RSV

negative, enveloped

RSV has a __ (+/-) ssRNA genome and the virion is __ (naked/enveloped)

G Glycoprotein, genetic

_ __ mediates attachment to host cell, with high __ diversity

F Glycoprotein, conformational

_ __ mediates fusion and entry into host cell → __ changes upon host receptor binding

SPF

Which would be the most effective target for neutralizing antibodies? Spike protein F or spike protein G?

Ciliated airway, endosome, cytoplasm, budding, cytolytic

• RSV Replication Cycle

  • (1) Viral attachment and entry to __ __ epithelial cells

  • (2) Capsid uncoating upon __ fusion

  • (3) Transcription/replication/translation in the __

  • (4) Virus __ as filamentous particles

  • (5) __ effects to cell

Second, infant, 2

RSV is the __ leading cause of __ deaths worldwide

• Infects 95% of children before age _, major cause of bronchitis and pneumonia

Long-term, re, season

RSV has a poor __-__ immunity in children and adults, with multiple __-infections occurring in the same __

Person-to-person, nasopharyngeal (NPG)

RSV is transmitted from __ to __ via respiratory droplet and or fomites

• It initially enters into __ mucosa

Lower, cytolytic, ciliary, airway edema, obstruction

RSV Pathology

• Spread into __ respiratory tract targeting apical ciliated epithelial cells

• Infection of cells __

• Mucus/cell debris/fibrin lead to __ dysfunction and __ __

• May lead to __ of bronchioles and alveoli (in infants)

Syncytia, F

__ formation (cytotoxic trait) facilitates viral spread and pathogenesis of RSV, utilizing glycoprotein _ (G/F)

Cytokines, chemokines, innate, DCs, T, antibodies, clearance

Immunology of RSV

• (1) Cytolytic infection → Releases inflammatory __ and __

• (2) __ immune cell recruitment to infection (NK cell killing)

• (3)__ prime T and B cell responses

• (4) _ cells and __ enter infection site

• (5) Inflammation and destruction eventually leads to viral __

Th2, eosinophils, neutrophils, Th1

Unintentional CD4 __ response from RSV results in enhanced disease

• Increased infiltration __, __, for extracellular pathogens

• Downregulates normal __ response

2-8, 1-3

RSV incubation period is about _-_ days

Duration of acute illness is about _-_ weeks

RSV Symptoms

Coughing, expiratory wheezes, tachypnea, dyspnea, low-grade fever, clear nasal discharge

infiltrates, hyperexpansion, hypoxemia, hypercapnia

Physical exam findings of RSV include

• Interstitial lung __

• __ of the lungs

• __ (oxygen) and __ (carbon states)

superinfection, right

Severe RSV complications

• Bronchiolitis, pneumonia, bacterial __, respiratory failure, __-sided heart failure

RT-PCR

More sensitive lab test of upper/lower respiratory specimens than antigen/culture

Antigen testing

Sensitive respiratory testing in children, less sensitive in adults

mRESVIA

F glycoprotein mRNA vaccine aka “Moderna”

ABRYSVO + GSK

Subunit vaccines against F glycoprotein aka “Pfizer”

Pregnant, IgG

ABRYSVO vaccine is safe for __ women, as __ (antibodies) are passed to baby via placenta

F, Prophylactics

Treatments

• Most protective RSV antibodies target _ protein via neutralization

• __ are monthly injections received during RSV season