Respiratory Syncytial Virus Transplacental Antibody Transfer and Kinetics in Mother-Infant Pairs in Bangladesh

Chu, Helen Y.; Steinhoff, Mark C.; Magaret, Amalia; Zaman, Khalequ; Roy, Eliza; Langdon, Gretchen; Formica, Mary Anne; Walsh, Edward E.; Englund, Janet A.

doi:10.1093/infdis/jiu316

Cited by 150 publications

(139 citation statements)

References 37 publications

(51 reference statements)

Supporting

Mentioning

125

Contrasting

Unclassified

Order By: Relevance

“…Immunization of pregnant mothers has proven an effective approach against tetanus, pertussis and influenza [52]. Maternally-transferred RSV antibody has been found to be associated with a lower risk of infectionin infants when antibody titers are maintained above levels that are considered protective [53]. It is estimated that transfer of high concentrations of RSV-specific antibody from vaccinated mothers could extend protection up to six months of age.…”

Section: Introductionmentioning

confidence: 99%

Determinants of early life immune responses to RSV infection

Ruckwardt

Morabito

Graham

2016

Current Opinion in Virology

View full text Add to dashboard Cite

Respiratory syncytial virus causes significant morbidity and mortality in both developed and developing countries, and a vaccine that adequately protects from severe disease remains an important unmet need. RSV disease has an inordinate impact on the very young, and the physical and immunological immaturity of early life complicates vaccine design. Defining and targeting the functional capacities of early life immune responses and controlling responses during primary antigen exposure with selected vaccine delivery approaches will be important for protecting infants by active immunization. Alternatively, vaccination of older children and pregnant mothers may ameliorate disease burden indirectly until infants reach about six months of age,when they can generate more effective anti-RSV immune responses.

show abstract

Section: Introductionmentioning

confidence: 99%

Determinants of early life immune responses to RSV infection

Ruckwardt

Morabito

Graham

2016

Current Opinion in Virology

View full text Add to dashboard Cite

show abstract

“…Both monoclonal and polyclonal RSV antibodies delivered prophylactically to children clearly reduce the incidence of severe RSV disease and document the impact of antibody to RSV on disease prevention (2). In healthy populations, RSVspecific IgG transfer from pregnant women to infants is an active process resulting in higher antibody titers in the infant than in the mother (8). Several studies have demonstrated a reduced incidence of RSV disease during the first several months after birth that correlates with higher concentrations of RSV-specific maternal antibody (9)(10)(11)(12).…”

mentioning

confidence: 99%

Progress toward a Respiratory Syncytial Virus Vaccine

Neuzil

2016

Clin Vaccine Immunol

View full text Add to dashboard Cite

Respiratory syncytial virus is the leading cause of serious lower respiratory disease in young children throughout the world. An estimated 3.4 million children younger than 5 years of age are hospitalized each year with severe respiratory syncytial virus (RSV) lower respiratory tract infection, with the highest incidence in children younger than 6 months of age. Up to 200,000 deaths occur annually, with most deaths occurring in children younger than 1 year of age and in developing-country settings (1). Unfortunately, options for prevention and control are limited. No RSV vaccine is licensed anywhere in the world. While prophylactic treatment with RSV-specific neutralizing antibody is effective in reducing RSV morbidity in infants, its use is currently limited to select populations in high-resource settings because of its expense and because of challenges with its delivery (2). Prevention of severe RSV disease through active immunization of infants would be optimal but has been extremely challenging to implement, given the young age by which immunity is necessary and the legacy of vaccine-enhanced illness leading to deaths in a number of young children after receipt of a formalin-inactivated RSV vaccine in the 1960s.In this issue of Clinical and Vaccine Immunology, two articles address important obstacles in the path to a successful RSV vaccine (3, 4). Acosta and colleagues provide a history and perspective on the vaccine-enhanced RSV illness that occurred in the 1960s. The devastating results from those trials have thwarted vaccine efforts for the past 5 decades. The authors summarize the large and important body of work that has informed our understanding of immune responses in seronegative infants. The authors caution that RSV vaccines triggering high levels of interleukin-4 (IL-4) and/or IL-13 are associated with enhanced disease in animal models and should be excluded as potential candidates for infant immunization. Likewise, vaccines eliciting nonneutralizing antibody may also be quite risky in seronegative individuals (3).The second article addresses the important issue of identifying a correlate of protection, which if established could make vaccine licensure easier to achieve. Vissers et al. studied a cohort of infants hospitalized with RSV infection in the Netherlands to determine the importance of serum versus mucosal antibody, presumed to be maternally derived given the young age of the infants (mean, 53 days). The authors found that RSV-specific mucosal IgG concentrations, but not plasma IgG concentrations, inversely correlated with viral load (4). While the results are provocative, the study was limited by its small sample size and cross-sectional design. It will be important to replicate these results in larger populations in other locales. Nonetheless, such innovative work is needed to inform measures of vaccine-induced immunity and accelerate RSV vaccine development.The RSV experience reminds us that vaccine development is by nature a prolonged, risky, and increasingly expensive process. Laborato...

show abstract

“…This compares to only 26 days in a study in a Dutch cohort 85 . Based on a half-life of 38 days, the duration of protection afforded by maternal vaccination would be predicted to increase by 19 days for each 0.5 log2 increase in cord blood antibody titre 70 .…”

Section: Rsvmentioning

confidence: 99%