Understanding how viruses impact the immune system has long been a focus at BRI. Two years of pandemic life have made answering two questions particularly important: Can respiratory viruses like the common cold or COVID-19 start the chain reaction that leads to immune system disease? Can they make conditions like asthma, allergies or rheumatoid arthritis (RA) worse?

A 5-year, $11.4 million grant from the Human Immunology Project Consortium (HIPC) will enable Carmen Mikacenic, MD, and Matt Altman, MD, MPhil, to dive into these questions. They’ll each study around 250 people who have immune system diseases linked with higher risk for complications from respiratory viruses. Dr. Mikacenic will study adults with RA while Dr. Altman will follow children with asthma and allergies.

Lung Inflammation in RA

When most people think about RA, they think about joint problems. But RA can also impact the lungs.

“A troublesome feature of RA is that some people develop airway disease that looks similar to asthma. The inflammation and scarring make it harder and harder to breathe,” says Dr. Mikacenic, a physician-researcher who focuses on lung disease. “Often, their lung disease is quite severe by the time they get to my office. We can treat the inflammation, but this doesn’t get to the root of the problem, which is that their immune cells are attacking the lungs.”

The research team will study people recently diagnosed with RA and others who have had RA for a while to learn if, or how, the immune system response is different. They’re also hoping to learn more about whether respiratory viruses can make RA worse.

Asthma, Allergies and Colds

When most kids get a cold, they’re sick for a few days and then they get better. But kids with allergies might get much sicker — and those with asthma may even experience asthma attacks as a result of the virus. Dr. Altman is working to understand why this happens and how to reduce their risk.

“Even when kids are mildly or moderately sick, these infections have a huge social burden. Kids miss school, parents miss work,” Dr. Altman says. “In serious cases, kids can die from asthma attacks and respiratory infections.”

Dr. Altman’s goal is to better understand exactly what’s going on with the immune cells in these children’s airways. This could ultimately help improve the health of kids with asthma and allergies by reducing their risk of complications from viral infections.

“Since there’s still no cure for the common cold, we need better strategies to prevent a common respiratory infection from triggering a health crisis,” Dr. Altman says. “Vaccines, treatments or prevention are all possibilities. Our work to map what is happening in the immune system is the first step.”