- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02544048
Markers of T Cell Suppression: Antimalarial Treatment and Vaccine Responses in Healthy Malian Adults
Background:
People with malaria often show altered immune responses to many illnesses and vaccines. This means that the malaria might cause immune suppression. It is not clear how or which vaccines are impacted by malaria. It is also not clear if the impacts are such that people should be preemptively treated before they get vaccinations. Researchers want to see if there is a link between taking an antimalaria drug prior to getting vaccines and the immune response to those vaccines. To do this, they will study people who are taking part in certain NIAID studies.
Objectives:
To compare the proportion of PD1+ CD4 T cells among all T cells in vaccine immune responses in adults who have or have not received antimalarials prior to getting a Menactra vaccine.
Eligibility:
Healthy Malian adults who:
Were previously enrolled in NIAID Protocol 13-I-N109 or 15-I-0044
Reside in Bancoumana and neighboring villages
Are not pregnant
Design:
Participants will be screened with a physical exam.
Participants will get the vaccines listed below as part of Protocol 13-I-N109 or 15-I-0044. This study will follow their schedule.
At each visit, participants will give a blood sample. They will also have a physical exam. Each visit will last 1 to 2 hours.
At visit 1, participants will get a hepatitis vaccine.
Two weeks later, participants may get the antimalarial drug Coartem . They will be chosen at random.
Two weeks later, participants will get Menactra .
Participants will have 5 follow-up visits after they get Menactra .
The study will last up to 4 months.
...
Study Overview
Status
Conditions
Detailed Description
Malaria patients often show altered immune responses, not only to malaria parasites but also to unrelated pathogens (eg, HIV, EBV, salmonella, helminthes) and antigens, including routine vaccines, suggesting that there is an active immune suppression or more accurately perhaps, immunomodulation, occurring during the course of malaria infection. How and which vaccines are impacted by clinical malaria or asymptomatic parasitemia is not completely clear and nor is whether the impacts are significant enough to recommend delaying or pre-emptively treating individuals prior to vaccinations.
Up to 75 adults will be recruited from volunteers enrolled in NIAID protocol 13-I-N109 and NIAID protocol 15-I-0044 who after unblinding have opted to receive or complete the comparator vaccine series: Euvax (Hepatitis B) or TWINRIX (Hepatitis B) and Menactra (Meningococcal). This longitudinal study will be conducted in Bancoumana and neighboring villages in Mali. In September 2015, up to 50 adults presenting for their Vaccination #3 of Euvax will be enrolled from NIAID protocol 13-I-N109. In October 2015, up to 25 adults presenting for their Study Day 168 will be enrolled following unblinding from NIAID protocol 15-I-0044.
Following receipt of their Euvax B or TWINRIX vaccination, subjects will be randomized to receive or not receive a course of Coartem (artemether-lumefantrine) 2 weeks prior to their scheduled Menactra vaccination. They will then be followed for approximately 3 months post receipt of Menactra . Samples will be collected from the adults at the time of prior to and following receipt of both vaccinations and assessed in ex vivo assays for markers of T-cell suppression as the primary outcome of this study. For our secondary outcomes, we will examine levels of regulatory T cells, measure T cell responses in stimulation assays, and survey parasitemia by blood smear and by polymerase chain reaction assays. We expect that levels of T-cell suppression and regulatory T cells will be similar between groups before antimalarial treatment or malaria infection, but after treatment or in those subjects that remain uninfected these levels will be significantly lower as compared to the untreated and or infected subjects.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
-
Bamako, Mali
- Malaria Research and Training Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
- INCLUSION
- Enrolled, completed unblinding, and have opted to receive the comparator vaccines in either NIAID Protocol 13-I-N109 or 15-I-0044
- In good general health and without any clinically significant medical history
- Willing to have blood samples stored for future research
- Known resident of Bancoumana or surrounding area
EXCLUSION
- Known to be pregnant (by history)
- Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, endocrine, rheumatologic, autoimmune, hematological, oncologic, psychiatric, or renal disease by history and/or physical examination
- Behavioral, cognitive, or psychiatric disease that in the opinion of the investigator affects the ability of the participant to understand and comply with the study protocol
- Prior to Study Day 0, receipt of a live vaccine within the past 4 weeks or a killed vaccine within the past 2 weeks
- Use of chronic (greater than or equal to 14 days) oral or intravenous corticosteroids (excluding topical or nasal) at immunosuppressive doses (eg, prednisone > 10 mg/day) or immunosuppressive drugs within 30 days of Study Day 0
- Known allergies or contraindications to study treatment (Coartem [artemether//lumefantrine]) or vaccines (Euvax B or TWINRIX and Menactra )
- Other condition that in the opinion of the investigator would jeopardize the safety or rights of a participant participating in the trial, interfere with the evaluation of the study objectives, or would render the subject unable to comply with the protocol
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Proportion of T cells expressing PD-1 among all T cells on Study Day 42
Time Frame: Study Day 42
|
Study Day 42
|
Collaborators and Investigators
Publications and helpful links
General Publications
- Cunnington AJ, Riley EM. Suppression of vaccine responses by malaria: insignificant or overlooked? Expert Rev Vaccines. 2010 Apr;9(4):409-29. doi: 10.1586/erv.10.16.
- Williamson WA, Greenwood BM. Impairment of the immune response to vaccination after acute malaria. Lancet. 1978 Jun 24;1(8078):1328-9. doi: 10.1016/s0140-6736(78)92403-0.
- Greenwood BM, Bradley-Moore AM, Bryceson AD, Palit A. Immunosuppression in children with malaria. Lancet. 1972 Jan 22;1(7743):169-72. doi: 10.1016/s0140-6736(72)90569-7. No abstract available.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 999915197
- 15-I-N197
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Malaria
-
University of California, San FranciscoCenters for Disease Control and Prevention; University of Massachusetts, Amherst and other collaboratorsRecruitingPlasmodium Falciparum Malaria | Plasmodium Vivax MalariaLao People's Democratic Republic
-
University of OxfordWellcome Trust; Ministry of public Health AfghanistanCompletedVivax Malaria | Uncomplicated Falciparum MalariaAfghanistan
-
Menzies School of Health ResearchInternational Centre for Diarrhoeal Disease Research, Bangladesh; Addis Ababa... and other collaboratorsCompletedMalaria | Vivax Malaria | Falciparum MalariaEthiopia, Bangladesh, Indonesia
-
Medicines for Malaria VentureAsociacion Civil Selva AmazonicaCompletedPlasmodium Falciparum Malaria | Plasmodium Vivax MalariaPeru
-
Gadjah Mada UniversityMenzies School of Health Research; Eijkman Institute for Molecular Biology; Timika...Completed
-
Menzies School of Health ResearchNational Health and Medical Research Council, Australia; Wellcome Trust; National...CompletedVivax Malaria | Falciparum MalariaIndonesia
-
London School of Hygiene and Tropical MedicineWorld Health Organization; United Nations High Commissioner for Refugees; HealthNet... and other collaboratorsCompletedMalaria | Vivax Malaria | Falciparum MalariaPakistan
-
Menzies School of Health ResearchNational Health and Medical Research Council, Australia; Wellcome Trust; National...CompletedVivax Malaria | Falciparum MalariaIndonesia
-
Research Institute for Tropical Medicine, PhilippinesWorld Health OrganizationCompletedTES of Artemether-lumefantrine for Pf and Chloroquine for Pv in the Philippines From 2013-2014 (TES)Malaria | Vivax Malaria | Falciparum Malaria | Malaria Recrudescence
-
University of IbadanShin Poong Pharm Co Ltd 161 yoksam-ro, Gangnam-Gu Seoul 135-925, Korea; Institute...CompletedPlasmodium Falciparum Malaria | Uncomplicated Malaria | Malaria FeverNigeria