In respiratory syncytial virus (RSV) disease the balance between the innate and adaptive immune responses determines the expression of the pathological phenotype favoring the development of acute
bronchiolitis, and in certain children the development of recurrent
wheezing. While humoral antibody plays a major role in protection against disease, T-cell immunity targeted to
viral proteins appears to terminate
viral infection. At the moment, treatment modalities for acute
RSV infection do not effectively modify the course of the disease, and
RSV vaccine development has shown conflicting results. To date, however, passive immunoprophylaxis with
monoclonal antibodies is the only strategy that has demonstrated consistent efficacy in reducing RSV hospitalizations in high-risk children. The potential benefit of new strategies for prevention and treatment of
RSV infections should be evaluated with respect to both the acute
infection as well as the chronic respiratory manifestations induced by RSV.