Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in the general population. AD is associated with defective skin barrier function, microbial and viral dysbiosis, as well as various cutaneous immune abnormalities including type 2 inflammation and decreased cutaneous host defense. The Atopic Dermatitis Research Network-Leadership Center (ADRN-LC) provides the scientific strategy and organizational structure to elucidate mechanisms of skin barrier dysfunction, cutaneous immune responses, and viral determinants of atopic dermatitis (AD). An emerging virus with potential direct implications to AD and other allergic diseases is SARS-CoV-2. SARS-CoV-2 is the virus which causes COVID-19 illnesses, which are rapidly affecting humans around the globe. While initial epidemiological data have focused on cases that resulted in severe respiratory disease seen predominantly in adults, little information regarding the infection burden in children is available. This is complicated by the observation that many children experience asymptomatic infections. Undocumented, and likely infectious, cases could result in exposure to a far greater proportion of the community than would otherwise occur. Thus, it is critical to determine the silent and symptomatic infection rate in children and to understand why they develop less severe or asymptomatic disease. To overcome challenges for clinical study implementation imposed by current healthcare access restrictions, the HEROS surveillance study has enrolled and is prospectively observing eligible children that are current participants in NIH-funded pediatric research studies and their family members. The HEROS study is collecting nasal swabs from all subjects in 2-week intervals for a 7-month period and during respiratory illnesses. Our group is acting as the laboratory processing and analysis site for the study. We are extracting RNA from all swabs and performing qPCR assays to test for the SARS-CoV-2 virus. This will allow us to determine the incidence of SARS-CoV-2 in the U.S. population and how it varies between children, adults, and those with asthma and other lung diseases. Secondly, we will perform Dual RNA-seq on RNA from nasal swabs to determine the host epithelial and immune cell response to infection with SARS-Cov-2 and COVID-19 respiratory illnesses. This data will also allow us to identify different strains of the SARS-Cov-2 virus circulating in the U.S., their geographical distribution, and how these strains relate to COVID-19 illness severity. Lastly, we will analyze these longitudinal swabs for infection with other respiratory viruses to determine if infection with these viruses influences the risk for SARS-CoV-2 infections and COVID-19 illness severity.
The ADRN study seeks to understand determinants of atopic dermatitis (AD) disease including ones of viral origin. Our goal here is to determine the spread of the SARS-CoV-2 virus across the U.S. population, especially in children with AD and other allergic diseases. Through this surveillance study we will determine transmission dynamics of the virus within families. We will also determine host airway epithelial and immune cell responses to SARS-CoV-2 infection and COVID-19 illnesses. Finally, we will determine if infection by other respiratory viruses predisposes children to infection with SARS-CoV-2.
