Subhashini Sellers, MD, MSc, assistant professor in the division of pulmonary and critical care medicine, has received pilot funding from the UNC Center for Environmental Health Sciences to study the upper respiratory immune response in COVID-19.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and resulting Coronavirus disease 2019 (COVID-19) represents a viral pandemic presently threatening global public health. Understanding the mechanisms resulting in severe disease is now an urgent research priority. While there is evidence of increased systemic inflammation among patients with severe illness, little is known about the immune response to SARS-CoV-2 in the upper respiratory tract (URT)– the primary site of virus infection and replication – and how it is impacted by demographic and environmental factors. A coordinated URT response is critical in clearance of infected respiratory epithelial cells and controlling viral replication. A novel, non-invasive nasal epithelial lining fluid (NELF) sampling method has been developed, allowing quantification of soluble mediators and viral RNA to characterize the URT immune response and viral replication. Extensive work demonstrates that inhaled environmental exposures and demographic factors are associated with dysfunctional URT immune response to viruses, some of which are implicated in COVID-19 severity. Understanding the relationship between the URT immune response, viral replication, extrinsic and intrinsic risk factors, and disease severity in COVID-19 is essential to identifying predictive biomarkers that allow the rapid identification of patients who will develop severe disease and potentially treatment targets to prevent severe disease.
The study’s co-investigators include William Fischer, MD, Ilona Jaspers, PhD, Meghan Rebuli, PhD, Natalie Bowman, MD, MPH, and David Wohl, MD. Collaborators include Jessica Lin, MD, MSCR, Ross Boyce, MD, MSc, and Emily Ciccone, MD, MHS.