Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 216, Issue 11, Pages 1398-1406Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jix489
Keywords
antibodies; infant; severity; prefusion; RSV
Categories
Funding
- National Institutes of Health [P01 AI112524 2524, R01 AI093848, R01 AI095684]
- Nationwide Children's Hospital intramural grants
- Janssen
- Medimmune
- Trimeris
- ReViral
- HuMabs
- Regeneron
- Novartis
- Gilead
- Pfizer
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Background. Respiratory syncytial virus (RSV) is the most frequent cause of lower respiratory tract infection in infants. Maternally derived RSV-specific antibodies play a role in protection against RSV infection in early life, but data regarding the concentration and specificity of those antibodies are incomplete. Methods. We prospectively enrolled a cohort of previously healthy infants and young children hospitalized (n = 45) or evaluated as outpatients (n = 20) for RSV infection, and healthy noninfected age-matched controls (n = 18). Serum samples were obtained at enrollment to quantify the concentrations and neutralizing activity of serum immunoglobulin G antibodies to the RSV prefusion (pre-F), postfusion (post-F), and G glycoproteins. We also assessed the associations between antibody concentrations and clinical disease severity. Results. Concentrations of pre-F antibodies were >= 3-fold higher than post-F antibodies and >30-fold higher than G antibodies in serum from infants with acute RSV infection. Antibody concentrations and neutralizing activity inversely correlated with age. The pre-F antibodies displayed the greatest neutralizing activity (55%-100%), followed by G (0%-45%), and post-F (0%-29%) antibodies. Higher concentrations of pre-F and G antibodies, but not post-F antibodies, were associated with lower clinical disease severity scores. Conclusions. Maternal antibodies directed to pre-F, followed by antibodies directed to G, can modulate RSV disease severity in young infants.
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