Current and emerging pharmacological treatments for respiratory syncytial virus infection in high-risk infants

ABSTRACT

Introduction

The human respiratory syncytial virus (hRSV) is the leading cause of respiratory infections in children, older adults, and patients with comorbidities. Since the hRSV discovery, multiple efforts have been made to generate therapies that control the devastating effects on the population at risk in winter.

Areas covered

This article describes the development of different drugs and treatments approved for use in the risk-population against hRSV infection. In addition, an exhaustive bibliographical review is presented here describing new candidate molecules under evaluation and showing promising results in different assays in animal models and clinical studies. Additionally, we highlight antiviral molecules, monoclonal antibodies, and nanobodies among the new candidate treatments.

Expert opinion

hRSV is a major burden for the health systems, promoting their collapse worldwide. Therefore, developing new therapies is an essential goal to decrease hospitalization rates caused by hRSV infection in high-risk populations. For this, injecting resources and exploring new targets in addition to the F protein is an interesting alternative to achieve this goal.

KEYWORDS:

• Human respiratory syncytial virus
• antibodies
• treatments
• prophylaxis
• nanobodies

Article highlights

• The currently approved therapies against hRSV are only palivizumab and Ribavirin.

• Nirsevimab is a new promising humanized hRSV-specific monoclonal antibody.

• Nanobodies, such as ALX-0171 against hRSV, are considered promising technology for therapy design against this virus.

• Most hRSV therapies, like drugs and antibodies, target the F protein to inhibit the fusion of the virus to the host cell.

Acknowledgments

We thank Biorender for making their templates available online, which we employed to construct the figure in this article.

Declaration of interest

The authors declare the following possible conflict of interest: Patent application (September 2018) entitled: Monoclonal Antibody specific against the antigen N of the Human Respiratory Syncytial Virus (VRSH), useful for the treatment of infection, its detection, and diagnosis. PCT/CL2018/050079.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by funding from the Millennium Institute on Immunology and Immunotherapy ANID ACE 210015 (CN09_016/ICN 2021_045; former P09/016-F, AMK); CONICYT/FONDECYT grants # 1231866 and PAI SA77210051 (JAS); #1190830 and 1231851 (AMK) and Biomedical Research Consortium CTU06 (AMK). This work was also supported by the Regional Government of Antofagasta through the Innovation Fund for Competitiveness FICR 2017 (BIP Code: 30488811-0).