{"title":"超越第一次呼吸:通过孕产妇免疫和婴儿免疫预防全面预防呼吸道合胞病毒。","authors":"Napaporn Chantasrisawad, Wicharn Boonjindasup, Thanyawee Puthanakit, Surasith Chaithongwongwatthana","doi":"10.2478/abm-2025-0015","DOIUrl":null,"url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is a major respiratory pathogen that particularly affects infants under 6 months, premature infants, and those with congenital heart disease (CHD) or chronic lung disease. In 2019, there was estimated 3.6 million hospital admissions among children under 5 years of age due to RSV-related lower respiratory tract infection (RSV-LRTI), with more than 26,000 deaths. For decades, monthly palivizumab injection has provided passive immunization for high-risk infants and has demonstrated efficacy in reducing RSV-related hospitalizations, while breastfeeding has been known to protect against severe RSV-LRTI. Recent advances aiming to reduce severe RSV-LRTI, that is, bronchiolitis and pneumonia, include maternal RSV immunization and long-acting monoclonal antibodies for infants. Bivalent non-adjuvanted RSV vaccine (Abrysvo®), RSVPreF, administered during pregnancy (gestational age 24-36 weeks) transfers protective RSV IgG antibodies across the placenta with high cord-to-maternal ratio at ~1.5. Studies have shown that maternal immunization significantly reduced medically attended severe RSV-associated LRTI in infants, with an efficacy of 81.8% at 90 days and 69.4% at 180 days after birth, respectively. For medically attended RSV-associated LRTI, the efficacy was 57.1% at 90 days and 51.3% at 180 days. Additionally, long-acting RSV monoclonal antibodies (Nirsevimab) provide season-long protection with a single dose for infants during the first RSV season, reducing both medically attended RSV-LRTI and hospitalizations by approximately 70%-80% in infants during their first RSV season. Consequently, in 2024, the Strategic Advisory Group of Experts (SAGE) recommended that countries introduce maternal RSVPreF vaccination and/or RSV monoclonal antibodies for infant RSV prevention. Many countries have already adopted these interventions, demonstrating cost-effectiveness of monoclonal antibodies.</p>","PeriodicalId":8501,"journal":{"name":"Asian Biomedicine","volume":"19 3","pages":"116-130"},"PeriodicalIF":0.9000,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303593/pdf/","citationCount":"0","resultStr":"{\"title\":\"Beyond the first breath: comprehensive respiratory syncytial virus prevention through maternal immunization and infant immunoprophylaxis.\",\"authors\":\"Napaporn Chantasrisawad, Wicharn Boonjindasup, Thanyawee Puthanakit, Surasith Chaithongwongwatthana\",\"doi\":\"10.2478/abm-2025-0015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Respiratory syncytial virus (RSV) is a major respiratory pathogen that particularly affects infants under 6 months, premature infants, and those with congenital heart disease (CHD) or chronic lung disease. In 2019, there was estimated 3.6 million hospital admissions among children under 5 years of age due to RSV-related lower respiratory tract infection (RSV-LRTI), with more than 26,000 deaths. For decades, monthly palivizumab injection has provided passive immunization for high-risk infants and has demonstrated efficacy in reducing RSV-related hospitalizations, while breastfeeding has been known to protect against severe RSV-LRTI. Recent advances aiming to reduce severe RSV-LRTI, that is, bronchiolitis and pneumonia, include maternal RSV immunization and long-acting monoclonal antibodies for infants. Bivalent non-adjuvanted RSV vaccine (Abrysvo®), RSVPreF, administered during pregnancy (gestational age 24-36 weeks) transfers protective RSV IgG antibodies across the placenta with high cord-to-maternal ratio at ~1.5. Studies have shown that maternal immunization significantly reduced medically attended severe RSV-associated LRTI in infants, with an efficacy of 81.8% at 90 days and 69.4% at 180 days after birth, respectively. For medically attended RSV-associated LRTI, the efficacy was 57.1% at 90 days and 51.3% at 180 days. Additionally, long-acting RSV monoclonal antibodies (Nirsevimab) provide season-long protection with a single dose for infants during the first RSV season, reducing both medically attended RSV-LRTI and hospitalizations by approximately 70%-80% in infants during their first RSV season. Consequently, in 2024, the Strategic Advisory Group of Experts (SAGE) recommended that countries introduce maternal RSVPreF vaccination and/or RSV monoclonal antibodies for infant RSV prevention. Many countries have already adopted these interventions, demonstrating cost-effectiveness of monoclonal antibodies.</p>\",\"PeriodicalId\":8501,\"journal\":{\"name\":\"Asian Biomedicine\",\"volume\":\"19 3\",\"pages\":\"116-130\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-07-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303593/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asian Biomedicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2478/abm-2025-0015\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Biomedicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2478/abm-2025-0015","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Beyond the first breath: comprehensive respiratory syncytial virus prevention through maternal immunization and infant immunoprophylaxis.
Respiratory syncytial virus (RSV) is a major respiratory pathogen that particularly affects infants under 6 months, premature infants, and those with congenital heart disease (CHD) or chronic lung disease. In 2019, there was estimated 3.6 million hospital admissions among children under 5 years of age due to RSV-related lower respiratory tract infection (RSV-LRTI), with more than 26,000 deaths. For decades, monthly palivizumab injection has provided passive immunization for high-risk infants and has demonstrated efficacy in reducing RSV-related hospitalizations, while breastfeeding has been known to protect against severe RSV-LRTI. Recent advances aiming to reduce severe RSV-LRTI, that is, bronchiolitis and pneumonia, include maternal RSV immunization and long-acting monoclonal antibodies for infants. Bivalent non-adjuvanted RSV vaccine (Abrysvo®), RSVPreF, administered during pregnancy (gestational age 24-36 weeks) transfers protective RSV IgG antibodies across the placenta with high cord-to-maternal ratio at ~1.5. Studies have shown that maternal immunization significantly reduced medically attended severe RSV-associated LRTI in infants, with an efficacy of 81.8% at 90 days and 69.4% at 180 days after birth, respectively. For medically attended RSV-associated LRTI, the efficacy was 57.1% at 90 days and 51.3% at 180 days. Additionally, long-acting RSV monoclonal antibodies (Nirsevimab) provide season-long protection with a single dose for infants during the first RSV season, reducing both medically attended RSV-LRTI and hospitalizations by approximately 70%-80% in infants during their first RSV season. Consequently, in 2024, the Strategic Advisory Group of Experts (SAGE) recommended that countries introduce maternal RSVPreF vaccination and/or RSV monoclonal antibodies for infant RSV prevention. Many countries have already adopted these interventions, demonstrating cost-effectiveness of monoclonal antibodies.
期刊介绍:
Asian Biomedicine: Research, Reviews and News (ISSN 1905-7415 print; 1875-855X online) is published in one volume (of 6 bimonthly issues) a year since 2007. [...]Asian Biomedicine is an international, general medical and biomedical journal that aims to publish original peer-reviewed contributions dealing with various topics in the biomedical and health sciences from basic experimental to clinical aspects. The work and authorship must be strongly affiliated with a country in Asia, or with specific importance and relevance to the Asian region. The Journal will publish reviews, original experimental studies, observational studies, technical and clinical (case) reports, practice guidelines, historical perspectives of Asian biomedicine, clinicopathological conferences, and commentaries
Asian biomedicine is intended for a broad and international audience, primarily those in the health professions including researchers, physician practitioners, basic medical scientists, dentists, educators, administrators, those in the assistive professions, such as nurses, and the many types of allied health professionals in research and health care delivery systems including those in training.