Rotavirus infection: current state and prospects for control using RNA technologies

Background. Rotavirus infection remains the leading cause of severe gastroenteritis in children under 5 years of age, particularly in low-income countries. Existing live oral vaccines have reduced efficacy in regions with high infection rates, and there is no etiological treatment available. Consequently, new platforms are being actively investigated: mRNA vaccines (capable of overcoming maternal antibody interference) and RNA interference (allowing for direct suppression of viral replication). The aim of this review is to systematize data on the molecular mechanisms of rotavirus replication and pathogenesis, epidemiology, and diagnosis, as well as to provide a comparative analysis of current vaccines and promising RNA technologies (mRNA vaccines, RNA interference) for the prevention and treatment of rotavirus infection. Objectives: to describe the structure and replication of the virus, the epidemiological situation, and diagnostic methods; to evaluate existing vaccines; and to analyze two areas of RNA technology: mRNA vaccines, as prevention, and RNA interference, as therapy based on siRNA, miRNA, and lncRNA. Conclusions. Conventional vaccines remain the foundation of mass vaccination programs, despite their limitations. mRNA vaccines (especially trivalent ones based on VP8*) induce durable humoral and cellular immunity in preclinical studies, overcoming maternal antibody interference. RNA interference (siRNA, miRNA) allows for direct suppression of viral replication. However, at present, no mRNA candidate vaccine has advanced to the clinical trial phase. Further research is needed to improve vaccine delivery systems and increase its thermal stability.