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Re-exposure of Human Volunteers to a Heterologous Strain of P. Falciparum Sporozoites (TIP4)

Primary Purpose

Malaria, Falciparum

Status
Completed
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
Heterologous challenge
Malarone treatment
Sponsored by
Radboud University Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Malaria, Falciparum focused on measuring Plasmodium, falciparum, malaria, heterologous, immunity

Eligibility Criteria

18 Years - 35 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Age ≥ 18 and ≤ 35 years healthy volunteers (males or females)
  2. Good health based on history and clinical examination
  3. Negative pregnancy test
  4. Use of adequate contraception for females
  5. Signing of the informed consent form, thereby demonstrating understanding of the meaning and procedures of the study
  6. Agreement to inform the general practitioner and to sign a request to release medical information concerning contra-indications for participation in the study
  7. Willingness to undergo a Pf controlled challenge through mosquito bites
  8. Agreement to stay in a hotel room close to the trial centre during a part of the study (Day 5 after challenge till treatment is finished)
  9. Reachable (24/7) by mobile phone during the whole study period
  10. Available to attend all study visit
  11. Agreement to refrain from blood donation to Sanquin or for other purposes, during the whole study period
  12. Willingness to undergo HIV, hepatitis B and hepatitis C tests
  13. Negative urine toxicology screening test at screening visit and the day before challenge
  14. Willingness to take a curative regimen of Malarone®

Exclusion Criteria:

  1. History of malaria (other than participation in ZonMw1 study) or residence in malaria endemic areas within the past six months
  2. Plans to travel to malaria endemic areas during the study period
  3. Plans to travel outside of the Netherlands during the challenge period
  4. Previous participation in any malaria vaccine study and/or positive serology for Pf (except ZonMw1 volunteers)
  5. Symptoms, physical signs and laboratory values suggestive of systemic disorders including renal, hepatic, cardiovascular, pulmonary, skin, immunodeficiency, psychiatric, and other conditions which could interfere with the interpretation of the study results or compromise the health of the volunteers
  6. History of diabetes mellitus or cancer (except basal cell carcinoma of the skin)
  7. History of arrhythmias or prolonged QT-interval
  8. Positive family history in 1st and 2nd degree relatives for cardiac events < 50 years old
  9. An estimated, ten year risk of fatal cardiovascular disease of ≥5%, as estimated by the Systematic Coronary Risk Evaluation (SCORE) system
  10. Clinically significant abnormalities in electrocardiogram (ECG) at screening
  11. Body Mass Index (BMI) below 18 or above 30 kg/m2
  12. Any clinically significant deviation from the normal range in biochemistry or hematology blood tests or in urine analysis
  13. Positive HIV, HBV or HCV tests
  14. Participation in any other clinical study within 30 days prior to the onset of the study
  15. Enrollment in any other clinical study during the study period
  16. For women: being pregnant or lactating
  17. Volunteers unable to give written informed consent
  18. Volunteers unable to be closely followed for social, geographic or psychological reasons
  19. History of drug or alcohol abuse interfering with normal social function
  20. A history of treatment for psychiatric disease
  21. A history of convulsions
  22. Contra-indications to Malarone®, including hypersensitivity or treatment taken by the volunteer that interferes with Malarone®
  23. The use of chronic immunosuppressive drugs, antibiotics, or other immune modifying drugs within three months of study onset (inhaled and topical corticosteroids and oral anti-histaminic are allowed) and during the study period
  24. Any confirmed or suspected immunosuppressive or immunodeficient condition, including (functional) asplenia
  25. Co-workers or trainees of the departments Infectious Diseases, Medical Microbiology or Parasitology of the Leiden University Medical Centre (LUMC) or Medical Microbiology, Parasitology, Radboud University Nijmegen (RUNMC)
  26. A history of sickle cell anaemia, sickle cell trait, thalassaemia (or trait), G6PD deficiency

Sites / Locations

  • Leiden University Medical Centre

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Heterologous challenge

Challenge control

Arm Description

Biological: Heterologous challenge with 5 infected mosquito bites (NF135) after previous CPS immunization and challenge. Drug: Malarone treatment When thick smear positive, of at day 21 after challenge, all volunteers will be treated with malarone. Other Name: atovaquone/proguanil

Biological: Plasmodium falciparum mosquito challenge by the bites of 5 Plasmodium falciparum infected mosquitoes (NF135). Drug: Malarone treatment When thick smear positive, of at day 21 after challenge, all volunteers will be treated with malarone. Other Name: atovaquone/proguanil

Outcomes

Primary Outcome Measures

Duration of prepatent period after challenge infection as measured by microscopy

Secondary Outcome Measures

• Parasitemia and kinetics of parasitemia as measured by PCR
Frequency of signs or symptoms in study groups
• Immune responses between study groups

Full Information

First Posted
July 23, 2012
Last Updated
February 12, 2013
Sponsor
Radboud University Medical Center
Collaborators
Leiden University Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT01660854
Brief Title
Re-exposure of Human Volunteers to a Heterologous Strain of P. Falciparum Sporozoites
Acronym
TIP4
Official Title
Re-exposure of Previously Immunized and Challenged Human Volunteers to a Heterologous Strain of P. Falciparum Sporozoites
Study Type
Interventional

2. Study Status

Record Verification Date
July 2012
Overall Recruitment Status
Completed
Study Start Date
July 2012 (undefined)
Primary Completion Date
January 2013 (Actual)
Study Completion Date
January 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Radboud University Medical Center
Collaborators
Leiden University Medical Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
In a previous study (NL33904.091.10) the investigators challenged 24 volunteers after Chloroquine Prophylaxis Sporozoites (CPS) immunization with 45, 30 or 15 infected mosquito-bites respectively. The availability of this immunized cohort opens the unique opportunity to determine protection to a heterologous challenge for both of the protected and unprotected volunteers as the previous challenge infection might have served as immunological boost to the unprotected volunteers. In the current observational, proof of principle study, the investigators aim to investigate the protection on an individual basis of these previously immunized and challenged volunteers against a heterologous P. falciparum challenge.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malaria, Falciparum
Keywords
Plasmodium, falciparum, malaria, heterologous, immunity

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
21 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Heterologous challenge
Arm Type
Experimental
Arm Description
Biological: Heterologous challenge with 5 infected mosquito bites (NF135) after previous CPS immunization and challenge. Drug: Malarone treatment When thick smear positive, of at day 21 after challenge, all volunteers will be treated with malarone. Other Name: atovaquone/proguanil
Arm Title
Challenge control
Arm Type
Active Comparator
Arm Description
Biological: Plasmodium falciparum mosquito challenge by the bites of 5 Plasmodium falciparum infected mosquitoes (NF135). Drug: Malarone treatment When thick smear positive, of at day 21 after challenge, all volunteers will be treated with malarone. Other Name: atovaquone/proguanil
Intervention Type
Biological
Intervention Name(s)
Heterologous challenge
Intervention Description
challenge by the bites of 5 Plasmodium falciparum infected mosquitoes.
Intervention Type
Drug
Intervention Name(s)
Malarone treatment
Other Intervention Name(s)
atovaquon/proguanil
Intervention Description
Three days: 4 tablets 250/100mg per day
Primary Outcome Measure Information:
Title
Duration of prepatent period after challenge infection as measured by microscopy
Time Frame
21 days after challenge
Secondary Outcome Measure Information:
Title
• Parasitemia and kinetics of parasitemia as measured by PCR
Time Frame
21 days after challenge
Title
Frequency of signs or symptoms in study groups
Time Frame
21 days after challenge
Title
• Immune responses between study groups
Time Frame
21 days after challenge

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
35 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 and ≤ 35 years healthy volunteers (males or females) Good health based on history and clinical examination Negative pregnancy test Use of adequate contraception for females Signing of the informed consent form, thereby demonstrating understanding of the meaning and procedures of the study Agreement to inform the general practitioner and to sign a request to release medical information concerning contra-indications for participation in the study Willingness to undergo a Pf controlled challenge through mosquito bites Agreement to stay in a hotel room close to the trial centre during a part of the study (Day 5 after challenge till treatment is finished) Reachable (24/7) by mobile phone during the whole study period Available to attend all study visit Agreement to refrain from blood donation to Sanquin or for other purposes, during the whole study period Willingness to undergo HIV, hepatitis B and hepatitis C tests Negative urine toxicology screening test at screening visit and the day before challenge Willingness to take a curative regimen of Malarone® Exclusion Criteria: History of malaria (other than participation in ZonMw1 study) or residence in malaria endemic areas within the past six months Plans to travel to malaria endemic areas during the study period Plans to travel outside of the Netherlands during the challenge period Previous participation in any malaria vaccine study and/or positive serology for Pf (except ZonMw1 volunteers) Symptoms, physical signs and laboratory values suggestive of systemic disorders including renal, hepatic, cardiovascular, pulmonary, skin, immunodeficiency, psychiatric, and other conditions which could interfere with the interpretation of the study results or compromise the health of the volunteers History of diabetes mellitus or cancer (except basal cell carcinoma of the skin) History of arrhythmias or prolonged QT-interval Positive family history in 1st and 2nd degree relatives for cardiac events < 50 years old An estimated, ten year risk of fatal cardiovascular disease of ≥5%, as estimated by the Systematic Coronary Risk Evaluation (SCORE) system Clinically significant abnormalities in electrocardiogram (ECG) at screening Body Mass Index (BMI) below 18 or above 30 kg/m2 Any clinically significant deviation from the normal range in biochemistry or hematology blood tests or in urine analysis Positive HIV, HBV or HCV tests Participation in any other clinical study within 30 days prior to the onset of the study Enrollment in any other clinical study during the study period For women: being pregnant or lactating Volunteers unable to give written informed consent Volunteers unable to be closely followed for social, geographic or psychological reasons History of drug or alcohol abuse interfering with normal social function A history of treatment for psychiatric disease A history of convulsions Contra-indications to Malarone®, including hypersensitivity or treatment taken by the volunteer that interferes with Malarone® The use of chronic immunosuppressive drugs, antibiotics, or other immune modifying drugs within three months of study onset (inhaled and topical corticosteroids and oral anti-histaminic are allowed) and during the study period Any confirmed or suspected immunosuppressive or immunodeficient condition, including (functional) asplenia Co-workers or trainees of the departments Infectious Diseases, Medical Microbiology or Parasitology of the Leiden University Medical Centre (LUMC) or Medical Microbiology, Parasitology, Radboud University Nijmegen (RUNMC) A history of sickle cell anaemia, sickle cell trait, thalassaemia (or trait), G6PD deficiency
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
RW Sauerwein, PhD
Organizational Affiliation
Radboud University Medical Center
Official's Role
Study Director
Facility Information:
Facility Name
Leiden University Medical Centre
City
Leiden
ZIP/Postal Code
2333ZA
Country
Netherlands

12. IPD Sharing Statement

Citations:
PubMed Identifier
19641203
Citation
Roestenberg M, McCall M, Hopman J, Wiersma J, Luty AJ, van Gemert GJ, van de Vegte-Bolmer M, van Schaijk B, Teelen K, Arens T, Spaarman L, de Mast Q, Roeffen W, Snounou G, Renia L, van der Ven A, Hermsen CC, Sauerwein R. Protection against a malaria challenge by sporozoite inoculation. N Engl J Med. 2009 Jul 30;361(5):468-77. doi: 10.1056/NEJMoa0805832.
Results Reference
background
PubMed Identifier
25933168
Citation
Schats R, Bijker EM, van Gemert GJ, Graumans W, van de Vegte-Bolmer M, van Lieshout L, Haks MC, Hermsen CC, Scholzen A, Visser LG, Sauerwein RW. Heterologous Protection against Malaria after Immunization with Plasmodium falciparum Sporozoites. PLoS One. 2015 May 1;10(5):e0124243. doi: 10.1371/journal.pone.0124243. eCollection 2015.
Results Reference
derived

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Re-exposure of Human Volunteers to a Heterologous Strain of P. Falciparum Sporozoites

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