Comprehensive assessment of SARS-CoV-2-reactive antibodies in human milk to determine their potential as a COVID-19 therapeutic and as a means to prevent infection of breastfed babies

  • Funded by National Institutes of Health (NIH)
  • Total publications:0 publications

Grant number: unknown

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Key facts

  • Disease

    COVID-19
  • Start & end year

    2020
    2023
  • Known Financial Commitments (USD)

    $793,353
  • Funder

    National Institutes of Health (NIH)
  • Principle Investigator

    Pending
  • Research Location

    United States of America, Americas
  • Lead Research Institution

    ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
  • Research Category

    Pathogen: natural history, transmission and diagnostics

  • Research Subcategory

    Immunity

  • Special Interest Tags

    Gender

  • Study Subject

    Non-Clinical

  • Clinical Trial Details

    N/A

  • Broad Policy Alignment

    Pending

  • Age Group

    Adults (18 and older)

  • Vulnerable Population

    Other

  • Occupations of Interest

    Unspecified

Abstract

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 comparedto adults, approximately 10% of infants experience severe COVID-19 illness requiring advanced care, andrecently, a possible link has been reported between COVID-19 and a serious inflammatory disease recentlytermed "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 youngchildren are likely responsible for a significant amount of SARS-CoV-2 dissemination (5-7). Clearly, protectingthis population from infection remains essential. One potential mechanism of protection in babies is the passiveimmunity 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 Absmay be effective in treating COVID-19 by providing secretory (s) IgA and sIgM Abs, the major Ab componentsin milk. Abs of the s class are resistant to proteolytic degradation and likely highly functional in respiratorytissue (2, 6). Nearly all sIgA/sIgM in milk is derived from the mucosal immune system, including the respiratorytract; 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 mustbe comprehensively studied for their potential therapeutic and protective efficacy. Towards that aim, we haverecruited over 1600 lactating participants, including over 600 who have recovered from COVID-19 illness. Ourpilot 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 inmilk following infection and the long-term durability of this response; (b) Determine the neutralization capacityof these Abs; and (c) Evaluate the non-neutralizing, Fc-mediated functionality of these Abs. Thiscomprehensive research will determine if COVID19-specific Abs in milk have protective biologic functions andshould be considered as a source of therapeutic Abs. These data would provide a foundation for 'convalescentmilk Ab' efficacy studies, and have implications beyond the pandemic, serving to fill a relatively largeknowledge gap regarding human milk immunology.