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Efficacy of Anti-CFA/I and CfaE Bovine Milk Immunoglobulin Against Challenge With H10407 ETEC Expressing CFA/I (BIgGI)

Primary Purpose

Diarrhea

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
anti-CFA/I bovine IgG, and anti-CfaE bovine IgG
Sponsored by
Johns Hopkins Bloomberg School of Public Health
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional prevention trial for Diarrhea focused on measuring traveler's diarrhea, ETEC diarrhea, passive immunization, bovine milk prophylaxis

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Male or female between 18 and 45 years of age.
  • General good health, without significant medical illness, abnormal physical examination findings or clinical laboratory abnormalities as determined by principal investigator.
  • Demonstrate comprehension of the protocol procedures and knowledge of ETEC illness by passing a written examination (pass grade ≥ 70%)
  • Willing to participate after informed consent obtained.
  • Available for all planned follow-up visits.
  • Negative serum pregnancy test at screening and a negative urine pregnancy test on the day of admittance to the inpatient phase for female volunteers of childbearing potential. Females of childbearing potential must agree to use an efficacious hormonal or barrier method of birth control during the study. Abstinence is acceptable. Female volunteers unable to bear children must have this documented (e.g., tubal ligation or hysterectomy).

Exclusion Criteria:

  • Presence of a significant medical condition, (e.g. psychiatric conditions or gastrointestinal disease, such as peptic ulcer, symptoms or evidence of active gastritis or gastroesophageal reflux disease, inflammatory bowel disease, alcohol or illicit drug abuse/dependency), or other laboratory abnormalities which in the opinion of the investigator precludes participation in the study.
  • Immunosuppressive illness or IgA deficiency (below the normal limits)
  • Positive serology results for HIV, HBsAg, or HCV antibodies.
  • Significant abnormalities in screening lab hematology, serum chemistry, urinalysis or EKG (EKG in volunteers ≥ 40 years), as determined by PI.
  • Allergy to fluoroquinolones, trimethoprim-sulfamethoxazole, or ampicillin/penicillin (excluded if allergic to two of three).
  • Abnormal stool pattern (fewer than 3 stools per week or more than 3 stools per day) on a regular basis.
  • History of diarrhea in the 2 weeks prior to planned inpatient phase
  • Regular use of laxatives, antacids, or other agents to lower stomach acidity (regular defined as at least weekly).
  • Use of antibiotics during the 7 days before dosing or proton pump inhibitors, H2 blockers, or antacids within 48 hours of dosing.
  • Travel to countries where ETEC or cholera infection is endemic (most of the developing world) within two years prior to dosing.
  • History of vaccination for or ingestion of ETEC, cholera, or LT toxin.
  • Stool culture (collected no more than 1 week prior to admission) positive for CFA/I + ETEC or other bacterial enteric pathogens (Salmonella, Shigella and Campylobacter).
  • Use of any investigational drug or any investigational vaccine within 30 days preceding the first dose of test article, or planned use during the active study period.
  • Clinical history of lactose intolerance or allergy to milk or milk products.
  • Use of any medication known to affect the immune function (e.g., corticosteroids and others) within 30 days preceding the first dose of study vaccine, or planned use during the active study period.
  • Inability to tolerate an over-the-counter, lactose-free, infant, powder formula suspended in 150 mL sodium bicarbonate buffer (based on requirement for frequent dosing).

Sites / Locations

  • Johns Hopkins Bayview Medicial Center, Inpatient Unit
  • General Clinical Research Center

Outcomes

Primary Outcome Measures

Clinical diagnosis of diarrhea defined as 1 loose/liquid stool (≥ Grade 3) of >300 g OR ≥ 2 loose/liquid stools totaling ≥ 200 g during any 48-hour period within 120 hours of challenge with ETEC strain H10407.

Secondary Outcome Measures

Prevention of moderate to severe diarrhea.

Full Information

First Posted
February 13, 2007
Last Updated
February 14, 2007
Sponsor
Johns Hopkins Bloomberg School of Public Health
Collaborators
Naval Medical Research Center, Walter Reed Army Institute of Research (WRAIR)
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1. Study Identification

Unique Protocol Identification Number
NCT00435526
Brief Title
Efficacy of Anti-CFA/I and CfaE Bovine Milk Immunoglobulin Against Challenge With H10407 ETEC Expressing CFA/I
Acronym
BIgGI
Official Title
Protective Efficacy of Orally Delivered Bovine Milk Immunoglobulin (BIgG) Specific for the Minor CFA/I Fimbrial Adhesin CfaE Against Challenge With H10407 Enterotoxigenic E. Coli (ETEC) Strain Expressing CFA/I
Study Type
Interventional

2. Study Status

Record Verification Date
February 2007
Overall Recruitment Status
Completed
Study Start Date
March 2006 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
October 2006 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Johns Hopkins Bloomberg School of Public Health
Collaborators
Naval Medical Research Center, Walter Reed Army Institute of Research (WRAIR)

4. Oversight

5. Study Description

Brief Summary
The purpose of this study is to assess anti-CFA/I and anti-CfaE BIgG safety and to determine protective efficacy of anti-CFA/I and anti-CfaE BIgG against diarrhea after challenge with H10407, a CFA/I-expressing ETEC strain.
Detailed Description
This is a Randomized, double-blinded, placebo-controlled trial involving up to 33 subjects. Subjects will be randomized into one of the following three groups. Group N Product 10 BIgG anti-CFA/I 10 BIgG anti-CfaE 10 LactoFree® Lipil® Volunteers will receive the test article three times daily following meals beginning 2 days prior to oral ETEC challenge (strain H10407). Test article will be administered for a total of 7 days. Monitoring procedures will assess volunteer safety, the primary endpoint (diarrhea), stool microbiology (H10407 excretion), and ETEC-specific immunology. All volunteers will receive antibiotic treatment (ciprofloxacin, trimethoprim-sulfamethoxazole or amoxicillin) starting 5 days after ETEC challenge or sooner based on pre-defined clinical criteria. Follow-up visits for 2 weeks post-discharge will monitor safety and immunological parameters.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diarrhea
Keywords
traveler's diarrhea, ETEC diarrhea, passive immunization, bovine milk prophylaxis

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
Double
Allocation
Randomized
Enrollment
30 (false)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
anti-CFA/I bovine IgG, and anti-CfaE bovine IgG
Primary Outcome Measure Information:
Title
Clinical diagnosis of diarrhea defined as 1 loose/liquid stool (≥ Grade 3) of >300 g OR ≥ 2 loose/liquid stools totaling ≥ 200 g during any 48-hour period within 120 hours of challenge with ETEC strain H10407.
Secondary Outcome Measure Information:
Title
Prevention of moderate to severe diarrhea.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male or female between 18 and 45 years of age. General good health, without significant medical illness, abnormal physical examination findings or clinical laboratory abnormalities as determined by principal investigator. Demonstrate comprehension of the protocol procedures and knowledge of ETEC illness by passing a written examination (pass grade ≥ 70%) Willing to participate after informed consent obtained. Available for all planned follow-up visits. Negative serum pregnancy test at screening and a negative urine pregnancy test on the day of admittance to the inpatient phase for female volunteers of childbearing potential. Females of childbearing potential must agree to use an efficacious hormonal or barrier method of birth control during the study. Abstinence is acceptable. Female volunteers unable to bear children must have this documented (e.g., tubal ligation or hysterectomy). Exclusion Criteria: Presence of a significant medical condition, (e.g. psychiatric conditions or gastrointestinal disease, such as peptic ulcer, symptoms or evidence of active gastritis or gastroesophageal reflux disease, inflammatory bowel disease, alcohol or illicit drug abuse/dependency), or other laboratory abnormalities which in the opinion of the investigator precludes participation in the study. Immunosuppressive illness or IgA deficiency (below the normal limits) Positive serology results for HIV, HBsAg, or HCV antibodies. Significant abnormalities in screening lab hematology, serum chemistry, urinalysis or EKG (EKG in volunteers ≥ 40 years), as determined by PI. Allergy to fluoroquinolones, trimethoprim-sulfamethoxazole, or ampicillin/penicillin (excluded if allergic to two of three). Abnormal stool pattern (fewer than 3 stools per week or more than 3 stools per day) on a regular basis. History of diarrhea in the 2 weeks prior to planned inpatient phase Regular use of laxatives, antacids, or other agents to lower stomach acidity (regular defined as at least weekly). Use of antibiotics during the 7 days before dosing or proton pump inhibitors, H2 blockers, or antacids within 48 hours of dosing. Travel to countries where ETEC or cholera infection is endemic (most of the developing world) within two years prior to dosing. History of vaccination for or ingestion of ETEC, cholera, or LT toxin. Stool culture (collected no more than 1 week prior to admission) positive for CFA/I + ETEC or other bacterial enteric pathogens (Salmonella, Shigella and Campylobacter). Use of any investigational drug or any investigational vaccine within 30 days preceding the first dose of test article, or planned use during the active study period. Clinical history of lactose intolerance or allergy to milk or milk products. Use of any medication known to affect the immune function (e.g., corticosteroids and others) within 30 days preceding the first dose of study vaccine, or planned use during the active study period. Inability to tolerate an over-the-counter, lactose-free, infant, powder formula suspended in 150 mL sodium bicarbonate buffer (based on requirement for frequent dosing).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robin McKenzie, M.D.
Organizational Affiliation
Johns Hopkins School of Public
Official's Role
Principal Investigator
Facility Information:
Facility Name
Johns Hopkins Bayview Medicial Center, Inpatient Unit
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21224
Country
United States
Facility Name
General Clinical Research Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States

12. IPD Sharing Statement

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Efficacy of Anti-CFA/I and CfaE Bovine Milk Immunoglobulin Against Challenge With H10407 ETEC Expressing CFA/I

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