A Phase 1 dose escalating study of ETEC candidate vaccine to determine safety and immunogenicity of a multi-dose regimen in healthy adult volunteers. The study will be conducted at Cincinnati Children's Hospital Medical Center (CCHMC). The primary objectives assess the safety and tolerability of dmLT vaccine when administered in three doses sublingually over a range of dosages in healthy adult subjects. The secondary objectives assess long-term safety follow-up from immunization through Month 7 post vaccination, following three SL doses of dmLT vaccine over a range of dosages and comparing with three doses of a comparable dosage of oral vaccine. The study subject population is 52 healthy adult male and female subjects, ages 18 to 45. Subject participation duration is approximately 8 months with study duration of approximately 1.5-2 years, including 6-7 months of follow-up.
Despite the public health burden of Enterotoxigenic Escherichia coli (ETEC) on travelers, deployed soldiers and, most significantly, young children in the developing world, there is no licensed vaccine against ETEC enteritis.This is a Phase 1 study in healthy adults to determine the safety and immunogenicity of an ETEC candidate vaccine, attenuated recombinant dmLT from ETEC, administered by the SL (Sublingual) or Oral Immunization. The study subject population is 52 healthy adult male and female subjects, ages 18 to 45. Subject participation duration is approximately 8 months with study duration of approximately 1.5-2 years, including 6-7 months of follow-up. Potential risks include subjects could develop varying degrees of diarrhea or other gastrointestinal symptoms (such as nausea, abdominal pain or cramping, gas, and decreased appetite). Blood drawing may be associated with pain and bruising at the site and rarely, with fainting or seizure. There is no direct benefit to subjects from participating in this study but the potential benefits to children and adults who may receive a future beneficial vaccine based on the results of this trial justify the more than minimal risk of the subjects who will participate in this trial. The primary objective is to assess the safety and tolerability of dmLT vaccine when administered in three doses sublingually over a range of dosages in healthy adult subjects. The secondary objectives are to assess long-term safety follow-up from immunization through Month 7 post vaccination, and following three SL doses of dmLT vaccine over a range of dosages and comparing with three doses of a comparable dosage of oral vaccine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
80
Attenuated, Recombinant Double Mutant Heat-Labile Toxin (dmLT) from Enterotoxigenic Escherichia coli (ETEC), LT(R192G/L211A); lot 1575. Subjects in 5 cohorts receive 3 doses ranging from 1 mcg to 50 mcg.
Attenuated, Recombinant Double Mutant Heat-Labile Toxin (dmLT) from Enterotoxigenic Escherichia coli (ETEC), LT(R192G/L211A); lot 1575. Subjects in 5b cohort receive 3 doses of 25 mcg.
Cincinnati Children's Hospital Medical Center - Gastroenterology, Hepatology and Nutrition
Cincinnati, Ohio, United States
Occurrence of solicited reactogenic side effects through Day 8 following each vaccination.
Time frame: Day 0 to Day 8
Occurrence of vaccine-related, non-solicited adverse events (AEs) for facial nerve disturbance through 75 days post third vaccination.
Time frame: Day 29 through Day 104
Occurrence of vaccine-related, non-solicited adverse events (AEs) through Day 36 following first vaccination.
Time frame: Day 0 to Day 36
Occurrence of vaccine-related serious adverse events (SAEs) through 7 months following first vaccination.
Time frame: Day 0 through Day 210
Proportion of subjects with =4-fold rise from the baseline in LT toxin neutralization titers.
Time frame: Days 0, 8, 15, 22, 29, 36, 64 and 85
Proportion of subjects with >/= 2-fold rise from the baseline in dmLT-specific IgA- and IgG-ALS at any time after vaccination.
Time frame: Days 0, 8, 15, 22, 29, 36, 64, and 85
Proportion of subjects with >/= 4-fold rise from the baseline in dmLT-specific fecal IgA or >/= 4-fold rise for the ratio of specific over total IgA after vaccination.
Time frame: Days 0, 8, 15, 22, 29, 36, and 64
Proportion of subjects with >/= 4-fold rise from the baseline in dmLT-specific IgA- and IgG-ALS after vaccination.
Time frame: Days 0, 8, 15, 20, 22, 29, 34, and 36
Proportion of subjects with >/= 4-fold rise from the baseline in dmLT-specific saliva IgA or >/= 4-fold rise for the ratio of specific over total IgA after vaccination.
Time frame: Days 0, 8, 15, 22, 29, 36, and 64
Proportion of subjects with >/= 4-fold rise from the baseline in dmLT-specific serum IgA or IgG at any time after vaccination.
Time frame: Days 0, 8, 15, 22, 29, 36, 64, and 85
Proportion of subjects with >8 IgA- or IgG-ASC/10^6 peripheral blood mononuclear cells (PBMCs) after vaccination.
Time frame: Days 0, 8, 15, 20, 22, 29, 34, and 36
Proportion of subjects with IgG and IgA dmLT-specific circulating ASC expressing gut homing receptors.
Time frame: Days 0 8, 15, 20, 22, 29, 34, and 36
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