ReviewFrontiers in immunology2026
Determinants of success and failure of antibody-based strategies against respiratory viruses: insights from RSV and SARS-CoV-2.
Review in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Comparative innate immune responses across major RNA and DNA viral infections: Mechanisms, immunopathology, and therapeutic perspectives.Human vaccines & immunotherapeutics · 2026Review
- Insights Into monoclonal antibodies and vaccines targeting respiratory viruses.Frontiers in pediatrics · 2026Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Respiratory syncytial virus (RSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represent two extremes in the outcome of antibody-based interventions. The long-acting monoclonal antibody nirsevimab has achieved durable, population-level protection against RSV in infants, reducing hospitalizations by 70-90% with no evidence of antigenic escape. In contrast, all neutralizing monoclonal antibodies against SARS-CoV-2 became obsolete within three years due to rapid viral evolution, particularly in the spike receptor-binding domain. This review dissects the mechanistic determinants underlying this divergence. We propose four key principles that govern antibody efficacy against respiratory viruses: (i) targeting a structurally conserved epitope with high fitness cost for escape; (ii) achieving sufficient antibody concentrations in the airway epithelial lining fluid; (iii) the vulnerability of single-epitope strategies against mutable viral targets; and (iv) the auxiliary but non-substitutable role of Fc effector functions. By comparing RSV and SARS-CoV-2, we illustrate how these principles align in successful interventions and fail in others. Finally, we discuss emerging strategies-particularly inhaled delivery and mRNA-encoded antibodies-that may overcome current limitations and enable durable protection against antigenically variable respiratory pathogens.
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Registered trials
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