Children’s National Research Institute Academic Annual report 2019-2020
A Leadership Message from the Director
Reflections on the Effects of COVID-19
Writing this letter in March 2020 during the COVID-19 pandemic, I reflected on my first pandemic experience.
It was 1949 and I was a four-year-old living in Atlanta during the polio pandemic. My father drove my mother and me to Panama City, Florida, to be outside the epicenter. Throughout that July we stayed there and I built sand castles, spending special time with my mom. It was wonderful. This reminds me how differently children experience disasters, and how we can protect them not only physically but psychologically by how we adults cope with crisis.
Today I am in a very different position, not only trying to support my own family and my “professional family” at the Children’s National Research Institute through this difficult time, but also helping to direct research efforts to understand and treat this novel coronavirus. In a short period of time, Children’s National Research Institute has mobilized its scientists to address COVID-19, focusing on understanding the virus and advancing solutions to ameliorate the impact today and for future generations. I would like to summarize a few of these projects.
Testing the Microbiome’s Power to Protect Against COVID-19
Eric Vilain, M.D., Ph.D., director of our Center for Genetic Medicine Research, is testing a compelling hypothesis: whether or not the microbiome of bacteria in the human nasal tract acts as a defensive shield against COVID-19. Younger people are more resilient to disease and death from the novel coronavirus. Microbiomes often become less diverse as humans age, which may make older people more vulnerable to viral infections. We are investigating whether the microbiome helps to halt the disease at the upper respiratory tract — where symptoms are often mild. This prevents it from entering the lower respiratory tract, which can lead to pneumonia and death. These findings may provide the basis for clinical trials of nasal sprays to prevent advanced disease in COVID-19 patients. This would add an additional tool to the global fight against the pandemic — one that will blunt the severity of the disease and complement the development of a vaccine.
“Training” T Cells to Attack the Invading Coronavirus
Catherine Bollard, M.D., MBChB, director of the Center for Cancer and Immunology Research, and her team extract T cells from cord blood samples. They then engineer these cells to fit with antigens on a virus-infected cell — in this case the novel coronavirus, SARS-CoV-2. The T cells are then allowed to “train” in vitro, where they reproduce and practice connecting to — and killing — infected cells and therefore the virus itself. The T cells can then be re-introduced to patients who now have “super-charged” blood that can quickly attack the targeted viral infection. Dr. Bollard’s team has already successfully bioengineered T cells for HIV patients and for patients after cancer treatment or bone marrow replacement. If the T cells are taken from a cord blood sample, the “trained” T cells can be used by anyone. Our team has used this approach to successfully counter the attacks of cytomegalovirus, Zika, Ebola and other viral invaders. They now seek to employ it in the fight against the novel coronavirus. In addition to creating an “off-the-shelf” treatment, which would likely be used for elderly patients or immunocompromised individuals, in time this research could help develop a T-cell therapy coronavirus “vaccine.”
Coronavirus and the Developing Brain
Sarah Mulkey, M.D., Ph.D., an investigator in the Center for Neuroscience Research and the Fetal Medicine Institute, is studying the effects of, and possible interventions for, coronavirus on the developing brain. Serious viral infections in pregnancy can lead to preterm birth, low birthweight and even infant death. But there are other questions: Can COVID-19 spread from an infected mother to her newborn? How is the developing brain affected if the mother contracts the virus during pregnancy? This pandemic is ongoing and knowledge is very limited. Dr. Mulkey will work with pregnant women who have COVID-19 to assess their baby’s brain development — its structure, maturation, volume and shape. We will follow these children from before they are born to age two years, gaining a rich narrative of each child’s neurological and behavioral development. We also will examine placentas from COVID-19-infected pregnancies to better understand how fetuses are affected by the virus.
All of this COVID-19 related work is in addition to the wonderful ongoing research projects performed in each of the centers of the Children’s National Research Institute described in this annual report. I wish you all good health.
Mark Batshaw, M.D.
Physician-In-Chief and Chief Academic Officer
Children's National Hospital
Director, Children’s National Research Institute
“Fight for Children” Professor of Pediatrics
The George Washington University School of Medicine and Health Sciences