---
title: "Allergic airway inflammation alters coronavirus outcomes: protection for SARS-CoV-2 and MERS-CoV,"
id: "biorxiv-21-allergic-airway-inflammation-protects-against-sars-cov-2-and-mers-cov-disease"
canonical_url: "https://medichelpline.com/clinical-feed/biorxiv-21-allergic-airway-inflammation-protects-against-sars-cov-2-and-mers-cov-disease"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "bioRxiv (Biomedical Preprints)"
source_url: "https://www.biorxiv.org/content/10.64898/2026.09.02.748812v1?rss=1"
published_at: "2026-09-07T12:00:00.000Z"
evidence_level: "Verified Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Allergic airway inflammation alters coronavirus outcomes: protection for SARS-CoV-2 and MERS-CoV,
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/biorxiv-21-allergic-airway-inflammation-protects-against-sars-cov-2-and-mers-cov-disease
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** bioRxiv (Biomedical Preprints)
- **Source URL:** [Original Journal Publication](https://www.biorxiv.org/content/10.64898/2026.09.02.748812v1?rss=1)
- **Published At:** 2026-09-07T12:00:00.000Z
- **Evidence Rating:** Verified Feed
## Executive GIST (TL;DR)
- The study used a house dust mite (HDM) respiratory exposure model to create **allergic airway inflammation** resembling allergic asthma, marked by goblet cell hyperplasia, mucin hypersecretion, eosinophil recruitment, M2 macrophage polarization, and induction of IL-13. - Researchers compared disease caused by three pathogenic coronaviruses—**SARS-CoV-2**, **MERS-CoV**, and **SARS-CoV-1**—in mice with preexisting HDM-driven airway allergy versus controls. - In multiple SARS-CoV-2 variant models, HDM-treated mice showed reduced viral titers, less weight loss, lower lung immunopathology, and improved survival relative to non-allergic controls. - In a MERS-CoV mouse model, HDM exposure similarly conferred protection: reduced lethality, lower viral burden, and blunted cytokine storm signatures were reported in allergic mice. - By contrast, HDM-induced allergic airway inflammation worsened SARS-CoV-1 disease: despite lower virus titers, allergic mice developed fulminant alveolar inflammation, severe weight loss, elevated pro-inflammatory cytokines and chemokines, and increased mortality. - The results show virus-specific effects of preexisting allergic airway inflammation on coronavirus pathogenesis in mice and help reconcile conflicting epidemiological and experimental data regarding asthma and coronavirus disease severity. - The authors note competing interests and funding disclosures linked to several labs; full experimental detail and quantitative data are reported in the source article PDF.
## Clinical Analysis & Structured Key Points
Allergic airway inflammation protects against SARS-CoV-2 and MERS-CoV disease but promotes fatal SARS-CoV-1 immunopathology | bioRxiv Skip to main content New Results Allergic airway inflammation protects against SARS-CoV-2 and MERS-CoV disease but promotes fatal SARS-CoV-1 immunopathology View ORCID Profile Jeremy Ardanuy , View ORCID Profile Grace Garrett , Carly Dillen , Meizi Liu , Louis Taylor , View ORCID Profile Achsah Keegan , Michael Diamond , View ORCID Profile Matthew Frieman doi: https://doi.org/10.64898/2026.09.02.748812 Jeremy Ardanuy 1 University of Maryland Baltimore; Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Jeremy Ardanuy Grace Garrett 2 University of Maryland School of Medicine; Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Grace Garrett Carly Dillen 2 University of Maryland School of Medicine; Find this author on Google Scholar Find this author on PubMed Search for this author on this site Meizi Liu 3 Washington University In St Louis: Washington University in St Louis Find this author on Google Scholar Find this author on PubMed Search for this author on this site Louis Taylor 2 University of Maryland School of Medicine; Find this author on Google Scholar Find this author on PubMed Search for this author on this site Achsah Keegan 2 University of Maryland School of Medicine; Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Achsah Keegan Michael Diamond 3 Washington University In St Louis: Washington University in St Louis Find this author on Google Scholar Find this author on PubMed Search for this author on this site Matthew Frieman 2 University of Maryland School of Medicine; Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Matthew Frieman For correspondence: mfrieman{at}som.umaryland.edu Abstract Info/History Metrics Preview PDF Abstract Epidemiological, clinical, and experimental data suggest that allergic asthma may have protective effects against severe Coronavirus Disease 2019 (COVID-19) but are often conflicting between different models of infection and epidemiological analyses. Allergic asthma is characterized by type 2 (T2) inflammation, mucus hypersecretion, and airway remodeling. We used a house dust mite (HDM) respiratory exposure model to determine how preexisting allergic inflammation alters the pathogenesis of three highly pathogenic coronaviruses, SARS-CoV-1, SARS-CoV-2, and MERS-CoV. HDM treatment induced canonical features of allergic asthma, including goblet cell hyperplasia, mucin hypersecretion, eosinophil recruitment, M2 macrophage polarization, and induction of IL-13. Across multiple SARS-CoV-2 variants, HDM treated mice exhibited reduced viral titers, less weight loss, diminished lung immunopathology, and improved survival rates. Similar protection was observed in a mouse model of MERS-CoV, with reduced lethality, lower viral burden, and blunted cytokine storm signatures in HDM treated mice. In contrast, allergic airway inflammation exacerbated SARS-CoV-1 pathogenesis, as HDM-treated mice developed fulminant alveolar inflammation, severe weight loss, elevated pro-inflammatory cytokines and chemokines, and increased mortality despite having reduced virus titer. Thus, in mice, allergic airway inflammation exerts opposing virus specific effects on coronavirus pathogenesis. These results reconcile conflicting epidemiological and mechanistic studies across coronavirus epidemics and highlight the need to consider host allergic status as a key variable influencing disease outcome from emerging coronaviruses. Competing Interest Statement M.B.F. and the Frieman lab have received unrelated funding support in sponsored research agreements with Novavax, AstraZeneca, Eli Lilly, Regeneron, and Irazu Bio. M.S.D. is a consultant or advisor for Inbios, IntegerBio, Akagera Medicines, and GlaxoSmithKline. The Diamond laboratory has received unrelated funding support in sponsored research agreements from Moderna. Copyright The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . Back to top Previous Next Posted September 07, 2026. Download PDF Email Thank you for your interest in spreading the word about bioRxiv. NOTE: Your email address is requested solely to identify you as the sender of this article. Your Email * Your Name * Send To * Enter multiple addresses on separate lines or separate them with commas. You are going to email the following Allergic airway inflammation protects against SARS-CoV-2 and MERS-CoV disease but promotes fatal SARS-CoV-1 immunopathology Message Subject (Your Name) has forwarded a page to you from bioRxiv Message Body (Your Name) thought you would like to see this page from the bioRxiv website. Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Share Allergic airway inflammation protects against SARS-CoV-2 and MERS-CoV disease but promotes fatal SARS-CoV-1 immunopathology Jeremy Ardanuy , Grace Garrett , Carly Dillen , Meizi Liu , Louis Taylor , Achsah Keegan , Michael Diamond , Matthew Frieman bioRxiv 2026.09.02.748812; doi: https://doi.org/10.64898/2026.09.02.748812 Share This Article: Copy Citation Tools Allergic airway inflammation protects against SARS-CoV-2 and MERS-CoV disease but promotes fatal SARS-CoV-1 immunopathology Jeremy Ardanuy , Grace Garrett , Carly Dillen , Meizi Liu , Louis Taylor , Achsah Keegan , Michael Diamond , Matthew Frieman bioRxiv 2026.09.02.748812; doi: https://doi.org/10.64898/2026.09.02.748812 Citation Manager Formats BibTeX Bookends EasyBib EndNote (tagged) EndNote 8 (xml) Medlars Mendeley Papers RefWorks Tagged Ref Manager RIS Zotero Tweet Widget Facebook Like Google Plus One Subject Areas All Articles Animal Behavior and Cognition (7969) Biochemistry (18633) Bioengineering (14770) Bioinformatics (44156) Biophysics (22458) Cancer Biology (19594) Cell Biology (26747) Clinical Trials (138) Developmental Biology (13903) Ecology (20890) Epidemiology (2067) Evolutionary Biology (25317) Genetics (16100) Genomics (23401) Immunology (18609) Microbiology (42216) Molecular Biology (17947) Neuroscience (92896) Paleontology (693) Pathology (2969) Pharmacology and Toxicology (5063) Physiology (8066) Plant Biology (15909) Scientific Communication and Education (2091) Synthetic Biology (4538) Systems Biology (10188) Zoology (2376)
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