Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: DrugBank:BIOD00097 (anti-RSV)
 466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Palivizumab, a humanized monoclonal antibody, has been approved by the FDA to prevent severe lower respiratory tract infections caused by RSV in high-risk patients. Prophylaxis of RSV infections with palivizumab requires monthly injections (15 mg/kg) during the RSV season. In the IMpact-RSV study, hospitalizations resulting from RSV decreased by 55% in the palivizumab treatment group. Palivizumab has also been shown to decrease the number of days with moderate or severe RSV infection, with an increased oxygen requirement, and ICU admissions. Palivizumab has been shown to be well tolerated with minimal adverse effects. The most frequently reported adverse effects were fever and minor injection site reactions. Determination of which patients should receive RSV prophylaxis should take into consideration all risk factors. Recommendations for RSV prophylaxis with RSV-IGIV and palivizumab have been published by the American Academy of Pediatrics. To date, no studies directly comparing RSV-IGIV and palivuzumab have been conducted. Neither product is recommended in children with congenital heart disease.
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PMID:Palivizumab for respiratory syncytial virus prophylaxis. 1069 84

An assay for respiratory syncytial virus (RSV)-specific IgG in saliva is described. The assay was used to examine the incidence of RSV infection in schoolchildren 7-10 years old during one RSV season. One hundred and twenty-one volunteer children provided saliva samples in October 1997 and March 1998; 18% of the children showed a fourfold or greater rise in anti-RSV IgG in the second sample. This prevalence of antibody increase is similar to that described in previous studies that measured CFT levels in serum samples. Overall, the children who showed rises in antibody levels, indicating that they had experienced an RSV infection, had lower levels of RSV-specific antibody in their preseason samples than those who showed no increase (P = 0.0018). These results show that saliva is an adequate substitute for serum in some antibody tests and may be useful for community studies. Such studies may provide surrogate markers for susceptibility to infection, which should benefit the planning of vaccination strategies.
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PMID:Estimation of incidence of respiratory syncytial virus infection in schoolchildren using salivary antibodies. 1074 37

Respiratory syncytial virus is one of the major respiratory pathogens for infants and immunocompromized children. With the exception of young children, all the population has encountered RSV and is seropositive. Recent reports have demonstrated however that the virus also affects the elderly and represents a major cause of illness associated with an excess of morbidity and mortality. We have generated a recombinant RSV vaccine, BBG2Na, which is highly protective in rodents against RSV infection. The aim of this study was to evaluate the ability of the vaccine to increase anti-RSV protection in RSV-primed mice and to characterize the induced immune responses. Immunization with BBG2Na increased the anti-RSV-A serum antibody titers of RSV-primed mice with induction of both IgG1 and IgG2a antibodies attesting for a mixed Th response. Moreover, the level of the induced anti-G2Na antibodies was greater in seropositive mice. Finally, sera from RSV-primed mice displayed a higher protective efficacy after transfer into naive mice following subsequent immunization with BBG2Na than sera of mice immunized with RSV-A only. Our results demonstrate that BBG2Na is immunogenic and increases the protective efficacy of serum antibodies in RSV-primed mice; they support the possibility of performing clinical trials in the seropositive human population.
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PMID:Influence of live respiratory syncytial virus priming on the immune response generated by a recombinant vaccine candidate, BBG2Na. 1078 50

Human Respiratory Syncytial Virus (RSV) is considered to be the leading cause of lower respiratory tract disease in infants and young children. RSV is also a common pathogen in immunocompromised adults and in the elderly. RSV infection can be epidemic and is evident worldwide. Ribavirin, a small molecule agent, and Synagis, a monoclonal neutralizing antibody, are the only approved drugs for treatment and prevention of RSV in high-risk patients. This review is focused on a group of novel and specific inhibitors discovered at Wyeth-Ayerst Research. Some of these inhibitors have IC50 <50 nM and are active against all the tested group A and B viruses. They also have shown good efficacy in cotton rats and primates. Mechanism of action studies indicate that the compounds inhibit the next step in infection after adsorption suggesting that fusion is the target. A strong relationship between the inhibitor structures and their anti-RSV activity was established. This relationship appears to derive from a multivalent interaction between the functional groupings of the inhibitors and the F protein, which seem to be highly complementary and directional.
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PMID:Novel anti-RSV dianionic dendrimer-like compounds: design, synthesis and biological evaluation. 1078 95

RSV is the most common cause of lower respiratory tract infections in infants. The humanised monoclonal antibody has been developed for prevention of serious lower respiratory tract disease caused by RSV. Palivizumab specifically inhibits subtypes A and B. In a large, multicenter, double-blind, randomised trial in 1502 infants at high risk of RSV infection, intramuscular palivizumab 15 mg/kg reduced the incidence of RSV-attributable hospitalization by 55% compared with placebo. Palivizumab was well tolerated. In Germany palivizumab prophylaxis should be considered only for high risk premature infants and high risk infants with chronic lung disease if the local rate of hospitalization attributable to confirmed RSV infection is frequent.
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PMID:[Palivizumab--a monoclonal antibody for passive immunoprophylaxis of respiratory syncytial virus infections]. 1090 69

We used differential display to detect enhanced expression of an mRNA fragment encoding cytokeratin 17 (Ck-17) in respiratory syncytial virus (RSV)-infected epithelial cells. Expression increased 12-fold by 96 h after infection but remained unchanged in cells challenged with virus in the presence of neutralizing anti-RSV fusion protein antibody. Immunoblots of RSV-infected cell lysates probed with an anti-keratin antibody demonstrated stable expression of total cytokeratins over time. When probed with an anti-Ck-17 monoclonal antibody, Ck-17 was first detected at 4 days after infection. In situ staining demonstrated that Ck-17 expression localized to regions of syncytia formation. Expression of Ck-17 mRNA also increased in response to intracellular RSV-F protein in the absence of active RSV infection. No increase in Ck-17 mRNA expression and no syncytia were observed in RSV-infected cells grown in the presence of the NF-kappaB inhibitor gliotoxin. These results suggest that RSV-induced transcriptional activation of the Ck-17 gene is dependent on an NF-kappaB-associated signaling pathway.
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PMID:Cytokeratin 17 is expressed in cells infected with respiratory syncytial virus via NF-kappaB activation and is associated with the formation of cytopathic syncytia. 1097 95

RSV is one of the major causes of pneumonia and bronchiolitis in infants and young children and is associated with high mortality. RSV neutralizing human antibody (hu-Ab) is known to mediate resistance to viral infection as well as to be an effective treatment for severe lower respiratory tract RSV infection. We have previously demonstrated that human primary and secondary immune responses can be established in severe combined immunodeficient mice engrafted with human peripheral blood lymphocytes (hu-PBL-SCID). By combining this animal model with the single-chain Fv antibody (scFv) phage display library technique, we were able to investigate further its clinical potential by generating a panel of human scFvs that exhibit both high F glycoprotein (RSV-F) binding affinities ( approximately 108 M(-1)) and strong neutralizing activities against RSV infection in vitro. Sequencing analysis of the randomly isolated anti-RSV-F scFv clones revealed that they were derived from different VH families with mutations in the complementarity-determining region 1 (CDR1). The results suggest that: (i) RSV-F-specific human immune responses and affinity maturation can be induced in hu-PBL-SCID mice; and (ii) this approach can be applied to generate large numbers of human scFvs with therapeutic potential. Despite the fact that hu-PBL-SCID mouse and human scFv phage display library have individually been established, our approach contributes a simple and significant step toward the generalization of antigen-specific human monoclonal antibody (hu-MoAb) production and their clinical applications.
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PMID:Efficient generation of respiratory syncytial virus (RSV)-neutralizing human MoAbs via human peripheral blood lymphocyte (hu-PBL)-SCID mice and scFv phage display libraries. 1101 23

We describe two patients who developed respiratory syncytial virus (RSV) pneumonia after BMT. One died of RSV pneumonia after three courses of steroid pulse therapy. Surprisingly, RSV antigen was identified in the bronchoalveolar lavage fluid (BALF) obtained post mortem. Steroid pulse therapy might have suppressed anti-RSV immunity, leading to persistent RSV infection for more than 1 month. The other patient received donor lymphocyte infusions (DLI) for relapsed plasma cell leukemia, while having active RSV pneumonia. His respiratory condition improved after DLI, and RSV antigen disappeared in BALF and nasal swabs. DLI might be effective in cases of life-threatening RSV pneumonia.
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PMID:Donor lymphocyte infusion for treatment of life-threatening respiratory syncytial virus infection following bone marrow transplantation. 1101 50

Respiratory syncytial virus (RSV) is a recognised cause of lower respiratory tract infection in infants and young children. It causes severe respiratory disease in preterm infants with or without chronic lung disease. This study, conducted at Waterford Regional Hospital, evaluates the incidence of RSV infection in hospitalised children, its seasonal variation, and effectiveness of its prevention. Thirty eight percent of admitted children with bronchiolitis were RSV positive in the year 1999 November to March is the peak season for this infection. A highly selected group of 7 preterm children with or without chronic lung disease received Palivizumab prophylaxis. Not one of them acquired RSV infection. The high cost of Palivizumab was the main factor for its restricted use. Palivizumab was found to be effective in preventing RSV infection in our study. Since we had a small number of patients, further studies are needed for its economic and judicious use. Respiratory syncytial virus (RSV) is virulent easily transmissible and the most common cause of lower respiratory tract disease in children of less than 2 years of age. Up to 98% of children attending day care will be infected in single RSV season. Between 0.5% and 3.2% of children with RSV infection require Hospitalisation. Approximately 90,000 hospital admissions and 4500 deaths per year were reported in United States. In Ireland 2807 patients were admitted with Bronchiolitis in 1998. Major risk factors for hospitalisation due to RSV are Prematurity, chronic lung disease, congenital heart disease, compromised immunity and age younger then 6 weeks in otherwise healthy children. No effective treatment of RSV positive bronchiolitis beside supportive care in the form of adequate nutrition and oxygen therapy is available. Antiviral therapies such as Ribavirin has not been proved to be effective in RSV infection. Bronchodilators show variable results. Corticosteroids were not found effective. There is no effective vaccine available as yet. There is no proven method for active immunity. Various immunoglobulins are available for acquiring passive immunity against RSV infection. PREVENT study group in Jan. 1997 showed intravenous immunoglobulin (RSV- IGIV) use in reducing 41% to 63% hospitalisation in RSV patients. But RSV-IGIV was not licensed outside the United States because of risk of transmission of blood borne products, difficulty in administration ie. intravenous access, large fluid volume (15 ml/kg), high protein load (750 mg/kg), shortage of supply and need to postpone live vaccine (eg. MMR, varicella). monoclonal antibody Palivizumab was developed for prophylaxis against RSV infection. Clinical safety and efficacy of Palivizumab were demonstrated in IMpact trial published in Sept. 1998. Reduction in hospitalisation up to 55% was noted in this study. It was a pivotal randomised, double blind, placebo controlled phase 3 study conducted in 139 centres throughout Canada, United States and United Kingdom. We looked at our experience in patients admitted with bronchiolitis in Waterford Regional Hospital. We described the outcome of carefully selected Seven children of high risk group for Palivizumab prophylaxis. Its clinical Implications and cost effectiveness was evaluated in this study.
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PMID:Prophylaxis in RSV infection (Palivizumab)--is it worthwhile? 1120 17

Respiratory syncytial virus (RSV) is a common cause of respiratory illness in young children, almost all will have been infected by the age of two years old. Very young infants, and those with underlying disease, are at risk of severe RSV disease, but even those who were previously healthy can suffer recurrent respiratory symptoms 9 to 10 years after their initial infection. The management of RSV infection is essentially supportive, thus prophylaxis offers the best hope of reducing the morbidity and mortality of RSV infection. There is no safe and effective RSV vaccine to use in those infants who are at highest risk from the infection. Immunoprophylaxis, however, has been shown to have benefits in randomised controlled trials. Standard immunoglobulin, however, is ineffective as its administration does not achieve an adequate titre of neutralising antibodies. RSV immunoglobulin (RSV-IGIV, RespiGam, Massachusetts Public Health Laboratories, Boston, MA), in contrast, contains high levels of RSV neutralising antibody and has been shown to significantly reduce hospitalisation in preterm infants with or without bronchopulmonary dysplasia (BPD). Its use is not recommended in infants with cyanotic congenital heart disease (CHD), as it was associated with an excess of adverse events. A humanised RSV monoclonal antibody (Palivizumab, MEDI-493, Synagis, MedImmune Inc, Gaithersburg, MD) also significantly reduces hospitalisation for RSV infection in high risk infants, but without serious side effects. The American Academy of Paediatrics has recommended that immunoprophylaxis should be considered for young children at high risk of severe RSV infection and that palivizumab is the preferred agent. Studies have suggested it is essential to carefully select patients for immunoprophylaxis, if its use is to be cost-effective.
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PMID:Respiratory syncytial virus prevention: past and present strategies. 1124 87


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