# Surfactant Protein-A and Type 2 Asthma in SARS-CoV-2 Infection

> **NIH NIH U19** · UNIVERSITY OF ARIZONA · 2022 · $450,752

## Abstract

During the first cycle of our AADCRC program, our project focused primarily on Surfactant Protein A (SP-A), a
known innate immune modulator that exhibits important anti-inflammatory effects in asthma. In this renewal, we
show preliminary data that SP-A binds the interleukin (IL)-6 receptor and disrupts IL-6 signaling, events relevant
to specific asthma phenotypes. While this work was progressing, the Severe Acute Respiratory Syndrome-
related Coronavirus 2 (SARS-CoV-2)-driven coronavirus disease 2019 (COVID-19) pandemic emerged and has
fundamentally changed our world. Elevated serum IL-6 is a hallmark of the “cytokine storm” associated with
severe COVID-19 acute respiratory distress and IL-6 inhibitors show promise as treatments. Our data suggest
that SP-A exhibits innate functions relevant to SARS-CoV-2 infection by inhibiting IL-6 signaling intermediates
and also by binding to angiotensin converting enzyme-2 (ACE2), the receptor used by SARS-CoV-2 for entry
into host cells. These findings suggest that SP-A may attenuate the inappropriate innate immune responses
in COVID-19 and by this mechanism, could play a role in the treatment of SARS-CoV-2 infection. Several
chronic lung-based comorbidities have been shown to increase the severity and mortality associated with
COVID-19 - with the notable exception of asthma. Evidence from our group suggests that type-2 (T2) cytokines
such as IL-4 and IL-13, which are critical molecular underpinnings of atopic asthma, reduce ACE2 expression in
airway epithelial cells from T2 asthma. These findings suggest that atopic asthma-associated T2 cytokines
protect against COVID-19 by modulating infection. In this AADCRC renewal, we will build on these
preliminary data and merge two complementary, unique lines of investigation to expand the focus of our proposal
and investigate the interplay of SP-A and T2 cytokines at both the initiation and the effector stages of SARS-
CoV-2 respiratory tract infection in asthma. We will test the novel hypothesis that SP-A effectively limits COVID-
19 by decreasing ACE2-mediated events through direct receptor binding and inhibition of IL-6 signaling
pathways. In the setting of atopic asthma, type-2 cytokines may reduce the susceptibility to SARS-CoV-
2 infection by inhibiting ACE2 expression and function. In aim 1, we will determine the impact of SP-A in
limiting SARS-CoV-2 infection of human nasal, bronchial and distal airway epithelial cells and whether these
effects depend upon ACE2 binding and modulation of IL-6 signaling. In aim 2, we will assess ACE2 expression
in nasal, bronchial and distal epithelial cells from normal atopic and non-atopic controls and T2 asthmatic
participants, and determine how T2 cytokines and virus-induced interferons interact to regulate epithelial cell
ACE2 expression and SARS-CoV-2 infection in these cells. We hypothesize that SP-A and T2 cytokines can
synergize to dampen both the initiation and the effector phases of SARS-CoV-2 infection, thereby pro...

## Key facts

- **NIH application ID:** 10473864
- **Project number:** 5U19AI125357-07
- **Recipient organization:** UNIVERSITY OF ARIZONA
- **Principal Investigator:** Monica Kraft
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $450,752
- **Award type:** 5
- **Project period:** 2016-06-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10473864

## Citation

> US National Institutes of Health, RePORTER application 10473864, Surfactant Protein-A and Type 2 Asthma in SARS-CoV-2 Infection (5U19AI125357-07). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10473864. Licensed CC0.

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