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A ce jour, seul le palivizumab, un AcM humanisé recombinant dirigé contre un épitope conservé de la protéine F, est indiqué pour la prévention des infections respiratoires basses graves dues au RSV nécessitant une hospitalisation chez les enfants à risque élevé (nés avant 35 SA et de moins de 6 mois au début de l’épidémie, enfants de moins de 2 ans atteints de cardiopathie congénitale avec retentissement hémodynamique ou dysplasie bronchopulmonaire).
Un nouvel AcM, le nirsevimab, a obtenu le 31 octobre 2022 l’autorisation de l’Agence Européenne du médicament pour la prévention des infections par le RSV chez les jeunes enfants. Il s’agit d’un AcM monoclonal recombinant d’isotype IgG1k qui cible la conformation pré-F de la protéine F du RSV, modifié de façon à avoir une demi-vie plasmatique longue et actif sur les RSV de types A et B. Cette autorisation est basée sur les résultats d’études cliniques menées chez des enfants prématurés ou nés à terme et plus récemment chez des nourrissons avec une pathologie à risque d’infection sévère par le RSV. Le traitement consiste en une injection intra-musculaire unique chez les enfants nés avant ou pendant la saison épidémique de circulation du RSV. L’étude de phase IIb, publiée en 2020, menée dans 23 pays, était une étude randomisée en double aveugle traitement contre placebo, ratio 2:1, réalisée chez 1453 enfants nés prématurément (i.e. entre 29 et 35 semaines d’aménorrhée [SA]). Dans cette étude, 2,5% des enfants traités par nirsevimab (n=25/949) ont présenté une infection par le RSV nécessitant une prise en charge médicale dans les 150 jours post-injection contre 9,5% dans le groupe placebo (n=46/484) (Griffin et al. 2020). Dans l’essai de phase III (Melody) mené dans 21 pays chez 1490 nourrissons en bonne santé nés à terme ou peu prématurés (35 semaines de gestation ou plus), 1,2% des enfants traités par nirsevimab (n=12/994) ont présenté une infection par le RSV nécessitant une prise en charge médicale dans les 150 jours post-injection contre 5% dans le groupe placebo (n=25/496) (Hammitt et al. 2022). L’analyse groupée de ces deux essais montre une diminution de 77,3% (intervalle de confiance à 95% [50,3 ; 89,7] ; P<0,001) des hospitalisations pour infections des voies respiratoires inférieures causées par le RSV.
Parallèlement, plusieurs candidats vaccins sont en évaluation clinique dont certains en phase III : des vaccins sous-unitaires pré-F (RSVPre-F3 [GSK] ; RSVPreF [Pfizer]), un vaccin ARNm pré-F (mRNA-1345 [Moderna]) et des vaccins à vecteur recombinant (MVA-BN RSV [Bavarian Nordic] ; AD26.RSV.PreF [Johnson et Johnson]). Ces vaccins sont évalués dans deux populations : les femmes enceintes, avec l’objectif de protéger les nourrissons pendant les premiers mois de vie, et les personnes âgées, à risque d’infections respiratoires sévères par le RSV. Les données préliminaires récemment publiées pour un des vaccins sous-unitaires (RSVpre-F [Pfizer]) montrent une bonne tolérance pendant la grossesse, des titres élevés d’AcN et la transmission de ces AcN au nouveau-né et suggèrent une protection vis-à-vis des infections pendant les premiers mois de vie (Simões et al. 2022).
Le positionnement de ces différentes stratégies chez les populations à risque sera à évaluer dans les années qui viennent. Leur déploiement éventuel devra s’accompagner d’une surveillance génomique virale accrue pour détecter l’émergence de mutations associées à un échappement à l’action des anticorps neutralisants. Une autre problématique est leur accessibilité dans les pays à revenu faible, alors que c’est dans ces pays que la mortalité infantile en lien avec les infections par le RSV est la plus importante. A suivre donc …
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Ronaldo de Asis Moreira https://ronaldinhogaucho.prostoprosport-br.com Brazilian footballer, played as an attacking midfielder and striker. World Champion (2002). Winner of the Golden Ball (2005). The best football player in the world according to FIFA in 2004 and 2005.
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Erling Breut Haaland https://erling-haaland.prostoprosport-br.com Futebolista noruegues, atacante do clube ingles Manchester City e Selecao da Noruega. Detentor do recorde da Premier League inglesa em gols por temporada.
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Philippe Coutinho Correia https://philippecoutinho.prostoprosport-br.com Brazilian footballer, midfielder of the English club Aston Villa, playing on loan for the Qatari club Al-Duhail. He is known for his vision, passing, dribbling and long-range ability.
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Carlos Henrique Casimiro https://carloscasemiro.prostoprosport-br.com Futebolista brasileiro, volante do clube ingles Manchester United e capitao do Selecao Brasileira. Pentacampeao da Liga dos Campeoes da UEFA, campeao mundial e sul-americano pela selecao juvenil brasileira.
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Kylian Mbappe Lotten https://kylianmbappe.prostoprosport-br.com Futebolista frances, atacante do Paris Saint-Germain e capitao da selecao francesa equipe . Em 1? de julho de 2024, ele se tornara jogador do clube espanhol Real Madrid.
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Kaka https://kaka.prostoprosport-br.com Futebolista brasileiro, meio-campista. O apelido “Kaka” e um diminutivo de Ricardo. Formado em Sao Paulo. De 2002 a 2016, integrou a Selecao Brasileira, pela qual disputou 92 partidas e marcou 29 gols. Campeao mundial 2002.
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Karim Mostafa Benzema https://karim-benzema.prostoprosport-br.com Futebolista frances, atacante do clube saudita Al-Ittihad . Jogou pela selecao francesa, pela qual disputou 97 partidas e marcou 37 gols.
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Lionel Messi https://lionelmessi.prostoprosport-br.com e um jogador de futebol argentino, atacante e capitao do clube da MLS Inter Miami. , capitao da selecao argentina. Campeao mundial, campeao sul-americano, vencedor da Finalissima, campeao olimpico. Considerado um dos melhores jogadores de futebol de todos os tempos.
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Mohamed Salah https://mohamedsalah.prostoprosport-br.com e um futebolista egipcio que joga como atacante do clube ingles Liverpool e do Selecao egipcia. Considerado um dos melhores jogadores de futebol do mundo. Tricampeao da Chuteira de Ouro da Premier League inglesa: em 2018 (sozinho), 2019 (junto com Sadio Mane e Pierre-Emerick Aubameyang) e 2022 (junto com Son Heung-min).
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Harry Kane https://harry-kane.prostoprosport-br.com recebeu um convite para a selecao sub-alterna da Inglaterra pela primeira vez tempo 17 para o torneio juvenil em Portugal. Ao mesmo tempo, o atacante, devido a doenca grave, nao compareceu ao triunfante Campeonato Europeu Sub-17 masculino de 2010 pelos britanicos.
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Jude Bellingham https://jude-bellingham.prostoprosport-br.com Futebolista ingles, meio-campista do clube espanhol Real Madrid e do Selecao da Inglaterra. Em abril de 2024, ele ganhou o premio Breakthrough of the Year do Laureus World Sports Awards. Ele se tornou o primeiro jogador de futebol a recebe-lo.
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Thibaut Nicolas Marc Courtois https://thhibaut-courtois.prostoprosport-fr.com Footballeur belge, gardien de but du club espagnol du Real Madrid . Lors de la saison 2010/11, il a ete reconnu comme le meilleur gardien de la Pro League belge, ainsi que comme joueur de l’annee pour Genk. Triple vainqueur du Trophee Ricardo Zamora
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Robert Lewandowski https://robert-lewandowski.prostoprosport-br.com e um futebolista polones, atacante do clube espanhol Barcelona e capitao da selecao polonesa. Considerado um dos melhores atacantes do mundo. Cavaleiro da Cruz do Comandante da Ordem do Renascimento da Polonia.
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Gareth Frank Bale https://garethbale.prostoprosport-br.com Jogador de futebol gales que atuou como ala. Ele jogou na selecao galesa. Ele se destacou pela alta velocidade e um golpe bem colocado. Artilheiro (41 gols) e recordista de partidas disputadas (111) na historia da selecao.
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Kevin De Bruyne https://kevin-de-bruyne.prostoprosport-br.com Futebolista belga, meio-campista do Manchester club City” e a selecao belga. Formado pelos clubes de futebol “Ghent” e “Genk”. Em 2008 iniciou sua carreira adulta, fazendo sua estreia no Genk.
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Ederson Santana de Moraes https://edersonmoraes.prostoprosport-br.com Futebolista brasileiro, goleiro do clube Manchester City e da Selecao Brasileira . Participante do Campeonato Mundial 2018. Bicampeao de Portugal pelo Benfica e pentacampeao de Inglaterra pelo Manchester City.
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Antoine Griezmann https://antoine-griezmann.prostoprosport-br.com Futebolista frances, atacante e meio-campista do Atletico de Madrid. Jogador e vice-capitao da selecao francesa, integrante da selecao – campea mundial 2018. Medalhista de prata no Europeu de 2016 e no Mundial de 2022.
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Virgil van Dijk https://virgilvandijk.prostoprosport-br.com Futebolista holandes, zagueiro central, capitao do clube ingles Liverpool e capitao do a selecao holandesa.
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Victor James Osimhen https://victor-osimhen.prostoprosport-br.com e um futebolista nigeriano que atua como atacante. O clube italiano Napoli e a selecao nigeriana.
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Romelu Menama Lukaku Bolingoli https://romelulukaku.prostoprosport-br.com Futebolista belga, atacante do clube ingles Chelsea e da selecao belga . Por emprestimo, ele joga pelo clube italiano Roma.
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Roberto Carlos da Silva Rocha https://roberto-carlos.prostoprosport-br.com Brazilian footballer, left back. He was also capable of playing as both a central defender and a defensive midfielder. World champion 2002, silver medalist at the 1998 World Championships.
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Thomas Mueller https://thomasmueller.prostoprosport-br.com is a German football player who plays for the German Bayern Munich. Can play in different positions – striker, attacking midfielder. The most titled German footballer in history
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Neymar da Silva Santos Junior https://neymar.prostoprosport-br.com e um futebolista brasileiro que atua como atacante, ponta e atacante. meio-campista do clube saudita Al-Hilal e da selecao brasileira. Considerado um dos melhores jogadores do mundo. O maior artilheiro da historia da Selecao Brasileira.
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Edson Arantes do Nascimento https://pele.prostoprosport-br.com Brazilian footballer, forward (attacking midfielder. Played for Santos clubs) and New York Cosmos. Played 92 matches and scored 77 goals for the Brazilian national team.
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Jude Victor William Bellingham https://jude-bellingham.prostoprosport-cz.org anglicky fotbalista, zaloznik spanelskeho klubu Real Madrid a anglicky narodni tym. V dubnu 2024 ziskal cenu za prulom roku z Laureus World Sports Awards. Stal se prvnim fotbalistou, ktery ji obdrzel.
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Erling Breut Haaland https://erling-haaland.prostoprosport-cz.org je norsky fotbalista, ktery hraje jako utocnik za Anglicky klub Manchester City a norska reprezentace. Rekordman anglicke Premier League v poctu golu za sezonu.
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Harry Kane https://harry-kane.prostoprosport-cz.org dostal pozvanku do anglickeho tymu nezletilych jako prvni cas 17. na turnaj mladeze v Portugalsku. Utocnik se zaroven kvuli vazne nemoci neobjevil na triumfalnim mistrovstvi Evropy muzu do 17 let 2010 pro Brity.
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Mohamed Salah https://mohamed-salah.prostoprosport-cz.org je egyptsky fotbalista, ktery hraje jako utocnik za anglictinu. klub Liverpool a egyptsky narodni tym. Povazovan za jednoho z nejlepsich fotbalistu na svete.
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Vinicius Jose Paixan de Oliveira Junior vinicius-junior.prostoprosport-cz.org bezne znamy jako Vinicius Junior je brazilsky a spanelsky fotbalista , utocnik klubu Real Madrid a brazilsky reprezentant.
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Kevin De Bruyne https://kevin-de-bruyne.prostoprosport-cz.org Belgicky fotbalista, zaloznik Manchesteru klub City” a belgicky narodni tym. Absolvent fotbalovych klubu „Ghent” a „Genk”. V roce 2008 zahajil svou karieru dospelych, debutoval v Genku.
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Bernardo Silva https://bernardo-silva.prostoprosport-cz.org Portugalsky fotbalista, zaloznik. Narozen 10. srpna 1994 v Lisabonu. Silva je povazovan za jednoho z nejlepsich utocnych zalozniku na svete. Fotbalista je povestny svou vytrvalosti a vykonem.
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Lionel Messi https://lionel-messi.prostoprosport-cz.org je argentinsky fotbalista, utocnik a kapitan klubu MLS Inter Miami. , kapitan argentinske reprezentace. Mistr sveta, vitez Jizni Ameriky, vitez finale, olympijsky vitez. Povazovan za jednoho z nejlepsich fotbalistu vsech dob.
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Antoine Griezmann https://antoine-griezmann.prostoprosport-cz.org Francouzsky fotbalista, utocnik a zaloznik za Atletico de Madrid. Hrac a vicekapitan francouzskeho narodniho tymu, clen tymu – mistr sveta 2018 Stribrny medailista z mistrovstvi Evropy 2016 a mistrovstvi sveta 2022.
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Robert Lewandowski https://robert-lewandowski.prostoprosport-cz.org je polsky fotbalista, utocnik spanelskeho klubu Barcelona a kapitan polskeho narodniho tymu. Povazovan za jednoho z nejlepsich utocniku na svete. Rytir krize velitele polskeho renesancniho radu.
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Luka Modric https://luka-modric.prostoprosport-cz.org je chorvatsky fotbalista, stredni zaloznik a kapitan spanelskeho tymu. klub Real Madrid, kapitan chorvatskeho narodniho tymu. Uznavan jako jeden z nejlepsich zalozniku nasi doby. Rytir Radu prince Branimira. Rekordman chorvatske reprezentace v poctu odehranych zapasu.
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Son Heung Min https://son-heung-min.prostoprosport-cz.org Jihokorejsky fotbalista, utocnik a kapitan anglickeho klubu Premier League Tottenham Hotspur a narodniho tymu Korejske republiky. V roce 2022 vyhral Zlatou kopacku Premier League.
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Pablo Martin Paez Gavira https://gavi.prostoprosport-cz.org Spanelsky fotbalista, zaloznik barcelonskeho klubu a spanelske reprezentace. Povazovan za jednoho z nejtalentovanejsich hracu sve generace. Ucastnik mistrovstvi sveta 2022. Vitez Ligy narodu UEFA 2022/23
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Cristiano Ronaldo https://cristiano-ronaldo.prostoprosport-cz.org je portugalsky fotbalista, utocnik, kapitan Saudske Arabie klubu An-Nasr a portugalskeho narodniho tymu. Mistr Evropy. Povazovan za jednoho z nejlepsich fotbalistu vsech dob. Nejlepsi strelec v historii fotbalu podle IFFIS a ctvrty podle RSSSF