Research continues to inform the medical community’s knowledge of the coronavirus that’s led to the global pandemic. In the Johns Hopkins Department of Surgery, clinician-researchers are studying organ transplant recipients and the medications they take to investigate possible treatments for and protection from COVID-19. Portions of this work are funded by philanthropy.
Clinical Trial to Examine Immune Suppression Drug to Treat Severe COVID-19
Johns Hopkins surgeon Russell Wesson, M.B.Ch.B., and nephrologist Nada Alachkar, M.D., are co-principal investigators of a clinical trial studying whether the monoclonal antibody clazakizumab can lessen severity in cases of severe COVID-19 and lead to faster recovery times with better outcomes.
Clazakizumab is an anti-interleukin-6 antibody that is sometimes used to alter the immune system in people with rejection after kidney transplantation. Interleukin-6 is a protein known to regulate immune response, which is dramatically elevated in people who have severe COVID-19.
Since May 2020, in collaboration with the Department of Medicine’s Division of Pulmonary and Critical Care Medicine and Division of Infectious Disease as well as the Department of Surgery’s Comprehensive Transplant Center, the researchers have enrolled 50 patients from The Johns Hopkins Hospital and Howard County General Hospital. Patients with severe COVID-19 infection who have pulmonary failure and symptoms consistent with cytokine storm syndrome are qualified for enrollment in the trial.
New York University Langone and NewYork-Presbyterian/Columbia University are also participating in the trial, with a goal of more than 150 participants across the three sites.
In addition to investigating this potential treatment, the Johns Hopkins researchers are characterizing the cytokine and cellular changes that happen when people with COVID-19 are treated with clazakizumab.
Researching the Medications and Immune Systems of Transplant Recipients with COVID-19
Johns Hopkins transplant surgeons Dorry Segev, M.D., Ph.D., and Jacqueline Garonzik Wang, M.D., Ph.D., are studying organ transplant recipients who had COVID-19 to gather information about the clinical and immune responses to the virus among patients taking immunosuppressive medications.
Through a multicenter network of hospitals developed by Segev’s Epidemiology Research Group in Organ Transplantation, and supported by the National Institutes of Health, the investigators are gathering information about COVID-19 symptoms, duration of hospital stays and long-term effects, as well as taking blood samples to identify antibodies to the coronavirus that causes CVID-19. Nontransplant individuals living in the same households are serving as controls in these studies.
Ultimately, Segev and his team hope to uncover whether any of the medications used to block the immunoinflammatory response of organ rejection are also working to block COVID-19’s immunoinflammatory response, thereby reducing illness severity. A better understanding of these mechanisms will help improve COVID-19 treatment for all patients.
The team also hopes to understand whether immunosuppressed patients have an antibody response to the virus and, if so, how long the antibodies remain. Such insights are critical to vaccine development for people with hampered immune systems.
