Published April 8, 2020
Mark D. Hicar, MD, PhD, assistant professor of pediatrics, is leading a clinical study that investigates why the novel coronavirus is so potentially devastating for adults but well tolerated in most children.
The research is exploring the possibility that the difference in the way COVID-19 affects children and adults lies in the kinds of antibodies produced to fight the infection.
He has spent his career studying how B cells, the cells that produce antibodies, respond to inflammation in Kawasaki disease, which affects very young children and causes severe cardiac damage if untreated, and HIV.
The current study began enrolling patients the last week of March and involves collecting and characterizing B cells from patients of all ages with COVID-19.
“Our hypothesis is that since even very young children seem to be protected from COVID-19’s effects, older adults may have abnormal antibody responses to this virus,” Hicar says.
“To study this question, we will look at the overall stimulation of B cell responses during infection with COVID-19,” he says.
The research will explore how those B cell responses target the spike protein of the virus, which sticks out around its surface like the top of a crown, hence the name coronavirus.
This protein is known to attach tightly to human lung cells and — with the associated structural proteins — forms a complex with a membrane that surrounds and protects the genetic instructions of the virus.
“We know from the immune responses to other coronaviruses, such as MERS and SARS-CoV-1, that neutralizing antibodies predominantly target the receptor binding domain of the spike protein,” Hicar says.
“By studying the COVID-19 antibody responses of individuals of all ages, we hope to elucidate what the antibodies target during natural infection,” he adds. “That information should allow us to characterize what might work in a potential treatment, as well as lay a foundation for formulating a potential vaccine against SARS-CoV-2.”
The COVID-19 study is funded by the Department of Pediatrics.