Na-GST-1 and Na-APR-1 are proteins expressed during the adult stage of the Necator americanus hookworm life cycle that are thought to play a role in the parasite's degradation of host hemoglobin for use as an energy source. Vaccination with recombinant GST-1 or APR-1 has protected dogs and hamsters from infection in challenge studies. This study will evaluate the safety and immunogenicity of co-administering Na-GST-1 and Na-APR-1 to healthy Gabonese adults living in an area of endemic hookworm infection.
Double-blind, randomized, controlled dose-escalation Phase 1 clinical trial in hookworm exposed adults. Study site: Centre de Recherches Médicales de Lambaréné Number of participants: 32 in 2 cohorts of 16 Doses of Na-GST-1 to be tested: 30 and 100 μg Doses of Na-APR-1 to be tested: 30 and 100 μg Dose of GLA-AF: 5 μg per antigen Cohort 1: 30 μg of each of the two antigens (Na-GST-1/Alhydrogel® and Na-APR-1 (M74)/Alhydrogel®) or hepatitis B vaccine; Cohort 2: 100 μg of each of the two antigens (Na-GST- 1/Alhydrogel® and Na-APR-1 (M74) /Alhydrogel®) or hepatitis B vaccine. Randomization: Cohort 1: 30 μg Na-GST-1 + 30 μg Na-APR-1 (M74) (n = 12) versus Hepatitis B Vaccine/placebo (n = 4) Cohort 2: 100 μg Na-GST-1 + 100 μg Na-APR-1 (M74) (n = 12) versus Hepatitis B Vaccine + placebo (n = 4) The cohorts will be enrolled in a staggered fashion with safety data assessed prior to the Na-GST-1 and Na-APR-1 dose escalation from 30 to 100 µg. Pre-treatment: Albendazole (400 mg) at least 2 weeks prior to first vaccination Immunization schedule: Study days 0, 28 and 180 Route: Intramuscular in the deltoid muscle Study duration: approximately 20 months; each participant will be followed for a total of 12 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
32
Hepatitis B vaccine co-administered with saline
Centre de Recherches Médicales de Lambaréné Albert Schweitzer Hospital
Lambaréné, Gabon
Vaccine-related Adverse Events
To estimate the frequency of vaccine-related adverse events, graded by severity, for each dose of co-administered Na-GST-1 and Na-APR-1 (M74). The frequency of immediate, systemic, and local injection site adverse events will be summarized. Adverse events will be assessed by study team members at 1 hour post-vaccination as well as 1, 3, 7, 14, and 28 days following each vaccination.
Time frame: Day 360
IgG response to Na-GST-1 and Na-APR-1 (M74)
To determine the doses of Na-GST-1 and Na-APR-1 (M74) that generate the highest IgG antibody responses at Day 194, as determined by indirect enzyme-linked immunosorbent assays (ELISA)
Time frame: Day 194
Duration of antibody response to Na-GST-1 and Na-APR-1 (M74)
To assess and compare the duration of antibody responses to Na- GST-1 and Na-APR-1 (M74).
Time frame: Day 14, 28, 42, 56, 180, 194, 208, 270, 360
Exploratory studies of memory B-cell responses
Exploratory studies of memory B-cell responses against the metabolomics changes before and after Na-GST-1 and NA-APR-1 (M74) vaccine antigens.
Time frame: Days 14, 28, 42, 56, 180, 194, 208, 270, 360
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