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. 2013:372:391-404.
doi: 10.1007/978-3-642-38919-1_20.

Challenges and opportunities for respiratory syncytial virus vaccines

Barney S Graham  1 , Larry J Anderson
Affiliations

Challenges and opportunities for respiratory syncytial virus vaccines

Barney S Graham et al. Curr Top Microbiol Immunol. 2013.

Abstract

Respiratory syncytial virus (RSV) causes a significant proportion of the global burden of respiratory disease. Here we summarize the conclusions of a series of chapters written by investigators describing and interpreting what is known about the virology, clinical manifestations, immunity, pathogenesis, and epidemiology of RSV relevant to vaccine development. Several technological and conceptual advances have recently occurred that make RSV vaccine development more feasible, and this collected knowledge is intended to help inform and organize the future contributions of funding agencies, scientists, regulatory agencies, and policy makers that will be needed to achieve the goal of a safe, effective, and accessible vaccine to prevent RSV-associated disease.

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Figures

Fig. 1
Fig. 1
Biological profiles of candidate RSV vaccines. When new vaccine candidates emerge they will be compared to the FI-RSV vaccine associated with enhanced disease. Instead of categorizing vaccines as “killed” or “live” there should be a more precise biological profile described. There will be nuances in each product that could distinguish it from the FI-RSV. With new antigen designs that display targets for potent neutralizing antibody, modern adjuvants with established safety databases, and new vaccine antigen delivery approaches, there should be acceptable and rational avenues for moving several new RSV vaccine approaches into sero-negative infants where the need for protective immunity is the greatest. The chart depicts F being expressed by gene-based vectors. It is representative of other vaccine antigens that could be chosen, just as the recombinant adenovirus vector is representative of other potential gene delivery vectors. The categories shown are not exhaustive, but illustrate some of the properties that can determine the safety and immunogenicity of a candidate vaccine. “Neutralizing epitopes” refer to the likelihood the vaccine approach will induce antibodies against all or some of the known neutralizing epitopes. “MHC pathway” indicates the major antigen processing and presentation pathway engaged by the vaccine. “CD8 T cell induction” is the relative potency for the vaccine platform to generate this response. “IL-4” is a representative term for the potential for inducing Th2-type cytokines following RSV challenge after vaccination. “Immune modulation” indicates the potential for the representative vaccine to contain elements that alter or avoid RSV-induced immune responses based on in vitro or animal model data. “Delivery route” and “replication competence” are self-explanatory
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