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Principal Investigator: Rebecca Powell
Organization: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Fiscal Year: 2021
Award: $668,126
Funding agency: National Institute of Allergy and Infectious Diseases
Project Summary
SARS-CoV-2, commonly termed COVID-19 for the illness it causes, has infected >4.1 million people,
including >240,000 deaths. Though COVID-19 pathology in children is believed to be relatively mild compared
to adults, approximately 10% of infants experience severe COVID-19 illness requiring advanced care, and
recently, a possible link has been reported between COVID-19 and a serious inflammatory disease recently
termed “Pediatric Multi-System Inflammatory Syndrome Temporally Associated with COVID-19” (1-4).
Furthermore, as COVID-19 symptoms do not appear to correlate with transmissibility, infants and young
children are likely responsible for a significant amount of SARS-CoV-2 dissemination (5-7). Clearly, protecting
this population from infection remains essential. One potential mechanism of protection in babies is the passive
immunity provided through breastfeeding by a previously-infected mother, and if the SARS-CoV-2 antibody
(Ab) response in milk is potent, these Abs may be highly beneficial as a COVID-19 therapeutic. These milk Abs
may be effective in treating COVID-19 by providing secretory (s) IgA and sIgM Abs, the major Ab components
in milk. Abs of the s class are resistant to proteolytic degradation and likely highly functional in respiratory
tissue (2, 6). Nearly all sIgA/sIgM in milk is derived from the mucosal immune system, including the respiratory
tract; therefore, we should expect a SARS-CoV-2-reactive sIgA/sIgM response, though the magnitude,
functionality, and durability of this response remains unknown. As such, SARS-CoV-2-reactive milk Abs must
be comprehensively studied for their potential therapeutic and protective efficacy. Towards that aim, we have
recruited over 1600 lactating participants, including over 600 who have recovered from COVID-19 illness. Our
pilot data using 15 samples found 93% obtained post-COVID-19 contain SARS-CoV-2-reactive sIgA Abs.
Based on this early evidence, our proposed project intends to: (a) Measure the SARS-CoV-2-reactive Abs in
milk following infection and the long-term durability of this response; (b) Determine the neutralization capacity
of these Abs; and (c) Evaluate the non-neutralizing, Fc-mediated functionality of these Abs. This
comprehensive research will determine if COVID19-specific Abs in milk have protective biologic functions and
should be considered as a source of therapeutic Abs. These data would provide a foundation for ‘convalescent
milk Ab’ efficacy studies, and have implications beyond the pandemic, serving to fill a relatively large
knowledge gap regarding human milk immunology.
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therapeutics><COVID-19 therapy><COVID-19 treatment><COVID-19 virus><COVID19><COVID19 S protein><COVID19 crisis><COVID19 epidemic><COVID19 global health crisis><COVID19 global pandemic><COVID19 health crisis><COVID19 infection><COVID19 pandemic><COVID19 public health crisis><COVID19 spike glycoprotein><COVID19 spike protein><COVID19 therapeutics><COVID19 therapy><COVID19 treatment><COVID19 virus><CV-19><CV19><Caring><Cell Body><Cells><Cessation of life><Child><Child Youth><Children (0-21)><CoV emergence><CoV-2><CoV2><Data><Death><Deposit><Deposition><Digestive Tract><Disease><Disorder><Enrollment><Exocrine IgA><Foundations><GI Tract><Gastrointestinal Tract><Gastrointestinal tract structure><High Throughput Assay><Human Milk><Human Mother's Milk><IgA><IgG><IgM><Immune Globulins><Immune response><Immunity><Immunoglobulin A><Immunoglobulin G><Immunoglobulin M><Immunoglobulins><Immunological response><Immunology><Infant><Infection><Infection 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Respiratory Syndrome-related coronavirus 2><Severe acute respiratory syndrome associated corona virus 2><Severe acute respiratory syndrome corona virus 2><Severe acute respiratory syndrome coronavirus 2><Severe acute respiratory syndrome coronavirus 2 S protein><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 infection><Severe acute respiratory syndrome coronavirus 2 inhibitor><Severe acute respiratory syndrome coronavirus 2 pandemic><Severe acute respiratory syndrome coronavirus 2 spike glycoprotein><Severe acute respiratory syndrome coronavirus 2 spike protein><Severe acute respiratory syndrome coronavirus 2 therapeutics><Severe acute respiratory syndrome related corona virus 2><Source><Symptoms><Therapeutic><Therapeutic Uses><Therapeutic antibodies><Tissues><Treatment Efficacy><Viral Activity><Viral Diseases><Viral Function><Viral Physiology><Virus Diseases><Work><Wuhan coronavirus><adulthood><alimentary tract><anti-viral 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