Research Article: Characteristics of RSV-Specific Maternal Antibodies in Plasma of Hospitalized, Acute RSV Patients under Three Months of Age

Date Published: January 30, 2017

Publisher: Public Library of Science

Author(s): Jop Jans, Oliver Wicht, Ivy Widjaja, Inge M. L. Ahout, Ronald de Groot, Teun Guichelaar, Willem Luytjes, Marien I. de Jonge, Cornelis A. M. de Haan, Gerben Ferwerda, Florian Krammer.


Respiratory syncytial virus (RSV) is the leading cause for respiratory illness that requires hospitalization in infancy. High levels of maternal antibodies can protect against RSV infection. However, RSV-infected infants can suffer from severe disease symptoms even in the presence of high levels of RSV-specific antibodies. This study analyzes several serological characteristics to explore potential deficiencies or surpluses of antibodies that could relate to severe disease symptoms. We compare serum antibodies from hospitalized patients who suffered severe symptoms as well as uninfected infants. Disease severity markers were oxygen therapy, tachypnea, oxygen saturation, admission to the intensive care unit and duration of hospitalization. Antibodies against RSV G protein and a prefusion F epitope correlated with in vitro neutralization. Avidity of RSV-specific IgG antibodies was lower in RSV-infected infants compared to uninfected controls. Severe disease symptoms were unrelated to RSV-specific IgG antibody titers, avidity of RSV-IgG, virus neutralization capacity or titers against pre- and postfusion F or G protein ectodomains and the prefusion F antigenic site Ø. In conclusion, the detailed serological characterization did not indicate dysfunctional or epitope-skewed composition of serum antibodies in hospitalized RSV-infected infants suffering from severe disease symptoms. It remains unclear, whether specific antibody fractions could diminish disease symptoms.

Partial Text

Human respiratory syncytial virus (RSV) infections are a major burden for infants [1]. The symptoms of RSV infection range from a common cold to severe bronchiolitis and pneumonia. Children below 3 months of age are at risk for developing severe symptoms that require admission to the hospital, whereas the vast majority shows only mild disease [2].

Infants encounter primary RSV infections even though matAbs are present in their blood. We investigated whether individual serologic properties of antibodies or any signature combinations thereof would be related to the observed disease symptoms. Our results indicate that (i) disease severity is not associated with differences in RSV-specific IgG titers, RSV-IgG avidity, or virus neutralization and (ii) plasma titers of RSV-specific IgG against the G protein and the prefusion F protein correlate with neutralizing capacity. In addition, (iii) IgG titers directed against the G protein, prefusion F protein, postfusion F protein, F-antigenic site Ø and site I, or any combination of thereof could not be associated with severity of symptoms.




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