Microbial Pathogenesis
The section of Pediatric Infectious Diseases has a strong tradition of studying viral pathogenesis and immune responses to viral infections. The studies encompass herpesviruses, with particular emphasis in varicella zoster and cytomegalovirus, HIV, respiratory and enteroviruses. These studies have a translational focus that links bench, clinical, and epidemiological research. Studies are funded by the NIH with grants to individual section members or through collaborative networks or by the pharmaceutical industry. Many projects involve collaborations of section members. These studies offer the opportunity of training MD and PhD post-doctoral fellows and graduate students.
- Mark Abzug, MD is leading (as co-PI) a multicenter natural history study of neonatal viral sepsis characterized by hepatitis, coagulopathy, and/or myocarditis. The objectives are to characterize neonatal viral sepsis caused by enteroviruses, parechoviruses, and novel viral agents; provide estimates of mortality and morbidity; and delineate clinical and laboratory markers (including quantitative viral load) that predict adverse outcomes. Dr. Abzug is also part of a multicenter group evaluating plasma biomarkers in perinatally HIV-infected children on antiretroviral therapy, with the goal of characterizing inflammation and immune activation despite well-controlled viremia and describing the impact of persisting inflammation and immune activation on neurodevelopmental outcomes.
- Samuel Dominguez, MD, PhD studies the epidemiology and disease presentations of picornaviruses and respiratory viruses, including influenza and enterovirus-D68. Dr. Dominguez is also involved in clinical trials of therapeutics for Kawasaki Disease and Multisystem Inflammatory Syndrome in Children (MIS-C), caused by SARS-CoV-2.
- Myron Levin, MD studies the immune response to herpes viruses (especially the varicella-zoster virus) and to vaccines against these and other viruses that frequently infect children. A new interest is the epidemiology and risk factors for pneumonia in people with Down syndrome.
- Kevin Messacar, MD studies the epidemiology and disease presentations of picornaviruses, including enteroviruses and parechoviruses. He is especially interested in central nervous system infections attributed to these viruses and emerging diagnostic techniques used to diagnose these infections. A particular area of research has been the characterization of the presentation and outcomes of children with acute flaccid myelitis, a condition associated with enterovirus-D68.
- Suchitra Rao, MBBS, MSCS is involved in research evaluating the epidemiology and disease manifestations of respiratory viral pathogens including influenza and COVID-19. These studies leverage large health system data networks, through national collaborations with the CDC and PEDSnet and PCORnet to study influenza vaccine effectiveness, measures of illness severity of influenza in children, testing and treatment practices of influenza and COVID-19 infection in children. Dr. Rao is also studying the host transcriptome to evaluate the immune response to influenza natural infection.
- Christiana Smith-Anderson, MD, MSCS studies the clinical and immunologic effects of perinatal exposure to HIV. She leads translational studies evaluating the immune responses of HIV-exposed, uninfected (HEU) infants to respiratory viral pathogens including influenza, parainfluenza, and respiratory syncytial virus. Dr. Smith-Anderson also studies the role of other viral infections such as cytomegalovirus on immune function in HEU infants.
- Adriana Weinberg, MD is studying the contribution of regulatory T cells (Treg) to the pathogenesis of HIV and TB infections in pregnant women and to the pathogenesis of cytomegalovirus (CMV) in individuals with and without HIV. In collaboration with other investigators, Dr. Weinberg is studying the role of inflammatory markers in the pathogenesis of HIV infection in children, adolescents, and pregnant women in the context of the International Maternal, Pediatric and Adolescent AIDS Clinical Trials network (IMPAACT). In collaboration with colleagues in the adult ID division, Dr. Weinberg is studying reconstitution of CMV cell-mediated immunity (CMI) in transplant recipients, including CMV CMI reconstitution during letermovir prophylaxis in hematopoietic transplant recipients and the association of CMV CMI reconstitution with protection against frailty and neurocognitive decline in renal transplant recipients.