The purpose of this study is to infect healthy volunteers aged 60-75 years old with Respiratory Syncytial Virus (RSV) to confirm how safe and well tolerated the use of an experimental RSV virus is in a population that has not previously received the virus. Additionally, this study will also look at various components of the volunteers' blood, the lining of their noses and other samples in order to measure the effects of the virus on the body, in particularly the immune system before, during and after viral infection.
RSV is a common virus that affects all human age groups. Typical RSV illness is identified by symptoms such as runny nose, stuffy nose, sneezing, sore throat, earache, malaise or tiredness, cough, shortness of breath, headache, muscle ache, joint ache or stiffness, chilliness and feverishness. RSV spreads easily from person to person through the eyes, nose or mouth when droplets containing the virus, such as those from coughing or sneezing, are inhaled or passed to others. Adults with risk factors, like another illness or disease, may experience an RSV illness that is more severe or lasts longer. RSV may also start a worsening of health in frail adults, people with weak immune systems, and those with chronic cardio-pulmonary disease. No treatment or vaccine to treat or prevent RSV disease is available in the UK. Vaccination against RSV has the potential to be a highly beneficial and effective approach to reduce RSV disease in older adults as well as other high-risk adult and paediatric populations. The use of RSV human viral challenge model provides an important tool to evaluate the effectiveness of new RSV vaccines. Specifically, a RSV human viral challenge in 60 to 75-year-old individuals would enable measuring the effectiveness of RSV vaccines in a population that is thought to be less responsive to vaccines than the 18-45-year-old population. The purpose of this study is to infect up to 74 healthy subjects aged 60 to 75 years old with RSV in a controlled quarantine environment to confirm how safe and well tolerated the use of an experimental RSV virus infection is in a population that has not previously received the virus. Additionally, the investigators will also look at various components of the subjects' blood, the lining of their noses and other samples in order to measure the effects of the virus on the body, in particularly the immune system before, during and after viral infection. The study will consist of 3 phases: 1) Screening, 2) Quarantine and 3) Follow-up. The enrolment of the subjects will be staggered with safety data reviews performed between groups. Each volunteer will be in the study for approximately 3 months from screening to their last scheduled clinic visit.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
24
Each subject will receive one titre of virus, which will be up to approximately 4.5 log10 PFU.
hVIVO Services Limited
London, United Kingdom
Number of routine clinical assessment abnormalities reported as adverse events.
Multiple safety clinical parameters will be used for safety evaluation: * Vital signs parameters (systolic blood pressure (mmHg), diastolic blood pressure (mmHg), respiratory rate (breaths per minute), heart rate (beats per minute) and SpO2 (%) * Tympanic temperature (deg C) * Spirometry parameters (FEV1(absolute), FEV1(% predicted), Forced vital capacity (FVC) (absolute), FVC (% predicted), FEV1/FVC ratio (absolute), FEV1/FVC ratio (% predicted) * ECG parameters (Heart Rate (beats/min), PR interval (msec), QRS duration (msec), QT interval (msec), QTc interval (msec), QTcB interval (msec), QTcF interval (msec) and RR interval (msec)) * Physical examination (complete examination and directed examination assessments).
Time frame: Safety data collected throughout the study (estimated 4 month).
Number of safety laboratory assessment abnormalities reported as adverse events.
* Haematology: platelet count, WBC count, neutrophils, lymphocytes, monocytes, eosinophils, basophils, reticulocyte count, reticulocyte count \[ each reported in 10\^9/L\]; RBC count (10\^12/L), haemoglobin (g/L), haematocrit (%), MCV (fL), MCH (PG), MCHC (g/L), Haemoglobin A1c * Biochemistry: sodium, potassium, glucose, chloride, bicarbonate, calcium, inorganic phosphate, urea, total cholesterol \[each reported in mmol/L\]; uric acid, creatinine, total bilirubin, indirect bilirubin, direct bilirubin \[each reported in umol/L\]; serum albumin (g/L), total protein (g/L), blood urea nitrogen (mg/dL), CRP (mg/L), GGT (IU/L), ALP (IU/L), ALT (IU/L), LDH (IU/L), AST (IU/L), urea (mmol/L), total cholesterol (mmol/L), Estimated Glomerular Filtration Rate. * Coagulation: PT (secs), APTT (secs) * Cardiac Enzymes: creatine kinase (IU/L), troponin T (ng/L) * Urinalysis: colour, specific gravity, appearance, pH, blood, glucose, leukocytes, ketones, nitrite, protein, urobilinogen, bilirubin.
Time frame: Safety data collected throughout the study (estimated 4 month).
Number of subjects with study related Adverse Events (AEs)
* use of concomitant medications * frequency and severity of AEs.
Time frame: Safety data collected throughout the study (estimated 4 month).
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Viral loads/shedding measurement following inoculation with RSV
The AUC of RSV-A Memphis 37b viral load measured in nasopharyngeal swabs by qPCR (log10 copies/mL units) and by cell base infectivity assay (log10 copies/mL units).
Time frame: Virology and clinical data collected throughout the study (estimated 4 month).
Duration of viral shedding.
The time (in hours) from first detectable viral shedding to first undetectable viral shedding.
Time frame: Virology and clinical data collected throughout the study (estimated 4 month)
Measurement of the total mucus weight produced.
Total weight of nasal discharge (grams).
Time frame: Virology and clinical data collected throughout the study (estimated 4 month).
Measurement of symptoms severity by self reported symptoms diary cards.
Symptoms are recorded on a grading scale of 0 to 3.
Time frame: Symptom Diary Cards data is collected throughout the quarantine period (estimated 15 days)
Measurement of the peak tympanic temperature.
Time of the highest recorded tympanic temperature.
Time frame: Temperature data is collected from day 0 to day 12.
Number and percentage of subjects with confirmed RSV infection.
Confirmed infection is measured by the presence of viral shedding in nasopharyngeal swabs.
Time frame: Virology data collected throughout the study (estimated 4 month)
Number and percentage of subjects with Upper and Lower Respiratory Tract Infection (URTI and LRTI)
URTI and LRTI are evaluated from Symptom Diary Cards and Physical Examination.
Time frame: Clinical data collected throughout the study (estimated 4 month)