{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:08:56Z","timestamp":1784534936634,"version":"3.55.0"},"reference-count":63,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Respiratory syncytial virus (RSV) remains a major cause of severe lower respiratory tract infection in early infancy, a period characterized by immunological immaturity and limited capacity for effective antiviral responses. Maternal RSV vaccination has emerged as a successful strategy to protect newborns by inducing high concentrations of IgG1-dominant, prefusion F-specific antibodies, which are selectively and actively transported across the placenta. This review synthesizes current mechanistic insights into how maternally derived antibodies confer neonatal protection, focusing on (i) FcRn-mediated transplacental transport, (ii) IgG subclass-specific differences in transfer and half-life, and (iii) the role of Fc glycosylation in modulating Fc\u03b3 receptor engagement and effector functions. Beyond neutralization, vaccine-induced antibodies mediate Fc-dependent mechanisms such as antibody-dependent cellular cytotoxicity and phagocytosis, which may be preferentially enriched in the neonatal circulation. Although emerging systems serology data suggest qualitative selectivity in placental transfer, evidence remains heterogeneous and highlights the need for further clarification of glycosylation-dependent and glycosylation-independent pathways. The timing of vaccination, maternal antibody characteristics, and placental integrity critically influence neonatal antibody levels and the duration of passive immunity. Understanding these molecular determinants is essential for optimizing maternal RSV immunization strategies and improving early-life protection.<\/jats:p>","DOI":"10.3390\/ijms27146363","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:54:13Z","timestamp":1784534053000},"page":"6363","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immune Mechanisms Underlying Neonatal Protection Following Maternal RSV Vaccination"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9065-7971","authenticated-orcid":false,"given":"Aikaterini I.","family":"Nikolaou","sequence":"first","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of Ioannina, 45500 Ioannina, Greece"},{"name":"Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5679-3850","authenticated-orcid":false,"given":"Vasileios","family":"Giapros","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Alexandra","family":"Kefala","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos G.","family":"Papanikolaou","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Baltogianni","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, School of Medicine, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1090-3698","authenticated-orcid":false,"given":"Fani","family":"Ladomenou","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/S0140-6736(17)30938-8","article-title":"Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: A systematic review and modelling study","volume":"390","author":"Shi","year":"2017","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jaci.2025.10.023","article-title":"A promise fulfilled: Updates on respiratory syncytial virus vaccines and monoclonal antibodies","volume":"157","author":"Murray","year":"2026","journal-title":"J. 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