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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 december 2020 bijgewerkt door: 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.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

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.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

50

Fase

  • Fase 1

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

    • Maryland
      • Silver Spring, Maryland, Verenigde Staten, 20910
        • Walter Reed Army Institute of Research Clinical Trial Center

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 45 jaar (Volwassen)

Accepteert gezonde vrijwilligers

Ja

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

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

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Preventie
  • Toewijzing: Niet-gerandomiseerd
  • Interventioneel model: Sequentiële toewijzing
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: 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
Andere namen:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Experimenteel: 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
Experimenteel: 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
Andere namen:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211
Experimenteel: 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
Andere namen:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211
Experimenteel: 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
Andere namen:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211
Experimenteel: 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
Andere namen:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Number of Participants With Solicited Adverse Events
Tijdsspanne: 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
Tijdsspanne: 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.

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Percentage of Participants With a Serum Immunologic Response to Coli Surface Antigen 6 (CS6)
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Onderzoekers

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

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

16 januari 2018

Primaire voltooiing (Werkelijk)

26 maart 2019

Studie voltooiing (Werkelijk)

26 maart 2019

Studieregistratiedata

Eerst ingediend

10 januari 2018

Eerst ingediend dat voldeed aan de QC-criteria

18 januari 2018

Eerst geplaatst (Werkelijk)

19 januari 2018

Updates van studierecords

Laatste update geplaatst (Werkelijk)

6 januari 2021

Laatste update ingediend die voldeed aan QC-criteria

10 december 2020

Laatst geverifieerd

1 november 2020

Meer informatie

Termen gerelateerd aan deze studie

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Ja

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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