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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 uppdaterad av: 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.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Faktisk)

50

Fas

  • Fas 1

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Maryland
      • Silver Spring, Maryland, Förenta staterna, 20910
        • Walter Reed Army Institute of Research Clinical Trial Center

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 45 år (Vuxen)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Icke-randomiserad
  • Interventionsmodell: Sekventiell tilldelning
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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
Andra namn:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Experimentell: 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
Experimentell: 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
Andra namn:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211
Experimentell: 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
Andra namn:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211
Experimentell: 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
Andra namn:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211
Experimentell: 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
Andra namn:
  • spd_dsc16Bntd14CssBAB7A[His]₆
Escherichia coli double mutant heat-labile toxin with mutations at amino acids 192 and 211

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Number of Participants With Solicited Adverse Events
Tidsram: 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
Tidsram: 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.

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Percentage of Participants With a Serum Immunologic Response to Coli Surface Antigen 6 (CS6)
Tidsram: 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
Tidsram: 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)
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Utredare

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

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

16 januari 2018

Primärt slutförande (Faktisk)

26 mars 2019

Avslutad studie (Faktisk)

26 mars 2019

Studieregistreringsdatum

Först inskickad

10 januari 2018

Först inskickad som uppfyllde QC-kriterierna

18 januari 2018

Första postat (Faktisk)

19 januari 2018

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

6 januari 2021

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

10 december 2020

Senast verifierad

1 november 2020

Mer information

Termer relaterade till denna studie

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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