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Dose Escalating Study of a Prototype CS6 Subunit Vaccine With a Modified Heat-labile Enterotoxin From Enterotoxigenic Escherichia Coli (ETEC)

10 décembre 2020 mis à jour par: PATH

A Phase 1 Dose Escalating Study of a Prototype CS6 Subunit Vaccine With a Modified Heat-labile Enterotoxin From Enterotoxigenic Escherichia Coli (ETEC)

This study will evaluate the safety of a prototype Coli surface antigen 6 (CS6) subunit vaccine (CssBA) alone or in combination with Escherichia coli double mutant heat labile toxin (dmLT) given by intramuscular (IM) injection.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

This is an open-label clinical trial in which a total of 50 participants will receive three injections of either CssBA alone, dmLT alone or CssBA + dmLT. The vaccine will be administered via IM injection to alternating deltoid regions on days 1, 22, and 43. Each participant will receive the same dose at each vaccination dependent upon group assignment. Group A is considered a pilot group in which all 3 doses will be administered and participants monitored for safety 7 days after the third vaccination, prior to the enrollment of participants in Group B.

Type d'étude

Interventionnel

Inscription (Réel)

50

Phase

  • La phase 1

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • Maryland
      • Silver Spring, Maryland, États-Unis, 20910
        • Walter Reed Army Institute of Research Clinical Trial Center

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans à 45 ans (Adulte)

Accepte les volontaires sains

Oui

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Healthy, adult, male or female, age 18 to 45 years (inclusive) at the time of enrollment.
  2. Completion and review of comprehension test (achieved > 70% accuracy).
  3. Signed informed consent document.
  4. Available for the required follow-up period and scheduled clinic visits.
  5. Women: Negative pregnancy test with understanding (through informed consent process) to not become pregnant during the study or within three (3) months following last vaccination.

Exclusion Criteria:

  1. Health problems (for example, intercurrent febrile illness, chronic medical conditions such as psychiatric conditions, diabetes mellitus, hypertension or any other condition that might place the subject at increased risk of adverse events) - study clinicians, in consultation with the PI, will use clinical judgment on a case-by-case basis to assess safety risks under this criterion. The PI will consult with the Research Monitor as appropriate.
  2. Clinically significant abnormalities on physical examination.
  3. Immunosuppressive drugs (use of systemic corticosteroids or chemotherapeutics that may influence antibody development) or illness (including immunoglobulin A [IgA] deficiency, defined by serum IgA < 7 mg/dL).
  4. Women who are pregnant or planning to become pregnant during the study period plus three (3) months beyond the last received dose and currently nursing women.
  5. Participation in research involving another investigational product (defined as receipt of investigational product or exposure to invasive investigational device) 30 days before planned date of first vaccination or anytime through the last study safety visit.
  6. Positive blood test for Hepatitis B surface antigen (HBsAg), Hepatitis C virus (HCV), human immunodeficiency virus (HIV)-1/2.
  7. Clinically significant abnormalities on basic laboratory screening.
  8. Exclusionary skin disease history/findings that would confound assessment or prevent appropriate local monitoring of adverse events (AEs), or possibly increase the risk of a local AE
  9. History of chronic skin disease (clinician judgement)
  10. Acute skin infection/eruptions on the upper arms including fungal infections, severe acne or active contact dermatitis
  11. Allergies that may increase the risk of AEs
  12. Regular use (weekly or more often) of antidiarrheal, anti-constipation, or antacid therapy
  13. Abnormal stool pattern (fewer than 3 stools per week or more than 3 stools per day) on a regular basis; loose or liquid stools on other than an occasional basis
  14. History of microbiologically confirmed ETEC or cholera infection in the last 3 years
  15. Travel to countries where ETEC or V. cholerae or other enteric infections are endemic (most of the developing world) within 3 years prior to dosing (clinician judgement)
  16. Symptoms consistent with Travelers' Diarrhea or concurrent with travel to countries where ETEC infection is endemic (most of the developing world) within 3 years prior to dosing, OR planned travel to endemic countries during the length of the study
  17. Vaccination for or ingestion of ETEC, cholera, or E. coli heat labile toxin within 3 years prior to dosing
  18. Occupation involving handling of ETEC or V. cholerae currently, or in the past 3 years

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: La prévention
  • Répartition: Non randomisé
  • Modèle interventionnel: Affectation séquentielle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Group A1: CssBA 5 ug
Participants received an intramuscular injection of 5 ug CssBA on days 1, 22, and 43.
Recombinant enterotoxigenic Escherichia coli (ETEC) surface antigen 6 containing modified structural subunits A and B
Autres noms:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Expérimental: Group A2: DmLT 100 ng
Participants received an intramuscular injection of 100 ng DmLT on days 1, 22, and 43.
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211
Expérimental: Group B: CssBA 5 ug + DmLT 100 ng
Participants received an intramuscular injection of 5 ug CssBA + 100 ng dmLT on days 1, 22, and 43.
Recombinant enterotoxigenic Escherichia coli (ETEC) surface antigen 6 containing modified structural subunits A and B
Autres noms:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211
Expérimental: Group C: CssBA 5 ug + DmLT 500 ng
Participants received an intramuscular injection of 5 ug CssBA + 500 ng dmLT on days 1, 22, and 43.
Recombinant enterotoxigenic Escherichia coli (ETEC) surface antigen 6 containing modified structural subunits A and B
Autres noms:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211
Expérimental: Group D: CssBA 15 ug + DmLT 500 ng
Participants received an intramuscular injection of 15 ug CssBA + 500 ng dmLT on days 1, 22, and 43.
Recombinant enterotoxigenic Escherichia coli (ETEC) surface antigen 6 containing modified structural subunits A and B
Autres noms:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211
Expérimental: Group E: CssBA 45 ug + DmLT 500 ng
Participants received an intramuscular injection of 45 ug CssBA + 500 ng dmLT on days 1, 22, and 43.
Recombinant enterotoxigenic Escherichia coli (ETEC) surface antigen 6 containing modified structural subunits A and B
Autres noms:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Number of Participants With Solicited Adverse Events
Délai: From first vaccination to 28 days after the third vaccination, 71 days.

Solicited adverse events included vaccine site pain, vaccine site pruritus, vaccine site rash/eruption, vaccine site swelling, vaccine site tenderness, fever, headache, diarrhea, arthralgia, myalgia, malaise, nausea, and vomiting.

Adverse events were assessed for severity by the investigator according to the following:

Mild (Grade 1): Does not interfere with routine activities, minimal level of discomfort

Moderate (Grade 2): Interferes with routine activities, moderate level of discomfort

Severe (Grade 3): Unable to perform routine activities, significant level of discomfort

Potentially life-threatening (Grade 4): Hospitalization or emergency room (ER) visit for potentially life-threatening event

From first vaccination to 28 days after the third vaccination, 71 days.
Number of Participants With Unsolicited Adverse Events
Délai: From first vaccination to 28 days after the third vaccination, 71 days.

Adverse events were assessed for severity by the investigator according to the following:

Mild (Grade 1): Does not interfere with routine activities Minimal level of discomfort

Moderate (Grade 2): Interferes with routine activities Moderate level of discomfort

Severe (Grade 3): Unable to perform routine activities Significant level of discomfort

Potentially life-threatening (Grade 4): Hospitalization or emergency room (ER) visit for potentially life-threatening event

From first vaccination to 28 days after the third vaccination, 71 days.

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Percentage of Participants With a Serum Immunologic Response to Coli Surface Antigen 6 (CS6)
Délai: Baseline (Day 1 predose), Days 22 and 43 predose, and Day 70
Serum samples were assayed for immunoglobulin G (IgG) and immunoglobulin A (IgA) antibody titers against CS6 using an enzyme-linked Immunosorbent assay (ELISA). Immunologic response was defined as a ≥ 4-fold increase in reciprocal endpoint titer between Baseline and any post-vaccination sample.
Baseline (Day 1 predose), Days 22 and 43 predose, and Day 70
Percentage of Participants With a Serum Immunologic Response to Labile Toxin
Délai: Baseline (Day 1 predose), Days 22 and 43 predose, and Day 70
Serum samples were assayed for immunoglobulin G (IgG) and immunoglobulin A (IgA) antibody titers against labile toxin using an enzyme-linked Immunosorbent assay (ELISA). Immunologic response was defined as a ≥ 4-fold increase in reciprocal endpoint titer between Baseline and any post-vaccination sample.
Baseline (Day 1 predose), Days 22 and 43 predose, and Day 70
Percentage of Participants With a Mucosal Immunologic Response to Coli Surface Antigen 6 (CS6)
Délai: Baseline (Day 1 pre-dose), Days 8 and 29 predose, and Day 50

Peripheral blood mononuclear cells (PBMCs) were collected to determine antibody responses from lymphocyte supernatant against CS6 at Baseline and 7 days after each vaccination. Antibody in lymphocyte supernatant (ALS) is an indirect quantification of antibody secreting cells (ASC) activated in the mucosa that circulate in the peripheral blood about seven days post-mucosal immunization/infection. After incubation, lymphocyte supernatant was assayed for antigen-specific IgG and IgA antibodies using ELISA.

A positive ALS response was defined as a four-fold rise in antibody titers between Baseline and any post vaccination sample.

Baseline (Day 1 pre-dose), Days 8 and 29 predose, and Day 50
Percentage of Participants With a Mucosal Immunologic Response to Labile Toxin
Délai: Baseline (Day 1 pre-dose), Days 8 and 29 predose, and Day 50

Peripheral blood mononuclear cells (PBMCs) were collected to determine antibody responses from lymphocyte supernatant against labile toxin at Baseline and 7 days after each vaccination. Antibody in lymphocyte supernatant (ALS) is an indirect quantification of antibody secreting cells (ASC) activated in the mucosa that circulate in the peripheral blood about seven days post-mucosal immunization/infection. After incubation, lymphocyte supernatant was assayed for antigen-specific IgG and IgA antibodies using ELISA.

A positive ALS response was defined as a four-fold rise in antibody titers between Baseline and any post vaccination sample.

Baseline (Day 1 pre-dose), Days 8 and 29 predose, and Day 50
Geometric Mean Titer of Serum Anti-CS6 Immunoglobulin G Antibodies
Délai: Days 1, 22, and 43 pre-vaccination, and Day 70
Serum samples were assayed for IgG antibody titers against CS6 using an enzyme-linked Immunosorbent assay (ELISA).
Days 1, 22, and 43 pre-vaccination, and Day 70
Geometric Mean Titer of Serum Anti-CS6 Immunoglobulin A Antibodies
Délai: Days 1, 22, and 43 pre-vaccination, and Day 70
Serum samples were assayed for IgA antibody titers against CS6 using an enzyme-linked Immunosorbent assay (ELISA).
Days 1, 22, and 43 pre-vaccination, and Day 70
Geometric Mean Titer of Serum Anti-LT Immunoglobulin G Antibodies
Délai: Days 1, 22, and 43 pre-vaccination, and Day 70
Serum samples were assayed for IgG antibody titers against labile toxin using an enzyme-linked Immunosorbent assay (ELISA).
Days 1, 22, and 43 pre-vaccination, and Day 70
Geometric Mean Titer of Serum Anti-LT Immunoglobulin A Antibodies
Délai: Days 1, 22, and 43 pre-vaccination, and Day 70
Serum samples were assayed for IgA antibody titers against labile toxin using an enzyme-linked Immunosorbent assay (ELISA).
Days 1, 22, and 43 pre-vaccination, and Day 70
Geometric Mean Titer of Antibody Lymphocyte Supernatant Anti-CS6 Immunoglobulin G Antibodies
Délai: Days 1, 8, 29 and 50
Lymphocyte supernatant was assayed for IgG antibody titers against CS6 using ELISA.
Days 1, 8, 29 and 50
Geometric Mean Titer of Antibody Lymphocyte Supernatant Anti-CS6 Immunoglobulin A Antibodies
Délai: Days 1, 8, 29, and 50
Lymphocyte supernatant was assayed for IgA antibody titers against CS6 using ELISA.
Days 1, 8, 29, and 50
Geometric Mean Titer of Antibody Lymphocyte Supernatant Anti-LT Immunoglobulin G Antibodies
Délai: Days 1, 8, 29, and 50
Lymphocyte supernatant was assayed for IgG antibody titers against labile toxin using ELISA.
Days 1, 8, 29, and 50
Geometric Mean Titer of Antibody Lymphocyte Supernatant Anti-LT Immunoglobulin A Antibodies
Délai: Days 1, 8, 29, and 50
Lymphocyte supernatant was assayed for IgA antibody titers against labile toxin using ELISA.
Days 1, 8, 29, and 50

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Les enquêteurs

  • Chercheur principal: Tida K Lee, MD, PhD, Naval Medical Research Center

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

16 janvier 2018

Achèvement primaire (Réel)

26 mars 2019

Achèvement de l'étude (Réel)

26 mars 2019

Dates d'inscription aux études

Première soumission

10 janvier 2018

Première soumission répondant aux critères de contrôle qualité

18 janvier 2018

Première publication (Réel)

19 janvier 2018

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

6 janvier 2021

Dernière mise à jour soumise répondant aux critères de contrôle qualité

10 décembre 2020

Dernière vérification

1 novembre 2020

Plus d'information

Termes liés à cette étude

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Oui

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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