Prevalence of Resistance-Associated Mutations in RSV F Protein Against Monoclonal Antibodies Prior to Widespread Implementation: Findings From a Prospective German Pediatric Cohort

IF 4.2 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses Pub Date : 2025-09-18 DOI:10.1111/irv.70164

Martin Wetzke, Duyen Bao Le, Inga Tometten, Simon Ritter, Nadine Lübke, Jörg Timm, Alexander Dilthey, Marcus Panning, Andreas Walker, Christine Happle

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引用次数: 0

Abstract

Background

The emergence of resistance-associated substitutions in RSV against novel monoclonal antibodies is a concern given widespread prophylactic use.

Aim

To assess the prevalence of resistance-associated substitutions in the RSV F protein against nirsevimab, clesrovimab, and palivizumab in German infants before widespread implementation of nirsevimab.

Materials & Methods

We sequenced the F protein of n = 1042 RSV samples from German infants from seasons 2021/2022 and 2022/2023 and screened for variants in binding sites for nirsevimab (Site Ø), clesrovimab (Site IV), and palivizumab (Site II).

Results

Prevalence of resistance-associated substitutions was low (< 1%) for all three monoclonal antibodies.

Conclusion

Although the current risk of infections with escape-mutants appears to be low, our results underline the need for continued surveillance, as resistance-conferring mutations to new mAbs circulated and may be selected under selection pressure.

Abstract Image

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广泛应用前RSV F蛋白抗单克隆抗体耐药相关突变的患病率：来自一项前瞻性德国儿科队列研究的发现

背景：RSV对新型单克隆抗体的耐药性相关替代的出现是一个广泛预防使用的问题。目的：评估在尼希米单抗广泛应用之前，德国婴儿中RSV F蛋白对尼希米单抗、克列罗维单抗和帕利珠单抗的耐药性相关替代的患病率。材料与方法：我们对2021/2022和2022/2023季节来自德国婴儿的n = 1042份RSV样本的F蛋白进行了测序，并筛选了nirsevimab （Site Ø）、clesrovimab （Site IV）和palvizumab （Site II）结合位点的变异。结果：所有三种单克隆抗体耐药相关替代的发生率均较低（< 1%）。结论：尽管目前逃逸突变体感染的风险似乎很低，但我们的研究结果强调了持续监测的必要性，因为对新的单克隆抗体具有耐药性的突变正在传播，并且可能在选择压力下被选择。

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来源期刊

Influenza and Other Respiratory Viruses 医学-病毒学

CiteScore

7.20

自引率

4.50%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.