Meet Our Faculty: In this Rutgers Global Health Institute content series, we highlight our core faculty members.

 

Maria Laura Gennaro

 

Maria Laura Gennaro is a versatile public health researcher whose laboratory’s discoveries and applications have influenced the world’s understanding of infectious diseases. Her career focus has been tuberculosis (TB), a chronic lung disease that remains one of the top 10 causes of death worldwide and disproportionately affects people living in developing countries.

While much of her TB work is literally microscopic—the disease is caused by bacteria called Mycobacterium tuberculosis—it is Gennaro’s broad expertise in immunology and microbiology that prepared her for a new venture: investigating the novel coronavirus.

The role of antibodies is a focus of her current research related to SARS-CoV-2 (the coronavirus) and COVID-19 (the infectious disease it causes). Gennaro, a core faculty member of Rutgers Global Health Institute, also is concerned about the impact of COVID-19 on vulnerable populations, which informs her work.

 

Other Rutgers Roles

 

A Critical Need

Because SARS-CoV-2 is new, the quest for evidence-based knowledge about the virus’s biological properties is urgent. Gennaro, who has conducted significant research on antibody responses and immune biomarkers in TB, recognized a global health need that she could help to fill.

“We’ve trained and worked all our lives on infectious diseases,” she says. “Now there is this gigantic infectious disease that is stopping the world and getting a lot of people sick and killing a lot of people. I asked myself, how can I contribute to this?”

 

The Role of Antibodies

An antibody is a protein produced by the human body after exposure to a pathogen, such as a virus, bacterium, or parasite, as part of the body’s immune response to remove the pathogen and protect against illness. The study of antibodies can reveal vital information about infectious diseases, and antibody research is being applied in many ways in the world’s fight against COVID-19.

There are important distinctions between antibody tests and the tests used to detect active COVID-19 infection, Gennaro says. “Testing to find out if someone is currently infected, using PCR or antigen tests, for example, is critical for stopping the chain of transmission. But the virus itself will no longer be detectable after a short period of time. Whereas antibodies, while they may decrease, typically do not disappear entirely after infection,” she says.

“The snapshot you can take with antibody testing is much more informative for understanding the widespread impact of an infection. Antibody testing tells you, almost completely, who has been exposed to the infection up to this day,” she says, noting there are caveats, such as for people who are immunocompromised or whose infection by SARS-CoV-2 happened within the two-week period before the antibody test and, therefore, their immune system may not have generated antibodies yet.

 

New Lines of Research

Gennaro and her colleagues at Rutgers’ Public Health Research Institute have developed laboratory tests to detect antibodies generated against the viral protein that allows the SARS-CoV-2 virus to enter human cells. These antibody tests are being used in a joint study with the School of Public Health that seeks to understand the spread of COVID-19 throughout a diverse community, and in clinical settings to analyze blood for clues about the virus’s interactions within the body.

Gennaro also is involved with studies of convalescent plasma therapy, which uses antibody-rich blood donated by people who have recovered from COVID-19 in order to help others recover. And Rutgers’ large study of health care workers calls upon her expertise, honed through decades of studying TB biomarkers, to investigate the variability of COVID-19 disease severity and immune response from one person to the next.

 

Health Inequity: an Acute Concern

While Gennaro’s research has the potential for universal impact, she is clear about the need to help people who are especially vulnerable due to socioeconomic factors and systemic inequalities.

“In the United States, we know there has been very large inequality, in terms of risk of getting sick or dying from COVID-19, among minorities, such as Latinx and Blacks. It is very important to use the antibody testing to see where the virus has hit, and who are the people it is affecting most,” she says.

This data, combined with information about populations’ sociodemographic characteristics and medical risk factors, can influence public health interventions and policies that address the vast health inequities driving the disease’s spread in some communities.

 

What About Immunity?

“Antibody testing detects an immune response, indicating whether someone has been exposed to the virus. It doesn’t say whether you are infectious, nor does it say whether you are protected,” Gennaro says. She also works to correct misinformation about immunity, noting that antibodies are expected to decrease after fighting an infection, and this does not equate to a decrease in immunity.

“Life is not black and white. There’s a lot of gray, in life and in biology. Getting infected and having antibodies in your system does not mean that you are immune, and it doesn’t mean the opposite. We still don’t fully know what the protective immune response is,” she says. “Moreover, immune protection against reinfection is provided by immunological memory. Thus, even if levels of circulating antibodies wane with time, if immunological memory has been established, antibodies will be produced again at the second encounter with the virus, and much faster than the first time. We still have to learn, though, about immunological memory to this virus—does it exist, and what does it do?”

In other words, there is still much work to be done to fully understand and control COVID-19. Researchers like Gennaro will continue, relentlessly, to heed the call to translate their laboratory discoveries into real-world impact. Global health depends on it.

 

In October, Maria Laura Gennaro received the inaugural Chancellor Basic Sciences Researcher Award for her work in infectious diseases with emphasis on host-pathogen interactions in tuberculosis. This distinguished honor is part of the Rutgers Biomedical and Health Sciences Chancellor Awards program.