Research aims to prevent lung damage in babies and toddlers with severe flu, RSV

Children under 2 years of age are at highest risk for getting critically ill from the flu or RSV and requiring intensive care. Currently, doctors can only provide breathing support for severe flu or RSV infection, since no medications exist to speed up recovery or prevent excessive damage to the lungs. With her lab research funded by the National Institutes of Health, Bria Coates, MD, from Ann & Robert H. Lurie Children’s Hospital of Chicago, is determined to discover how to interrupt the process of injury to the lungs and promote cell repair, so patients can avoid long term consequences from lung damage.

“We want to understand why some babies and toddlers get so much sicker from viral infections,” said Dr. Coates, critical care medicine physician at Lurie Children’s and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “One possible cause might be an overactive immune response.”

Dr. Coates studies how the innate immune system responds to severe flu or RSV. This is the type of immune system that is preprogrammed to recognize something foreign in the body and is the first responder to infection.

When triggered, the innate immune system sends out macrophages, a type of white blood cell that is meant to engulf and digest the virus. Dr. Coates found, however, that in young mice, macrophages do not remove the virus. They cause damage to the lungs instead.

Her team is attempting to calm down this macrophage attack by introducing existing medications and tracking the effect.

“When we examine cells in a dish, we can see how the medication helps with lung cell repair,” said Dr. Coates.

“The virus injures the lung by causing DNA damage in lung cells, which activates the innate immune system. But the resulting inflammation is excessive and causes even more harm to the growing lung. We are trying to find ways to modify the inflammation pathway and support more effective DNA damage repair, which would lead to faster recovery in critically ill children,” she explained.

Dr. Coates is the Crown Family Research Scholar in Developmental Biology at Lurie Children’s.