ER, Sverlova MV, Sorokin EV, Tsareva TR, Komissarov AB, Fadeev AV, Pisareva MM, Buzitskaya ZV, Afanaseva VS, Sukhovetskaya VF, Sominina AA. GENETIC AND ANTIGENIC CHARACTERISTICS OF RESPIRATORY SYNCYTIAL VIRUS STRAINS ISOLATED IN ST. PETERSBURG IN 2013-2016. Vopr Virusol 2017; 62:273-282. [PMID: 36494959 DOI: 10.18821/0507-4088-2017-62-6-273-282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Indexed: 12/13/2022]
Abstract
Antigenic and genetic characteristics of Russian RSV isolates are presented for the first time. Of the 69 strains isolated in St. Petersburg, 93% belonged to the RSV-A antigenic group. The antigenic variations in the F-protein RSV were analyzed using a panel from 6 monoclonal antibodies by the method of micro-cultural ELISA. Depending on the decrease in the effectiveness of interaction with monoclonal antibodies (relative to the reference strain Long), RSV-A isolates were divided into 4 antigenic subgroups. The results of 24 isolates sequencing showed that more than 60% of them had substitutions in significant F-protein sites compared to the ON67-1210A reference strain of the current RSV genotype ON1/GA2. The most variable were the signal peptide and antigenic site II. When comparing the results of ELISA and sequencing, it was not possible to identify any specific key substitutions in the amino acid sequence of the F-protein that affect the interaction of the virus with antibodies. The nucleotide sequence of the F-gene from 19 of the 24 characterized isolates was close to that of ON67-1210A reference virus and was significantly different from RSV-A Long and A2 viruses. A separate group consisted of 5 strains, in which the F-protein structure was approximated to RSV Long.
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Tang JW, Lam TT, Zaraket H, Lipkin WI, Drews SJ, Hatchette TF, Heraud JM, Koopmans MP. Global epidemiology of non-influenza RNA respiratory viruses: data gaps and a growing need for surveillance. THE LANCET. INFECTIOUS DISEASES 2017; 17:e320-e326. [PMID: 28457597 PMCID: PMC7164797 DOI: 10.1016/s1473-3099(17)30238-4] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 01/06/2017] [Accepted: 02/07/2017] [Indexed: 01/13/2023]
Abstract
Together with influenza, the non-influenza RNA respiratory viruses (NIRVs), which include respiratory syncytial virus, parainfluenza viruses, coronavirus, rhinovirus, and human metapneumovirus, represent a considerable global health burden, as recognised by WHO's Battle against Respiratory Viruses initiative. By contrast with influenza viruses, little is known about the contemporaneous global diversity of these viruses, and the relevance of such for development of pharmaceutical interventions. Although far less advanced than for influenza, antiviral drugs and vaccines are in different stages of development for several of these viruses, but no interventions have been licensed. This scarcity of global genetic data represents a substantial knowledge gap and impediment to the eventual licensing of new antiviral drugs and vaccines for NIRVs. Enhanced genetic surveillance will assist and boost research and development into new antiviral drugs and vaccines for these viruses. Additionally, understanding the global diversity of respiratory viruses is also part of emerging disease preparedness, because non-human coronaviruses and paramyxoviruses have been listed as priority concerns in a recent WHO research and development blueprint initiative for emerging infectious diseases. In this Personal View, we explain further the rationale for expanding the genetic database of NIRVs and emphasise the need for greater investment in this area of research.
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Affiliation(s)
- Julian W Tang
- Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Leicester, UK; Department of Infection, Inflammation and Immunity, University of Leicester, Leicester, UK.
| | - Tommy T Lam
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Hassan Zaraket
- Department of Experimental Pathology, Immunology, and Microbiology, American University of Beirut, Beirut, Lebanon
| | - W Ian Lipkin
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Steven J Drews
- Alberta Provincial Laboratory for Public Health, University of Alberta, Edmonton, AB, Canada
| | - Todd F Hatchette
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
| | | | - Marion P Koopmans
- Department of Viroscience, Erasmus Medical Centre, Rotterdam, Netherlands
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Durigon EL, Botosso VF, de Oliveira DBL. Human Respiratory Syncytial Virus: Biology, Epidemiology, and Control. HUMAN VIROLOGY IN LATIN AMERICA 2017. [PMCID: PMC7121549 DOI: 10.1007/978-3-319-54567-7_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Moschovi M, Adamaki M, Vlahopoulos SA. Progress in Treatment of Viral Infections in Children with Acute Lymphoblastic Leukemia. Oncol Rev 2016; 10:300. [PMID: 27471584 PMCID: PMC4943096 DOI: 10.4081/oncol.2016.300] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 06/29/2016] [Indexed: 02/08/2023] Open
Abstract
In children, the most commonly encountered type of leukemia is acute lymphoblastic leukemia (ALL). An important source of morbidity and mortality in ALL are viral infections. Even though allogeneic transplantations, which are often applied also in ALL, carry a recognized risk for viral infections, there are multiple factors that make ALL patients susceptible to viral infections. The presence of those factors has an influence in the type and severity of infections. Currently available treatment options do not guarantee a positive outcome for every case of viral infection in ALL, without significant side effects. Side effects can have very serious consequences for the ALL patients, which include nephrotoxicity. For this reason a number of strategies for personalized intervention have been already clinically tested, and experimental approaches are being developed. Adoptive immunotherapy, which entails administration of ex vivo grown immune cells to a patient, is a promising approach in general, and for transplant recipients in particular. The ex vivo grown cells are aimed to strengthen the immune response to the virus that has been identified in the patients' blood and tissue samples. Even though many patients with weakened immune system can benefit from progress in novel approaches, a viral infection still poses a very significant risk for many patients. Therefore, preventive measures and supportive care are very important for ALL patients.
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Affiliation(s)
- Maria Moschovi
- Hematology-Oncology Unit, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital , Athens, Greece
| | - Maria Adamaki
- Hematology-Oncology Unit, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital , Athens, Greece
| | - Spiros A Vlahopoulos
- Hematology-Oncology Unit, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital , Athens, Greece
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Jorquera PA, Anderson L, Tripp RA. Understanding respiratory syncytial virus (RSV) vaccine development and aspects of disease pathogenesis. Expert Rev Vaccines 2015; 15:173-87. [PMID: 26641318 DOI: 10.1586/14760584.2016.1115353] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Respiratory syncytial virus (RSV) is the most important cause of lower respiratory tract infections causing bronchiolitis and some mortality in young children and the elderly. Despite decades of research there is no licensed RSV vaccine. Although significant advances have been made in understanding the immune factors responsible for inducing vaccine-enhanced disease in animal models, less information is available for humans. In this review, we discuss the different types of RSV vaccines and their target population, the need for establishing immune correlates for vaccine efficacy, and how the use of different animal models can help predict vaccine efficacy and clinical outcomes in humans.
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Affiliation(s)
- Patricia A Jorquera
- a Department of Infectious Disease, College of Veterinary Medicine , University of Georgia , Athens , GA , Georgia
| | - Lydia Anderson
- a Department of Infectious Disease, College of Veterinary Medicine , University of Georgia , Athens , GA , Georgia
| | - Ralph A Tripp
- a Department of Infectious Disease, College of Veterinary Medicine , University of Georgia , Athens , GA , Georgia
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