Life-Saving Prevention Therapy Has Roots in NIAID Research
For most parents, respiratory syncytial virus (RSV) is of no more concern than a common cold. Almost all kids have been infected with the virus by age 2, but it generally disappears after two weeks of coughing and runny noses. But for the parents of the 75,000 to 125,000 children hospitalized for RSV in the United States each year, the virus is terrifying because it can lead to life-threatening respiratory illness.
RSV is a global problem, causing an estimated 160,000 deaths per year worldwide. No vaccine has been licensed for use. There is a single preventive therapy available to children at risk, grounded in innovative work at NIAID, and it has helped save thousands of lives for more than 10 years.
Therapy Helps Protect High-Risk Infants and Young Children
In the early 1980s, a team of scientists led by NIAID pediatrician Robert M. Chanock, M.D., showed that giving anti-RSV antibodies to cotton rats protected the animals from RSV infection. NIAID scientists then developed monoclonal antibodies that efficiently neutralized RSV infection. Building on the breakthrough work of these NIAID scientists, MedImmune, a biotechnology company based in Gaithersburg, MD, modified one of the NIAID antibodies by splicing it to a human protein. This created a “humanized” antibody that prevented RSV in humans. The result was Synagis (palivizumab), which the FDA approved for use in 1998.
Synagis is prescribed to those at high risk for serious RSV infection or complications: infants born prematurely, children under age 2 who have heart or lung problems, and infants who are otherwise immune-compromised. Some doctors also might prescribe Synagis for infants born within six months of RSV season, which runs from November through April in the United States.
An injection with Synagis once a month during the RSV season will protect a person for 30 days at a time. The therapy has reduced the overall incidence of hospitalization due to RSV and has reduced the length of hospital stays for RSV-infected children.
More Work To Be Done
Synagis is the only preventive treatment available for RSV. While it has eased the burden of RSV, NIAID scientists continue to explore better prevention strategies. The antibody in Synagis that neutralizes RSV gradually degrades after injection, thus requiring a new dose each month. Additionally, visiting the doctor for an injection once a month, for several months in a row, can be a burdensome process for parents.
NIAID scientists are pursuing an RSV vaccine, which would confer longer-lasting protection. It would be administered as a nasal spray, instead of a needle stick, and require only one trip to the doctor’s office. It would be more convenient, less expensive, and could be used in a greater number of infants. There are currently two vaccine candidates under development by NIAID and its partner, MedImmune. Both have shown promise and could finally give all parents reason to see RSV as no more concerning than the common cold.
For more information on these vaccine candidates, see NIAID Lab Developing Intranasal RSV Vaccines.
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