From the Duke Cancer Institute archives. Content may be out of date.
Tony Sung, MD
The bacteria in your gut help regulate your immune system. So, can priming them with an over-the-counter probiotic protect against COVID-19?
A Duke Cancer Institute physician-scientist and a critical care specialist are exploring that question, via a clinical study being conducted entirely remotely and made possible by philanthropy.
Tony Sung, MD, a stem cell transplant physician and an associate director of the Duke Microbiome Center, has long been interested in the microbiome (the collection of all the bacteria and other microorganisms that live in the human body) because it can influence complications in patients after stem cell transplant, including relapse, survival, and infection.
Paul Wischmeyer, MD, professor of anesthesiology and surgery, specializes in enhancing preparation and recovery from surgery and critical care.
Paul Wischmeyer, MD
Both were familiar with studies showing that taking an over-the-counter probiotic can help reduce the risk of respiratory infections and even more severe infections such as sepsis. Wischmeyer himself had done studies showing that, in a mouse model that mimics pneumonia, giving the mouse a probiotic (Lactobacillus rhamnosus GG) protected against infection and improved survival.
The two scientists knew each other but had never collaborated. Then the pandemic cemented a partnership. “In the setting of COVID-19, we have a call to respond,” Sung says.
Sung and Wischmeyer launched a trial that tests whether taking a common, over-the-counter probiotic (the same one that Wischmeyer used in his study with mice) can help prevent development of symptoms or reduce severity of symptoms in people who live with someone who has tested posted for COVID-19.
Participants receive the probiotics and submit nasal swabs and fecal samples by mail, so anyone in the United States can participate without having to leave home.
“There are lots of data supporting this as a viable hypothesis, but it’s a hypothesis that needs to be tested, which is what makes this clinical trial so important,” Sung says. While he can’t make recommendations to the general public about taking probiotics until the trial is completed, he acknowledges that since the pandemic began, he has been taking one himself, as does his two-year-old daughter, who spent time in the ICU with a common cold as a baby.
“Probiotics are cheap, safe for healthy people, and readily available. If probiotics could help attenuate symptoms and prevent hospitalizations, it would be a huge win,” Sung says.
An established investigator funded by the National Institutes of Health (NIH), Sung had never funded his research with philanthropy before. But the urgency of the pandemic promoted him to reach out to his former classmate from Stanford University, Joe Lonsdale, who thought the study was important enough to make a $40,000 gift through his company, Lonsdale Enterprises.
"Tony embodies a lot of great traits, including brilliance, integrity, and hard work,” Lonsdale says. “The microbiome is an important area of research, and it's an honor to be able to support a researcher like Tony with resources to work on ways to ameliorate the terrible impact of COVID-19."
The trial would not be open now without that gift and other donor funds, Sung says.
“There was a grant application we sent to the NIH around the same time that we started this study. We still have yet to hear back whether that is funded or not,” he says. “Philanthropy allows us to move much more quickly and react to emergencies like the COVID-19 pandemic.”
The study is also funded by the Duke Microbiome Center, as well as small donations from several other individuals. Manufacturer DSM is providing the probiotic and a placebo for use in the trial.
This article appears in the Winter 2021 issue of Breakthroughs magazine. Breakthroughs is produced twice yearly by Duke Cancer Institute Office of Development.
Being diagnosed with cancer and going through treatment isn’t easy for anyone. For people diagnosed as young adults (ages 18-39), the experience comes with some unique challenges.“This is an age of transition,” said Caroline Dorfman, PhD, a clinical psychologist at the Duke Cancer Institute. People in this age group are often in the midst of reaching milestones such as graduation, landing a job, building a friend group, getting married, and having children, she said. “One of the things we hear from our patients,” she said, “is that the cancer diagnosis stops them in their tracks from being able to move forward on life milestones.”Even after treatment ends, life doesn’t suddenly switch back to normal. Physical symptoms like pain and fatigue can linger, and emotional distress is common during the post-treatment period. Multiple follow-up appointments can present financial and logistical difficulties as well as emotional reminders of cancer.“Sometimes they just want the cancer behind them and to get back to doing what matters to them,” Dorfman said. “The trouble is that when they are in the midst of treatment, they are just trying to get through it, and they don’t stop to process the experience.”That emotional processing often happens after the last chemo treatment or radiation session.To support young adults during this vulnerable period, Dorfman has designed a 10-week program that aims to give them the tools they need to navigate physical and emotional symptoms and learn how to successfully manage their new lives as cancer survivors.
When Gabriella Torres was eight, she needed steroids to control asthma and allergies. Then her allergist recommended she take up swimming, and it helped. When she was nine, her younger brother was diagnosed with leukemia. He was treated and recovered. But watching him go through that left an impression.As she got older, Torres had nothing but questions. Why did swimming improve her asthma? Why did her brother get so sick? And why did treatment work for him when it doesn’t for so many other children?Torres was driven to find the answers. In college at New York University, she thought about becoming a pediatric oncologist; she pursued research experiences recommended for students interested in medicine. But then during her junior year an internship at a pharmaceutical company got her interested in pursuing a PhD. “I had never heard of getting a PhD before that,” said Torres, who is from New York City, where her parents are chefs. “But I was able to see that I could use my love of thinking critically about problems long term but still work on a project that relates directly to helping people.”Torres was on the swim team in college and spent much of her free time training. But she got as much research experience as she could, then applied to the integrative immunobiology PhD program at Duke University School of Medicine in 2023.Torres didn’t get in. Her goal of becoming a scientist could have ended there. Instead, she received a call from Johnna Frierson, PhD, associate dean of equity, diversity, and inclusion for the basic sciences at the School of Medicine, asking her if she’d be interested in applying for Duke’s PRIME PREP Program, which provides a year of research experience to recent undergraduates.Torres interviewed for PRIME PREP and got in, then she spent time at Duke conducting research in the lab of Stacy Horner, PhD, associate professor in integrative immunobiology.
Being diagnosed with cancer and going through treatment isn’t easy for anyone. For people diagnosed as young adults (ages 18-39), the experience comes with some unique challenges.“This is an age of transition,” said Caroline Dorfman, PhD, a clinical psychologist at the Duke Cancer Institute. People in this age group are often in the midst of reaching milestones such as graduation, landing a job, building a friend group, getting married, and having children, she said. “One of the things we hear from our patients,” she said, “is that the cancer diagnosis stops them in their tracks from being able to move forward on life milestones.”Even after treatment ends, life doesn’t suddenly switch back to normal. Physical symptoms like pain and fatigue can linger, and emotional distress is common during the post-treatment period. Multiple follow-up appointments can present financial and logistical difficulties as well as emotional reminders of cancer.“Sometimes they just want the cancer behind them and to get back to doing what matters to them,” Dorfman said. “The trouble is that when they are in the midst of treatment, they are just trying to get through it, and they don’t stop to process the experience.”That emotional processing often happens after the last chemo treatment or radiation session.To support young adults during this vulnerable period, Dorfman has designed a 10-week program that aims to give them the tools they need to navigate physical and emotional symptoms and learn how to successfully manage their new lives as cancer survivors.
When Gabriella Torres was eight, she needed steroids to control asthma and allergies. Then her allergist recommended she take up swimming, and it helped. When she was nine, her younger brother was diagnosed with leukemia. He was treated and recovered. But watching him go through that left an impression.As she got older, Torres had nothing but questions. Why did swimming improve her asthma? Why did her brother get so sick? And why did treatment work for him when it doesn’t for so many other children?Torres was driven to find the answers. In college at New York University, she thought about becoming a pediatric oncologist; she pursued research experiences recommended for students interested in medicine. But then during her junior year an internship at a pharmaceutical company got her interested in pursuing a PhD. “I had never heard of getting a PhD before that,” said Torres, who is from New York City, where her parents are chefs. “But I was able to see that I could use my love of thinking critically about problems long term but still work on a project that relates directly to helping people.”Torres was on the swim team in college and spent much of her free time training. But she got as much research experience as she could, then applied to the integrative immunobiology PhD program at Duke University School of Medicine in 2023.Torres didn’t get in. Her goal of becoming a scientist could have ended there. Instead, she received a call from Johnna Frierson, PhD, associate dean of equity, diversity, and inclusion for the basic sciences at the School of Medicine, asking her if she’d be interested in applying for Duke’s PRIME PREP Program, which provides a year of research experience to recent undergraduates.Torres interviewed for PRIME PREP and got in, then she spent time at Duke conducting research in the lab of Stacy Horner, PhD, associate professor in integrative immunobiology.
