{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:11:36Z","timestamp":1790187096007,"version":"4.1.0"},"reference-count":96,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EU funding","award":["PE00000007, INF-ACT"],"award-info":[{"award-number":["PE00000007, INF-ACT"]}]},{"name":"EU funding","award":["(COC-1-2023-ISS-01)\u2014CUP I83C22001810007"],"award-info":[{"award-number":["(COC-1-2023-ISS-01)\u2014CUP I83C22001810007"]}]},{"name":"One Health Basic and Translational Research Actions","award":["PE00000007, INF-ACT"],"award-info":[{"award-number":["PE00000007, INF-ACT"]}]},{"name":"One Health Basic and Translational Research Actions","award":["(COC-1-2023-ISS-01)\u2014CUP I83C22001810007"],"award-info":[{"award-number":["(COC-1-2023-ISS-01)\u2014CUP I83C22001810007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Human metapneumovirus (HMPV) is a major cause of acute respiratory tract infections, particularly in infants, young children, older adults, and immunocompromised individuals. Since its discovery in 2001, the virus has been recognized for its significant clinical and socioeconomic impact. Despite extensive research, no licensed vaccines or antiviral therapies are currently available for HMPV. This review aims to synthesize current knowledge on HMPV prevention and treatment, and to highlight promising avenues for future interventions. Several monoclonal antibodies (mAbs) targeting conserved epitopes of the HMPV fusion (F) protein have shown strong neutralizing activity in vitro and in animal models, although none have reached clinical trials. Vaccine development, including subunit, live attenuated, vector-based, and mRNA platforms, is progressing, with some candidates showing promise in adult populations. However, data in children, especially seronegative infants, remain limited. Antiviral research has explored repurposed drugs such as ribavirin and probenecid, along with novel agents like fusion inhibitors and T-cell-based immunotherapies, though none are yet approved. The development of safe, effective interventions\u2014especially multivalent approaches targeting multiple respiratory viruses\u2014remains a high priority. Continued research is essential to bridge the gap between preclinical promise and clinical application and to reduce the burden of HMPV infection worldwide.<\/jats:p>","DOI":"10.3390\/v17081140","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T13:18:14Z","timestamp":1755695894000},"page":"1140","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Human Metapneumovirus: A Narrative Review on Emerging Strategies for Prevention and Treatment"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3468-5568","authenticated-orcid":false,"given":"Nicola","family":"Principi","sequence":"first","affiliation":[{"name":"Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4601-7484","authenticated-orcid":false,"given":"Valentina","family":"Fainardi","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Pietro Barilla Children\u2019s Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4103-2837","authenticated-orcid":false,"given":"Susanna","family":"Esposito","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Pietro Barilla Children\u2019s Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1038\/89098","article-title":"A newly discovered human pneumovirus isolated from young children with respiratory tract disease","volume":"7","author":"Groen","year":"2001","journal-title":"Nat. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1128\/JCM.43.3.1213-1219.2005","article-title":"Seroepidemiology of human metapneumovirus (hMPV) on the basis of a novel enzyme-linked immunosorbent assay utilizing hMPV fusion protein expressed in recombinant vesicular stomatitis virus","volume":"43","author":"Leung","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.jcv.2014.01.003","article-title":"Paediatric human metapneumovirus infection: Epidemiology, prevention and therapy","volume":"59","author":"Principi","year":"2014","journal-title":"J. Clin. Virol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1055\/s-0036-1584800","article-title":"Metapneumovirus Infections and Respiratory Complications","volume":"37","author":"Esposito","year":"2016","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/j.1469-0691.2005.01325.x","article-title":"Human metapneumovirus in paediatric patients","volume":"12","author":"Principi","year":"2006","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e33","DOI":"10.1016\/S2214-109X(20)30393-4","article-title":"Global burden of acute lower respiratory infection associated with human metapneumovirus in children under 5 years in 2018: A systematic review and modelling study","volume":"9","author":"Wang","year":"2021","journal-title":"Lancet Glob. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1002\/jmv.26401","article-title":"Report of death in children with SARS-CoV-2 and human metapneumovirus (hMPV) coinfection: Is hMPV the trigger?","volume":"93","author":"Hashemi","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_8","first-page":"13","article-title":"Severe respiratory failure due to co-infection with human metapneumovirus and Streptococcus pneumoniae","volume":"12","author":"Seki","year":"2014","journal-title":"Respir. Med. Case Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1093\/jpids\/piv027","article-title":"Incidence, Morbidity, and Costs of Human Metapneumovirus Infection in Hospitalized Children","volume":"5","author":"Davis","year":"2016","journal-title":"J. Pediatr. Infect. Dis. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1056\/NEJMc040541","article-title":"Human metapneumovirus and lower respiratory tract disease in children","volume":"350","author":"Principi","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100679","DOI":"10.1016\/j.lanhl.2024.100679","article-title":"The global burden of human metapneumovirus-associated acute respiratory infections in older adults: A systematic review and meta-analysis","volume":"6","author":"Kulkarni","year":"2025","journal-title":"Lancet Healthy Longev."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Goldstein, L.A., Michaels, M.G., Salthouse, A., Toepfer, A.P., Musa, S., Hickey, R.W., Johnson, M., Wang-Erickson, A.F., Weinberg, G.A., and Szilagyi, P.G. (2025). Human Metapneumovirus and Respiratory Syncytial Virus in Children: A Comparative Analysis. Pediatrics, e2024070218.","DOI":"10.1542\/peds.2024-070218"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"7261","DOI":"10.1038\/s41467-025-62358-w","article-title":"Using COVID-19 pandemic perturbation to model RSV-hMPV interactions and potential implications under RSV interventions","volume":"16","author":"Howerton","year":"2025","journal-title":"Nat. Commun."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"105405","DOI":"10.1016\/j.antiviral.2022.105405","article-title":"Antiviral strategies against human metapneumovirus: Targeting the fusion protein","volume":"207","author":"Bergh","year":"2022","journal-title":"Antivir. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1080\/14656566.2025.2495091","article-title":"Past, present and future of respiratory syncytial infection prevention in infants and young children","volume":"26","author":"Esposito","year":"2025","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"105948","DOI":"10.1016\/j.antiviral.2024.105948","article-title":"Direct-acting antivirals for RSV treatment, a review","volume":"229","author":"Bonneux","year":"2024","journal-title":"Antivir. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.ijid.2014.03.1394","article-title":"Human metapneumovirus: Review of an important respiratory pathogen","volume":"25","author":"Panda","year":"2014","journal-title":"Int. J. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1111\/1348-0421.12543","article-title":"A novel 111-nucleotide duplication in the G gene of human metapneumovirus","volume":"61","author":"Saikusa","year":"2017","journal-title":"Microbiol. Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Saikusa, M., Kawakami, C., Nao, N., Takeda, M., Usuku, S., Sasao, T., Nishimoto, K., and Toyozawa, T. (2017). 180-nucleotide duplication in the G gene of human metapneumovirus A2b subgroup strains circulating in Yokohama City, Japan, since 2014. Front. Microbiol., 8.","DOI":"10.3389\/fmicb.2017.00402"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"565","DOI":"10.2217\/fmb-2016-0211","article-title":"Novel human metapneumovirus with a 180-nucleotide duplication in the G gene","volume":"12","author":"Vila","year":"2017","journal-title":"Futur. Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1007\/s11033-022-08092-8","article-title":"The emergence of human metapneumovirus G gene duplication in hospitalized patients with respiratory tract infection, India, 2016\u20132018","volume":"50","author":"Parida","year":"2023","journal-title":"Mol. Biol. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.jcv.2008.03.029","article-title":"Association between high nasopharyngeal viral load and disease severity in children with human metapneumovirus infection","volume":"42","author":"Bosis","year":"2008","journal-title":"J. Clin. Virol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e111","DOI":"10.1086\/504378","article-title":"Differences in clinical severity between genotype A and genotype B human metapneumovirus infection in children","volume":"42","author":"Vicente","year":"2006","journal-title":"Clin. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"102562","DOI":"10.1016\/j.coi.2025.102562","article-title":"Immunological insights into the re-emergence of human metapneumovirus","volume":"94","author":"Acharya","year":"2025","journal-title":"Curr. Opin. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/j.virol.2005.10.016","article-title":"Individual contributions of the human metapneumovirus F, G, and SH surface glycoproteins to the induction of neutralizing antibodies and protective immunity","volume":"345","author":"Skiadopoulos","year":"2006","journal-title":"Virology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1007\/s44162-025-00079-w","article-title":"Rising global threat of human metapneumovirus (hMPV in 2024\/2025): Pathogenesis, immune dynamics, vulnerabilities in immunocompromised individuals, and lessons from past pandemics","volume":"4","author":"Adedokun","year":"2025","journal-title":"J. Rare Dis."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wen, X., Mousa, J.J., Bates, J.T., Lamb, R.A., Crowe, J.E., and Jardetzky, T.S. (2017). Structural basis for antibody cross-neutralization of respiratory syncytial virus and human metapneumovirus. Nat. Microbiol., 2.","DOI":"10.1038\/nmicrobiol.2016.272"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ye, X., Iwuchukwu, O.P., Avadhanula, V., Aideyan, L.O., McBride, T.J., Ferlic-Stark, L.L., Patel, K.D., Piedra, F.-A., Shah, D.P., and Chemaly, R.F. (2019). Antigenic site-specific competitive antibody responses to the fusion protein of respiratory syncytial virus were associated with viral clearance in hematopoietic cell transplantation adults. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.00706"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Huang, J., Diaz, D., Mousa, J.J., and Bukreyev, A. (2020). Antibody recognition of the Pneumovirus fusion protein trimer interface. PLoS Pathog., 16.","DOI":"10.1101\/2020.05.20.107508"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Lee, Y.Z., Han, J., Zhang, Y.N., Ward, G., Gomes, K.B., Auclair, S., Stanfield, R.L., He, L., Wilson, I.A., and Zhu, J. (2024). A tale of two fusion proteins: Understanding the metastability of human respiratory syncytial virus and metapneumovirus and implications for rational design of uncleaved prefusion-closed trimers. bioRxiv.","DOI":"10.1101\/2024.03.07.583986"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e0059321","DOI":"10.1128\/JVI.00593-21","article-title":"Structure, immunogenicity, and conformation-dependent receptor binding of the postfusion human metapneumovirus F protein","volume":"95","author":"Huang","year":"2021","journal-title":"J. Virol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1016\/j.vaccine.2020.01.047","article-title":"Evaluation of pre- and post-fusion Human metapneumovirus F proteins as subunit vaccine candidates in mice","volume":"38","author":"Pilaev","year":"2020","journal-title":"Vaccine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e230023","DOI":"10.1001\/jamanetworkopen.2023.0023","article-title":"Monoclonal Antibody for the Prevention of Respiratory Syncytial Virus in Infants and Children: A Systematic Review and Network Meta-analysis","volume":"6","author":"Sun","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e01068-20","DOI":"10.1128\/JVI.01068-20","article-title":"Respiratory Syncytial Virus and Human Metapneumovirus Infections in Three-Dimensional Human Airway Tissues Expose an Interesting Dichotomy in Viral Replication, Spread, and Inhibition by Neutralizing Antibodies","volume":"94","author":"Kinder","year":"2020","journal-title":"J. Virol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1089\/hyb.2005.24.201","article-title":"Production and characterization of neutralizing monoclonal antibodies against human metapneumovirus F protein","volume":"24","author":"Ma","year":"2005","journal-title":"Hybridoma"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"7799","DOI":"10.1128\/JVI.00318-06","article-title":"Isolation and characterization of monoclonal antibodies which neutralize human metapneumovirus in vitro and in vivo","volume":"80","author":"Ulbrandt","year":"2006","journal-title":"J. Virol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.antiviral.2010.07.001","article-title":"Prophylactic and therapeutic benefits of a monoclonal antibody against the fusion protein of human metapneumovirus in a mouse model","volume":"88","author":"Hamelin","year":"2010","journal-title":"Antivir. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1038\/nature12442","article-title":"Cross-neutralization of four paramyxoviruses by a human monoclonal antibody","volume":"501","author":"Corti","year":"2013","journal-title":"Nature"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1093\/infdis\/jiu307","article-title":"A broadly neutralizing human monoclonal antibody exhibits in vivo efficacy against both human metapneumovirus and respiratory syncytial virus","volume":"211","author":"Schuster","year":"2015","journal-title":"J. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e70094","DOI":"10.1002\/puh2.70094","article-title":"Global Burden of Human Metapneumovirus: Bridging Gaps in Prevention, Diagnostics and Treatment","volume":"4","author":"Adepoju","year":"2025","journal-title":"Public Health Chall."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e732","DOI":"10.1016\/S2666-5247(23)00134-9","article-title":"Neutralising antibodies against human metapneumovirus","volume":"4","author":"Guo","year":"2023","journal-title":"Lancet Microbe"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1016\/j.immuni.2022.07.003","article-title":"Potently neutralizing and protective anti-human metapneumovirus antibodies target diverse sites on the fusion glycoprotein","volume":"55","author":"Rappazzo","year":"2022","journal-title":"Immunity"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1038\/nsmb.2250","article-title":"Structure of the human metapneumovirus fusion protein with neutralizing antibody identifies a pneumovirus antigenic site","volume":"19","author":"Wen","year":"2012","journal-title":"Nat. Struct. Mol. Biol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e00342-19","DOI":"10.1128\/JVI.00342-19","article-title":"A Potent Neutralizing Site III-Specific Human Antibody Neutralizes Human Metapneumovirus In Vivo","volume":"93","author":"Diaz","year":"2019","journal-title":"J. Virol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e2203326119","DOI":"10.1073\/pnas.2203326119","article-title":"Structural basis for ultrapotent antibody-mediated neutralization of human metapneumovirus","volume":"119","author":"Banerjee","year":"2022","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1038\/s41467-022-30205-x","article-title":"Profiling of hMPV F-specific antibodies isolated from human memory B cells","volume":"13","author":"Xiao","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1089\/vim.2017.0137","article-title":"Vaccines for the Paramyxoviruses and Pneumoviruses: Successes, Candidates, and Hurdles","volume":"31","author":"Russell","year":"2018","journal-title":"Viral Immunol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3391","DOI":"10.1099\/vir.0.83250-0","article-title":"Enhanced lung disease and Th2 response following human metapneumovirus infection in mice immunized with the inactivated virus","volume":"88","author":"Hamelin","year":"2007","journal-title":"J. Gen. Virol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"5034","DOI":"10.1016\/j.vaccine.2007.04.075","article-title":"Human metapneumovirus: Enhanced pulmonary disease in cotton rats immunized with formalin-inactivated virus vaccine and challenged","volume":"25","author":"Yim","year":"2007","journal-title":"Vaccine"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"B209","DOI":"10.1016\/j.vaccine.2012.11.106","article-title":"Strategic priorities for respiratory syncytial virus (RSV) vaccine development","volume":"31","author":"Anderson","year":"2013","journal-title":"Vaccine"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1099\/vir.0.2008\/002022-0","article-title":"Generation of temperature-sensitive human metapneumovirus strains that provide protective immunity in hamsters","volume":"89","author":"Herfst","year":"2008","journal-title":"J. Gen. Virol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"15114","DOI":"10.1128\/JVI.79.24.15114-15122.2005","article-title":"Chimeric recombinant human metapneumoviruses with the nucleoprotein or phosphoprotein open reading frame replaced by that of avian metapneumovirus exhibit improved growth in vitro and attenuation in vivo","volume":"79","author":"Pham","year":"2005","journal-title":"J. Virol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1093\/jpids\/pix006","article-title":"Evaluation of a Live Attenuated Human Metapneumovirus Vaccine in Adults and Children","volume":"7","author":"Karron","year":"2018","journal-title":"J. Pediatr. Infect. Dis. Soc."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"12608","DOI":"10.1128\/JVI.79.19.12608-12613.2005","article-title":"Infection of nonhuman primates with recombinant human metapneumovirus lacking the SH, G, or M2-2 protein categorizes each as a nonessential accessory protein and identifies vaccine candidates","volume":"79","author":"Biacchesi","year":"2005","journal-title":"J. Virol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1038\/s41541-024-00899-9","article-title":"Mucosal bivalent live attenuated vaccine protects against human metapneumovirus and respiratory syncytial virus in mice","volume":"9","author":"Brun","year":"2024","journal-title":"npj Vaccines"},{"key":"ref_56","unstructured":"Vaxxel (2025, May 27). Preclinical In Vivo Efficacy Results on Vaxxel\u2019s Intranasal Vaccine Candidate Against Pneumovirus Infections Confirmed Through Study Funded by National Institute of Allergy and Infectious Diseases. Available online: https:\/\/lyonbiopole.com\/wp-content\/uploads\/2024\/10\/Vaxxell-PR-NIAID-20241001-EN-VDEF1.pdf."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Ogonczyk Makowska, D., Hamelin, M.\u00c8., and Boivin, G. (2020). Engineering of Live Chimeric Vaccines against Human Metapneumovirus. Pathogens, 9.","DOI":"10.3390\/pathogens9020135"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1038\/s41541-023-00734-7","article-title":"The road to approved vaccines for respiratory syncytial virus","volume":"8","author":"Ruckwardt","year":"2023","journal-title":"npj Vaccines"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Tariq, H., Batool, S., Asif, S., Ali, M., and Abbasi, B.H. (2022). Virus-Like Particles: Revolutionary Platforms for Developing Vaccines Against Emerging Infectious Diseases. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.790121"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"ofaf160","DOI":"10.1093\/ofid\/ofaf160","article-title":"A Randomized Phase 1 Clinical Trial of a Respiratory Syncytial Virus and Human Metapneumovirus Combination Protein-Based Virus-like Particle Vaccine in Adults 60\u201375 Years of Age","volume":"12","author":"Shapiro","year":"2025","journal-title":"Open Forum Infect. Dis."},{"key":"ref_61","unstructured":"Icosavax (2025, August 19). Icosavax Granted FDA Fast Track Designation for IVX-A12. Available online: https:\/\/drug-dev.com\/icosavax-granted-fda-fast-track-designation-for-rsv-hmpv-vaccine-candidate\/."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Wijesundara, D.K., Avumegah, M.S., Lackenby, J., Modhiran, N., Isaacs, A., Young, P.R., Watterson, D., and Chappell, K.J. (2020). Rapid Response Subunit Vaccine Design in the Absence of Structural Information. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.592370"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"6270","DOI":"10.1038\/s41467-024-50659-5","article-title":"Efficacious human metapneumovirus vaccine based on AI-guided engineering of a closed prefusion trimer","volume":"15","author":"Bakkers","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_64","unstructured":"Food and Drug Administration (2025, May 05). Vaccines and Related Biological Products Advisory Committee Meeting, Available online: https:\/\/www.fda.gov\/advisory-committees\/vaccines-and-related-biological-products-advisory-committee\/2024-meeting-materials-vaccines-and-related-biological-products-advisory-committee."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"ofac206","DOI":"10.1093\/ofid\/ofac206","article-title":"Safety and immunogenicity of an mRNA-based human metapneumovirus and parainfluenza virus type 3 combined vaccine in healthy adults","volume":"9","author":"August","year":"2022","journal-title":"Open Forum Infect. Dis."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e2023064748","DOI":"10.1542\/peds.2023-064748","article-title":"Safety and Immunogenicity of an mRNA-Based hMPV\/PIV3 Combination Vaccine in Seropositive Children","volume":"153","author":"Essink","year":"2024","journal-title":"Pediatrics"},{"key":"ref_67","unstructured":"Sanofi (2025, May 25). Study of a Human Metapneumovirus\/Respiratory Syncytial Virus mRNA Vaccine Candidate Encapsulated in a Lipid Nanoparticle-Based Formulation in Adults Aged 60 Years and Older. Available online: https:\/\/www.sanofistudies.com\/us\/en\/listing\/312997\/study-of-a-human\/#original."},{"key":"ref_68","first-page":"2293300","article-title":"Development of a novel multi-epitope mRNA vaccine candidate to combat HMPV virus","volume":"19","author":"Ma","year":"2023","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1099\/vir.0.000083","article-title":"Recent vaccine development for human metapneumovirus","volume":"96","author":"Ren","year":"2015","journal-title":"J. Gen. Virol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1007\/s00109-001-0308-0","article-title":"Ribavirin\u2019s antiviral mechanism of action: Lethal mutagenesis?","volume":"80","author":"Crotty","year":"2002","journal-title":"J. Mol. Med."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0166-3542(03)00153-0","article-title":"Comparison of the inhibition of human metapneumovirus and respiratory syncytial virus by ribavirin and immune serum globulin in vitro","volume":"60","author":"Wyde","year":"2003","journal-title":"Antivir. Res."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1128\/AAC.50.2.774-777.2006","article-title":"Effect of ribavirin and glucocorticoid treatment in a mouse model of human metapneumovirus infection","volume":"50","author":"Hamelin","year":"2006","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/j.1365-2141.2009.07654.x","article-title":"Successful treatment of human metapneumovirus pneumonia using combination therapy with intravenous ribavirin and immune globulin","volume":"145","author":"Bonney","year":"2009","journal-title":"Br. J. Haematol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1038\/sj.bmt.1705781","article-title":"Human metapneumovirus infection in a hematopoietic transplant recipient","volume":"40","author":"Kamble","year":"2007","journal-title":"Bone Marrow Transplant."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1002\/pbc.23019","article-title":"Treatment with oral ribavirin and IVIG of severe human metapneumovirus pneumonia (HMPV) in immune compromised child","volume":"57","author":"Kassis","year":"2011","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1111\/j.1399-3062.2010.00575.x","article-title":"The human metapneumovirus: A case series and review of the literature","volume":"13","author":"Shahda","year":"2011","journal-title":"Transplant. Infect. Dis."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e311","DOI":"10.1097\/MPH.0b013e3182915d2d","article-title":"Treatment of severe human metapneumovirus (hMPV) pneumonia in an immunocompromised child with oral ribavirin and IVIG","volume":"35","author":"Kitanovski","year":"2013","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1128\/CVI.00230-15","article-title":"New Approaches for Immunization and Therapy against Human Metapneumovirus","volume":"22","author":"Wen","year":"2015","journal-title":"Clin. Vaccine Immunol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"4620","DOI":"10.1128\/AAC.00709-16","article-title":"Antiviral Activity of Favipiravir (T-705) against a Broad Range of Paramyxoviruses In Vitro and against Human Metapneumovirus in Hamsters","volume":"60","author":"Jochmans","year":"2016","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1128\/AAC.01532-12","article-title":"Targeting organic anion transporter 3 with probenecid as a novel anti-influenza a virus strategy","volume":"57","author":"Perwitasari","year":"2013","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.bbrc.2017.01.005","article-title":"c-Jun N-terminal kinase activity is required for efficient respiratory syncytial virus production","volume":"483","author":"Caly","year":"2017","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Bergeron, H.C., Crabtree, J., Nagy, T., Martin, D.E., and Tripp, R.A. (2024). Probenecid Inhibits Human Metapneumovirus (HMPV) Replication In Vitro and in BALB\/c Mice. Viruses, 16.","DOI":"10.3390\/v16071087"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Martin, D.E., Pandey, N., Chavda, P., Singh, G., Sutariya, R., Sancilio, F., and Tripp, R.A. (2023). Oral Probenecid for Nonhospitalized Adults with Symptomatic Mild-to-Moderate COVID-19. Viruses, 15.","DOI":"10.3390\/v15071508"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"2709","DOI":"10.1099\/vir.0.2008\/003301-0","article-title":"Effect of NMSO3 treatment in a murine model of human metapneumovirus infection","volume":"89","author":"Spetch","year":"2008","journal-title":"J. Gen. Virol."},{"key":"ref_85","first-page":"2","article-title":"DAS181 Blocks Respiratory Syncytia Virus Infection of Hep-2 Cells","volume":"8","author":"Boivin","year":"2016","journal-title":"J. Antivir. Antiretrovir."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1177\/2040206616665971","article-title":"Effect of sialidase fusion protein (DAS 181) on human metapneumovirus infection of Hep-2 cells","volume":"24","author":"Thammawat","year":"2015","journal-title":"Antivir. Chem. Chemother."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"3230","DOI":"10.1128\/JVI.06706-11","article-title":"Human metapneumovirus (HMPV) binding and infection are mediated by interactions between the HMPV fusion protein and heparan sulfate","volume":"86","author":"Chang","year":"2012","journal-title":"J. Virol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"2040206619830197","DOI":"10.1177\/2040206619830197","article-title":"A medium-throughput screen for inhibitors of human metapneumovirus","volume":"27","author":"Becker","year":"2019","journal-title":"Antivir. Chem. Chemother."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1006\/viro.1996.0459","article-title":"Peptides corresponding to the heptad repeat sequence of human parainfluenza virus fusion protein are potent inhibitors of virus infection","volume":"223","author":"Yao","year":"1996","journal-title":"Virology"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/S0006-291X(03)00197-9","article-title":"Both heptad repeats of human respiratory syncytial virus fusion protein are potent inhibitors of viral fusion","volume":"302","author":"Wang","year":"2003","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"9770","DOI":"10.1073\/pnas.91.21.9770","article-title":"Peptides corresponding to a predictive alpha-helical domain of human immunodeficiency virus type 1 gp41 are potent inhibitors of virus infection","volume":"91","author":"Wild","year":"1994","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1128\/AAC.00793-07","article-title":"Identification and evaluation of a highly effective fusion inhibitor for human metapneumovirus","volume":"52","author":"Deffrasnes","year":"2008","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"5278","DOI":"10.1128\/AAC.00771-12","article-title":"Inhibition of human respiratory syncytial virus infectivity by a dendrimeric heparan sulfate-binding peptide","volume":"56","author":"Donalisio","year":"2012","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.antiviral.2004.02.006","article-title":"Comparison of the inhibition of human metapneumovirus and respiratory syncytial virus by NMSO3 in tissue culture assays","volume":"63","author":"Wyde","year":"2004","journal-title":"Antivir. Res."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Ciejka, J., Botwina, P., Nowakowska, M., Szczubia\u0142ka, K., and Pyrc, K. (2019). Synthetic sulfonated derivatives of poly(allylamine hydrochloride) as inhibitors of human metapneumovirus. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0214646"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.jtct.2023.12.135","article-title":"ALVR106, an Off-the-Shelf, Multivirus-Specific T-Cell Therapy, for the Treatment of Respiratory Viral Infections: Results from a Phase 1, First-in-Human, Dose-Ranging Trial","volume":"30","author":"Nikiforow","year":"2024","journal-title":"Transplant. Cell Ther."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/8\/1140\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:31:28Z","timestamp":1760034688000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/8\/1140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":96,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["v17081140"],"URL":"https:\/\/doi.org\/10.3390\/v17081140","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,20]]}}}