Status and outlook of mRNA therapeutics for viral diseases

Endemic and emerging viral diseases continue to impose significant health, economic, and societal burdens worldwide. Vaccines and therapeutics represent two key pillars in the fight against these threats. Since the clinical success of mRNA vaccines during the COVID-19 pandemic, mRNA therapeutics have rapidly evolved from a niche innovation into a validated and versatile medical platform. While early efforts focused primarily on vaccine development, recent advances have expanded the scope to antiviral applications of in vitro-transcribed mRNA. Emerging strategies include in vivo expression of neutralizing antibodies for passive immunization, delivery of innate immune effectors such as interferons and antiviral peptides, and programmable CRISPR-based antiviral systems. In parallel, progress in mRNA delivery technologies has enabled clinical translation, although challenges related to stability, specificity, and immunogenicity remain. In this Perspective article, we review recent preclinical and clinical advances in mRNA therapeutics for viral infections. We also highlight key scientific, technical, and regulatory challenges, and propose strategic solutions to address the pressing need for controlling endemic viral diseases and enhancing global pandemic preparedness.