Oral Microbiome & Mucosal Immunity in COVID-19 disease (MIMSA)
Research type
Research Study
Full title
Role of the oral microbiome & mucosal immunity in COVID-19 disease: diagnostic/prognostic utility in South Asian populations
IRAS ID
295430
Contact name
Stephen Challacombe
Contact email
Sponsor organisation
King's College London
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 6 months, 1 days
Research summary
Sars-CoV2 primarily infects lungs, mouth, oropharynx, nasopharynx and nose, the linings of which are fundamental components of the body’s mucosal immune system: this is distinct from systemic immunity. The role of mucosal immunity or previous oral disease in COVID resistance, susceptibility or severity is unknown. In the UK, South Asian origin patients have higher mortality from COVID-19 than most ethnic groups, even after adjusting for co-morbidities. In India, similarly adjusted mortality rates are lower. We hypothesise that variations in the efficacy of mucosal immunity is critical in susceptibility to, and severity of, COVID-19 and explains differences in morbidity and mortality.
Mucosal surfaces have their own normal fungal, bacterial and viral flora (microbiome) which protects against pathogens. We will compare mucosal and systemic immunity and the oral microbiome in South Asian and non-Asian populations. Early in COVID-19 infection, extremely high viral counts can be found in saliva and in minor salivary glands. Subsequently there is increased production of non-specific immune factors and especially of the products of cells (cytokines) some of which protect and others damage. The oral microbiome is closely related to both lung and nose microbiomes and upsetting their normal balance is likely a factor in COVID-19 severity. Uninfected persons, carriers and SARS-CoV2-positive patients with mild or severe disease will be recruited. Blood and saliva will be collected for up to 90 days and anti-SARS-CoV2 antibodies in the mouth (reflecting those in nose and lung) assayed. Cytokines and T lymphocyte types will be determined in saliva and blood. The salivary microbiome will be analysed by new molecular techniques and correlated with measures of immune functionality and oral disease. We envisage that mucosal factors account for the differential susceptibility and severity of COVID between SA populations which this UK based study can help to identify.REC name
South Central - Oxford C Research Ethics Committee
REC reference
22/SC/0105
Date of REC Opinion
28 Mar 2022
REC opinion
Favourable Opinion