Host immune response to respiratory syncytial virus infection and its contribution to protection and susceptibility in adults: a systematic literature review
Creators: name: Chaumont, Agnes
name: Martin, Alison
name: Flamaing, Johan
name: Wiseman, Dexter J
name: Vandermeulen, Corinne
name: Jongert, Erik
name: Doherty, Timothy Mark
name: Buchy, Philippe
name: Varga, Steven M
name: Warter, Lucile
Publisher: name: Taylor & Francis
Year: 2025
Subjects: subject: Medicine
subject: Microbiology
subject: FOS: Biological sciences
subject: Immunology
subject: FOS: Clinical medicine
subject: Biological Sciences not elsewhere classified
subject: Science Policy
subject: Mental Health
subject: Infectious Diseases
subject: FOS: Health sciences
subject: Plant Biology
subject: Virology
subject: Computational Biology

description: Respiratory syncytial virus (RSV) is an important pathogen in infants, children, older adults, and those with comorbidities. Mechanisms involving viral proteins appear to underlie the ability of RSV to evade and modulate host immunity. We aimed to understand virus- and host-dependent factors regulating the development and severity of RSV infection, as related to the prevention and treatment of RSV-associated disease in adults, through a systematic literature review (SLR). An SLR was conducted to identify immune mechanisms involved in the protective response to RSV infection in adults, and responses that may contribute to the development of severe disease. Concurrent searches (MEDLINE/Embase) using embase.com identified relevant papers published between 1990 and 19 April 2023. Of 1813 records identified, 113 were selected for review. Inclusion criteria were based on relevant patient populations, outcomes, and study methodologies. RSV is common, recurrent, and associated with high morbidity and mortality in older adults and people with underlying chronic diseases. Immune responses differ between younger and older adults. The approval of effective vaccines may protect older individuals from symptomatic RSV infection. We established the complexities of RSV immune response, but further research is required to fully understand anti-RSV immunology. The authors of this article wanted to understand how the immune system protects adults from a virus called respiratory syncytial virus. This virus, also known as RSV, is important worldwide. Most children have been exposed to RSV at least once by 2 or 3 years of age, and infections happen again throughout life. RSV spreads through the air and by picking up virus particles from surfaces or other people. RSV usually causes mild cold-like symptoms, but some people have a higher chance of getting severe symptoms; this includes babies, older adults, and people with certain underlying medical conditions. Older adults with severe symptoms may need to stay in hospital, and estimates suggest about seven in every 100 older adults who are hospitalized with RSV die. In this study, we searched for medical articles that contained information about how the immune system in adults responds to RSV infection. This included how the immune system protects people from infection, how the virus bypasses immune responses, and what happens when symptoms become severe. Several parts of the immune system help to protect against RSV in adults, including parts that respond to any virus and parts that learn to recognize RSV. There are important differences in how the immune system responds to RSV infection in younger and older adults, particularly in the parts that specifically recognize RSV. Some of these differences are related to aging. Vaccines may help protect older people from symptomatic RSV disease and more research is needed in this area. <b>Protocol registration</b>: CRD42021293278