Immunotherapy and immunoprophylaxis of respiratory syncytial virus infections

Abstract

Respiratory syncytial virus continues to be a major cause of pulmonary disease in infants and young children, and an occasional cause of serious pneumonia in the elderly and immunocompromised patients. This review summarizes the evidence that immunotherapeutic and immunoprophylactic strategies for respiratory syncytial virus infection may succeed in controlling this disease. Recent data from studies in experimental animals and humans suggest that respiratory syncytial virus pneumonitis can be treated by neutralizing antibody administration; expanded clinical trials of this strategy are in progress. Other studies show that respiratory syncytial virus pneumonitis can be prevented by passive immunoprophylaxis with neutralizing antibodies, including high-titre human immunoglobulin, chimeric humanized murine monoclonal antibodies, and recombinant Fab fragments. Preliminary data also suggest that active immunization will be effective, although it remains unclear whether it will be safe or effective in children less than 18 months of age.