This is a research study about an experimental (investigational) vaccine called ACE527. ACE527 is a vaccine that is being made to prevent disease from a germ called enterotoxigenic Escherichia coli (ETEC). This germ causes diarrhea, largely in children living in developing countries and in travelers to those countries. One purpose of this study is to see if the vaccine is safe and develops an immune response. Another purpose is to see if it prevents people from getting sick when exposed to the ETEC germ. This ETEC germ is also experimental (investigational).
This is a single-center, double-blind, placebo-controlled, Phase II vaccination and challenge study designed to assess the protective efficacy of the ACE 527 vaccine, as well as collect expanded safety and immunogenicity data. The study will be carried out in two phases. In the initial vaccination phase, up to 72 subjects will be randomized 1:1 to receive either ACE527 or placebo on an outpatient basis. Vaccine and placebo preparations will be given orally. Following vaccination, subjects will be followed as out-patients for safety using diary card surveillance, for vaccine shedding by qualitative stool culture (i.e. presence or absence) and for the development of local and systemic antibody responses to the ACE527 vaccine strains. In the subsequent inpatient challenge phase, up to 56 vaccinated subjects will be admitted as inpatients and challenged with the ETEC strain, H10407. The challenge dose will be administered orally.After challenge, subjects will be monitored for diarrhea and other signs/symptoms of enteric illness by daily medical checks, vital sign determinations, grading and weighing of all stools. Monitoring for fecal shedding of the challenge ETEC strain H10407 will occur daily, after challenge, while in-patient. Local and systemic antibody responses to the challenge ETEC strain H10407 will also be assessed. All subjects will be treated with Abx.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
70
ACE527 comprises a mixture of three live, attenuated ETEC strains; ACAM2025 (CFA/I+ and LTB+), ACAM2022 (CS5+, CS6+ and LTB+), and ACAM2027 (CS1+, CS2+, CS3+ and LTB+). The vaccine is administered orally as a two-dose regimen, at 9x1010 cfu, on Days 0 and 21, in 200 ml CeraVacx buffer. The required volume of each vaccine strain, supplied as a frozen suspension, is mixed into the buffer solution prior to dosing.
Placebo
Center for Immunization Research (CIR)
Baltimore, Maryland, United States
Severe diarrhea: ≥6 grade 3-5 stools in 24 hrs, or >800g of grade 3-5 stools in 24 hrs and moderate diarrhea: 4-5 grade 3-5 stools in 24 hrs or 401-800g of grade 3-5 stools in 24 hrs
Time frame: Study Day 49 to 57
Number of subjects with severe diarrhea (if any)
Time frame: Study Day 49 to 57
Number of subjects with diarrhea of any severity
Time frame: Study Day 49 to 57
Mean total weight of grade 3-5 stools passed per subject
Time frame: Study Day 49 to 57
Mean number of grade 3-5 stools per subject
Time frame: Study day 49 to 57
Number of subjects with nausea, vomiting, anorexia, or abdominal pain/cramps rated as moderate to severe.
Time frame: Study Day 0 to 77
Number of subjects who indicate they would have reduced their daily activity if they had been vacationing or traveling for business because of their ETEC illness.
Time frame: Last visit
Mean time to onset of diarrhea.
Time frame: Study Day 49 to 57
Number of subjects with moderate to severe ETEC illness
Time frame: Study Day 49 to 57
Number of colony forming unite (cfu) of the challenge strain per gram of stool
Time frame: Study day 49 to 57
Number of subjects requiring early antibiotic treatment
Time frame: Study Day 49 to 57
Number of subjects requiring IV fluids
Time frame: Study Day 49 to 57
Systemic immune responses to the constituent strains of the vaccine
Time frame: Selected Time Points
Mucosal immune responses to the constituent strains of the vaccine
Time frame: Selected Time Points
The intestinal colonization by the three individual vaccine strains and challenge strain post-vaccination
Time frame: Selected Time Points
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