Current state and challenges in respiratory syncytial virus drug discovery and development

Antiviral Res. 2024 Jan:221:105791. doi: 10.1016/j.antiviral.2023.105791. Epub 2023 Dec 29.

Abstract

Human respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections (LRTI) in young children and elderly people worldwide. Recent significant progress in our understanding of the structure and function of RSV proteins has led to the discovery of several clinical candidates targeting RSV fusion and replication. These include both the development of novel small molecule interventions and the isolation of potent monoclonal antibodies. In this review, we summarize the state-of-the-art of RSV drug discovery, with a focus on the characteristics of the candidates that reached the clinical stage of development. We also discuss the lessons learned from failed and discontinued clinical developments and highlight the challenges that remain for development of RSV therapies.

Keywords: Antiviral; Neutralizing antibody; Resistance; Respiratory syncytial virus.

Publication types

  • Review

MeSH terms

  • Aged
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Neutralizing
  • Antibodies, Viral
  • Child
  • Child, Preschool
  • Humans
  • Respiratory Syncytial Virus Infections*
  • Respiratory Syncytial Virus Vaccines* / therapeutic use
  • Respiratory Syncytial Virus, Human*
  • Respiratory Tract Infections*
  • Viral Fusion Proteins

Substances

  • Antibodies, Monoclonal
  • Respiratory Syncytial Virus Vaccines
  • Viral Fusion Proteins
  • Antibodies, Viral
  • Antibodies, Neutralizing