Portal de Boas Práticas em Saúde da Mulher, da Criança e do Adolescente

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Palivizumab, a humanized respiratory syncytial virus monoclonal antibody …

Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. The IMpact-RSV Study Group. Pediatrics. 1998 Sep;102(3 Pt 1):531-7. PubMed PMID: 9738173. To determine the safety and efficacy of prophylaxis with palivizumab in reducing the incidence of hospitalization because of respiratory syncytial virus (RSV) infection in high-risk infants.Monthly intramuscular administration of palivizumab is safe and effective for prevention of serious RSV illness in premature children and those with BPD.

Humanized Monoclonal Antibody for Prevention of Respiratory Syncytial …

Storch GA. Humanized monoclonal antibody for prevention of respiratory syncytial virus infection. Pediatrics. 1998 Sep;102(3 Pt 1):648-51. PubMed PMID: 9738192. Respiratory syncytial virus (RSV) continues to stand out as a compelling target for prevention. This ubiquitous virus is responsible for tens of thousands of pediatric hospitalizations per year in the United States, and is a dangerous land mine lying in the path of tenuously balanced premature infants, especially those with bronchopulmonary dysplasia (BPD). Although research directed at developing an RSV vaccine is in progress and candidates are undergoing testing in selected children,1 a vaccine for widespread use is not on the immediate horizon. Recent preventive efforts have focused on passive protection with preparations of RSV antibodies.

Report of the Committee on Infectious Diseases – 2009

American Academy of Pediatrics. [Chapter title]. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2009 Report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009. The Red Book is a unique source of information on immunizations and infectious diseases for practitioners. The practice of pediatric infectious diseases is changing rapidly. With the limited time available to the practitioner, the ability to quickly obtain up-to-date infor-mation about new vaccines and vaccine recommendations, emerging infectious diseases, new diagnostic modalities, and treatment recommendations is essential. The Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) and the editors of the Red Book are dedicated to providing the most current and accurate information avail-able in the concise, practical format for which the Red Book is known.

Respiratory Syncytial Virus

American Academy of Pediatrics. Respiratory Syncytial Virus. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 Report of the Committee on Infectious Diseases. American Academy of Pediatrics; 2018; 682-692Respiratory syncytial virus (RSV) causes acute respiratory tract infections in people of all ages and is one of the most common diseases of early childhood. Most infants infected with RSV experience upper respiratory tract symptoms, and 20% to 30% develop lower respiratory tract disease (eg, bronchiolitis and/or pneumonia) with the first infection. Signs and symptoms of bronchiolitis typically begin with rhinitis and cough, which progress to increased respiratory effort with tachypnea, wheezing, rales, crackles, intercostal and/or subcostal retractions, grunting, and nasal flaring. Infection with RSV during the first few weeks of life, particularly among preterm infants, may produce minimal respiratory tract signs, lethargy, irritability, and poor feeding, sometimes accompanied by apneic episodes. These infants are at particular risk of life-threatening apnea even in the absence of any other severe respiratory symptoms. Most previously healthy infants who develop RSV bronchiolitis do not require hospitalization, and most who are hospitalized improve with supportive care and are discharged after 2 or 3 days. However, approximately 1% to 3% of all children in the first 12 months of life will be hospitalized because of RSV lower respiratory tract disease, with most RSV hospitalizations occurring in the first 6 months of life. RSV hospitalization rates are highest between 30 and 60 days of age.

Safety, Tolerability, and Pharmacokinetics of MEDI8897, the Respiratory Syncytial Virus …

Griffin, M Pamela et al. "Safety, Tolerability, and Pharmacokinetics of MEDI8897, the Respiratory Syncytial Virus Prefusion F-Targeting Monoclonal Antibody with an Extended Half-Life, in Healthy Adults." Antimicrobial agents and chemotherapy vol. 61,3 e01714-16. 23 Feb. 2017, doi:10.1128/AAC.01714-16 Prevention of respiratory syncytial virus (RSV) illness in infants is a major public health priority, but there is no approved vaccine. Palivizumab is a monoclonal antibody that provides RSV prophylaxis but requires 5 monthly injections and is approved only for infants who experience the greatest morbidity and mortality from RSV. Thus, there remains a significant unmet medical need for prevention of RSV disease in healthy infants. MEDI8897 is a recombinant human RSV monoclonal antibody with a modified Fc region that extends its half-life and is being developed as RSV prophylaxis for all infants.

Expression of the F Glycoprotein of Respiratory Syncytial Virus by a Recombinant Vaccinia Virus: …

Olmsted RA, Elango N, Prince GA, Murphy BR, Johnson PR, Moss B, Chanock RM, Collins PL. Expression of the F glycoprotein of respiratory syncytial virus by a recombinant vaccinia virus: comparison of the individual contributions of the F and G glycoproteins to host immunity. Proc Natl Acad Sci U S A. 1986 Oct;83(19):7462-6. PubMed PMID: 3532115; PubMed Central PMCID: PMC386738. A cDNA clone representing the mRNA coding sequence of the fusion glycoprotein (F) gene of human respiratory syncytial virus (RSV) was constructed and inserted into the thymidine kinase gene of vaccinia virus (WR strain) under the control of a vaccinia virus promoter. The resulting recombinant vaccinia virus, vaccinia F, expressed the F1 and F2 cleavage products (48 and 20 kDa, respectively) of the F glycoprotein in cell culture. F1 and F2 were indistinguishable from their authentic RSV counterparts with respect to glycosylation, disulfide linkage, electrophoretic mobility, cell-surface expression, and antigenic specificity.

Novel recombinant DNA vaccine candidates for human respiratory syncytial virus: Preclinical …

Farrag MA, Amer HM, Öhlschläger P, Hamad ME, Almajhdi FN. Novel recombinant DNA vaccine candidates for human respiratory syncytial virus: Preclinical evaluation of immunogenicity and protection efficiency. Hum Vaccin Immunother. 2017 Jul 3;13(7):1586-1597. doi: 10.1080/21645515.2017.1295190. Epub 2017 Mar 8. PubMed PMID: 28272978; PubMed Central PMCID: PMC5512761.The development of safe and potent vaccines for human respiratory syncytial virus (HRSV) is still a challenge for researchers worldwide. DNA-based immunization is currently a promising approach that has been used to generate human vaccines for different age groups. In this study, novel HRSV DNA vaccine candidates were generated and preclinically tested in BALB/c mice. Three different versions of the codon-optimized HRSV fusion (F) gene were individually cloned into the pPOE vector. The new recombinant vectors either express full-length (pPOE-F), secretory (pPOE-TF), or M282-90 linked (pPOE-FM2) forms of the F protein. Distinctive expression of the F protein was identified in HEp-2 cells transfected with the different recombinant vectors using ELISA and immunofluorescence.

A recombinant subunit vaccine for bovine RSV and Histophilus somni protects calves against …

Gershwin LJ, Behrens NE, McEligot HA, Carvallo-Chaigneau FR, Crum LT, Gunnarson BM, Corbeil LB. A recombinant subunit vaccine for bovine RSV and Histophilus somni protects calves against dual pathogen challenge. Vaccine. 2017 Apr 4;35(15):1954-1963. doi: 10.1016/j.vaccine.2017.01.059. Epub 2017 Mar 6. PubMed PMID: 28274639. Bovine respiratory syncytial virus (BRSV) and Histophilus somni synergize to cause respiratory disease in cattle. These pathogens cause enhanced disease during dual-infection and an IgE response to antigens of H. somni in dual-infected but not singly infected calves. Vaccines containing whole inactivated BRSV or H. somni have been associated with IgE responses A vaccine strategy that avoids stimulation of IgE antibodies would provide superior protection from dual infection. We hypothesized that a subunit vaccine consisting of the nucleoprotein (NP) from BRSV and the recombinant antigen IbpA DR2 (a surface antigen of H. somni with two toxic fic motifs) in Quil A adjuvant would elicit protection without disease enhancement.

SENTINEL1: An Observational Study of Respiratory Syncytial Virus Hospitalizations among …

Anderson EJ, Krilov LR, DeVincenzo JP, Checchia PA, Halasa N, Simões EA, Domachowske JB, Forbes ML, Pannaraj PS, McBride SJ, McLaurin KK, Kumar VR, Ambrose CS. SENTINEL1: An Observational Study of Respiratory Syncytial Virus Hospitalizations among U.S. Infants Born at 29 to 35 Weeks' Gestational Age Not Receiving Immunoprophylaxis. Am J Perinatol. 2017 Jan;34(1):51-61. doi:10.1055/s-0036-1584147. Epub 2016 May 27. PubMed PMID: 27233106. SENTINEL1 characterized U.S. preterm infants 29 to 35 weeks' gestational age (wGA) < 12 months old hospitalized for laboratory-confirmed respiratory syncytial virus (RSV) disease and not receiving RSV immunoprophylaxis during the 2014 to 2015 RSV season.

Special Populations

Fauroux B, Special Populations. Paediatric Respiratory Reviews. Volume 10, Supplement 1, June 2009, Pages 21-22. https://doi.org/10.1016/S1526-0542(09)70010-7. Bronchiolitis is a leading cause of hospitalisation in infancy, with respiratory syncytial virus (RSV) being the most common pathogen. Younger age, especially infants younger than 3 months of age, environmental factors and genetic susceptibility, are associated with increased risk of hospitalisation. Most importantly, conditions such as prematurity, in particular if associated with chronic lung disease, congenital heart disease, lung disease such as cystic fibrosis, neuromuscular disease or impairment, or congenital or acquired immune deficiencies, are associated with increased risk of RSV hospitalisation and severe RSV lung disease

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, Johnson DW, Light MJ, Maraqa NF, Mendonca EA, Phelan KJ, Zorc JJ, Stanko-Lopp D, Brown MA, Nathanson I, Rosenblum E, Sayles S 3rd, Hernandez-Cancio S; American Academy of Pediatrics. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014 Nov;134(5):e1474-502. doi: 10.1542/peds.2014-2742. Erratum in: Pediatrics. 2015 Oct;136(4):782. PubMed PMID: 25349312. This guideline is a revision of the clinical practice guideline, "Diagnosis and Management of Bronchiolitis," published by the American Academy of Pediatrics in 2006. The guideline applies to children from 1 through 23 months of age. Other exclusions are noted. Each key action statement indicates level of evidence, benefit-harm relationship, and level of recommendation. Key action statements are as follows.

Recovery of Respiratory Syncytial Virus From Stethoscopes by Conventional Viral …

Blydt-Hansen T, Subbarao K, Quennec P, McDonald J. Recovery of respiratory syncytial virus from stethoscopes by conventional viral culture and polymerase chain reaction. Pediatr Infect Dis J. 1999 Feb;18(2):164-5. PubMed PMID: 10048692.