Progress in understanding and controlling respiratory syncytial virus: Still crazy after all these years

摘要: Abstract Human respiratory syncytial virus (RSV) is a ubiquitous pathogen that infects everyone worldwide early in life and leading cause of severe lower tract disease the pediatric population as well elderly profoundly immunosuppressed individuals. RSV an enveloped, nonsegmented negative-sense RNA classified Family Paramyxoviridae one its more complex members. Although replicative cycle follows general pattern , it encodes additional proteins. Two these (NS1 NS2) inhibit host type I III interferon (IFN) responses, among other functions, another gene two novel synthesis factors (M2-1 M2-2). The attachment (G) glycoprotein also exhibits unusual features, such high sequence variability, extensive glycosylation, cytokine mimicry, shed form helps evade neutralizing antibodies. notable for being able to efficiently infect life, with peak hospitalization at 2–3 months age. It ability reinfect symptomatically throughout without need significant antigenic change, although immunity from prior infection reduces disease. widely thought re-infection due or subvert immune response. Mechanisms viral pathogenesis remain controversial. historic, tragic vaccine failure involving formalin-inactivated preparation was evaluated 1960s poorly protective paradoxically primed enhanced development successful strategy passive immunoprophylaxis high-risk infants using RSV-neutralizing Vaccines new antiviral drugs are pre-clinical clinical development, but controlling remains formidable challenge.