High seroprevalence and high risk: why are older adults more prone to respiratory syncytial virus?
Abstract
Despite widespread seropositivity, respiratory syncytial virus (RSV) remains a major cause of severe illness in adults aged 60 years and older. This review examines why infection-acquired immunity fails to protect this group, focusing on four key factors: structural lung decline, comorbidities, immunosenescence, and impaired antibody responses. Age-related changes weaken mechanical defenses and antiviral immunity, while chronic diseases amplify RSV risk. Critically, repeated RSV infections may preferentially boost non-neutralizing antibodies targeting the postfusion F protein, limiting protection and possibly enhancing disease. The review also highlights how newly approved vaccines, based on stabilized prefusion F protein, can overcome these barriers by inducing strong neutralizing responses, offering a targeted strategy to reduce RSV burden in older adults.
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Research summary
Older adults are more prone to respiratory syncytial virus due to factors like structural lung decline and immunosenescence, which limit effective immunity. The paper is relevant as it addresses age-related vulnerabilities and explores potential interventions to improve health outcomes in older adults, aligning with longevity research goals.
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