Skip to main content
Book cover

pp 1–28Cite as

Controlled Human Infection Challenge Studies with RSV

Part of the Current Topics in Microbiology and Immunology book series

Abstract

Despite considerable momentum in the development of RSV vaccines and therapeutics, there remain substantial barriers to the development and licensing of effective agents, particularly in high-risk populations. The unique immunobiology of RSV and lack of clear protective immunological correlates has held back RSV vaccine development, which, therefore, depends on large and costly clinical trials to demonstrate efficacy. Studies involving the deliberate infection of human volunteers offer an intermediate step between pre-clinical and large-scale studies of natural infection. Human challenge has been used to demonstrate the potential efficacy of vaccines and antivirals while improving our understanding of the protective immunity against RSV infection. Early RSV human infection challenge studies determined the role of routes of administration and size of inoculum on the disease. However, inherent limitations, the use of highly attenuated/laboratory-adapted RSV strains and the continued evolutionary adaptation of RSV limits extrapolation of results to present-day vaccine testing. With advances in technology, it is now possible to perform more detailed investigations of human mucosal immunity against RSV in experimentally infected adults and, more recently, older adults to optimise the design of vaccines and novel therapies. These studies identified defects in RSV-induced humoral and CD8+ T cell immunity that may partly explain susceptibility to recurrent RSV infection. We discuss the insights from human infection challenge models, ethical and logistical considerations, potential benefits, and role in streamlining and accelerating novel antivirals and vaccines against RSV. Finally, we consider how human challenges might be extended to include relevant at-risk populations.

Keywords

  • Respiratory
  • Virus
  • Immunity
  • Infection
  • RSV
  • Human challenge

This is a preview of subscription content, access via your institution.

References

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christopher Chiu .

Rights and permissions

Reprints and Permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Dayananda, P., Chiu, C., Openshaw, P. (2022). Controlled Human Infection Challenge Studies with RSV. In: Current Topics in Microbiology and Immunology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/82_2022_257

Download citation

  • DOI: https://doi.org/10.1007/82_2022_257

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg