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Leprosy Skin Test Antigens Phase 1

Primary Purpose

Leprosy

Status
Completed
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
MLCwA
MLSA-LAM
Mock Antigen
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Leprosy focused on measuring Leprosy, skin test, MLSA-LAM, MLCwA, diagnosis, Protocol 98-202

Eligibility Criteria

18 Years - 40 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Born in the United States (less chance of previous exposure to tuberculosis or leprosy)
  • Healthy individuals who are free of any evidence of leprosy or tuberculosis by established clinical examinations
  • Between the ages of 18 and 40 years old
  • Females of child-bearing age (defined from the period of menarche to menopause, usually between the ages of 15 to 45), certified as not pregnant (as determined by a pregnancy test performed within 7 days prior to admission into the study)
  • Agreement to participate in the study after verbal explanation by the physician and nurses and signing of an informed consent form.
  • Weight greater than 100 lbs. (female) and.140 lbs. (male)
  • No known hypersensitivities or allergies
  • Negative tuberculin skin test (as determined by skin tests performed 3 weeks prior to study entry)

Exclusion Criteria:

  • Pregnant or lactating females
  • Oral corticosteroid treatment
  • Chronic illness
  • Immunosuppressive condition
  • Tuberculosis
  • Leprosy
  • Age <18 or >40
  • Weight <100 lbs. (female) or <140 lbs. (male)
  • Positive tuberculin skin test
  • Extensive travel (2-3 trips/year) in leprosy/tuberculosis endemic regions

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Group 2

    Group 1

    Arm Description

    5 subjects will receive d single 0.1 ml intracutaneous injections of 3 titrated doses (1, 10, and 25 grams/ml) of MLCwA and one of mock antigen equally in two arms

    5 subjects received single 0.1 ml intracutaneous injections of 3 titrated doses (1, 10, and 25 grams/ml) of MLSA-LAM and one of mock antigen equally in two arms

    Outcomes

    Primary Outcome Measures

    Range of concentration (1, 10, and 25 micrograms/ml) responses in the two leprosy skin test antigens in the control and mock antigens
    Incidence of leprosy

    Secondary Outcome Measures

    Full Information

    First Posted
    July 25, 2013
    Last Updated
    July 24, 2014
    Sponsor
    National Institute of Allergy and Infectious Diseases (NIAID)
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01920750
    Brief Title
    Leprosy Skin Test Antigens Phase 1
    Official Title
    Phase I Study to Evaluate New Leprosy Skin Test Antigens: MLSA-LAM and MLCwA
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2013
    Overall Recruitment Status
    Completed
    Study Start Date
    January 1989 (undefined)
    Primary Completion Date
    February 1999 (Actual)
    Study Completion Date
    February 1999 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    National Institute of Allergy and Infectious Diseases (NIAID)

    4. Oversight

    5. Study Description

    Brief Summary
    This is a small Phase I trial to evaluate the safety of the use as skin test antigens of the immunologically active proteins from the soluble/cytosol and insoluble cell wall of Mycobacterium leprae. The overall objective is to generate new leprosy skin-test antigens, equivalent to tuberculin-PPD in the tuberculosis context, to be used (I) for the early diagnosis of leprosy; and (ii) as epidemiological tools to measure the incidence of disease. Evaluating new leprosy skin test antigens may provide a better way to diagnose leprosy in its early stages of infection. With the early administration of drug therapy, infected individuals can then be cured of this disease before nerve damage occurs or nodules (lepromas) start to develop on the skin. Ten healthy, leprosy-unexposed, tuberculin-negative volunteers, 18-40 years old, from within the staff of the Mycobacteria Research Laboratories, Department of Microbiology, Colorado State University, Fort Collins, Colorado, will be selected.
    Detailed Description
    This is a small Phase I trial to evaluate the safety of the use as skin test antigens of the immunologically active proteins from the soluble/cytosol and insoluble cell wall of Mycobacterium leprae. The overall objective is to generate new leprosy skin-test antigens, equivalent to tuberculin-PPD in the tuberculosis context, to be used (I) for the early diagnosis of leprosy; and (ii) as epidemiological tools to measure the incidence of disease. Evaluating new leprosy skin test antigens may provide a better way to diagnose leprosy in its early stages of infection. With the early administration of drug therapy, infected individuals can then be cured of this disease before nerve damage occurs or nodules (lepromas) start to develop on the skin. Ten healthy, leprosy-unexposed, tuberculin-negative volunteers, ages 18-40 years old, from within the staff of the Mycobacteria Research Laboratories, Department of Microbiology, Colorado State University, Fort Collins, Colorado, will be selected for this study. The volunteers will be recruited by direct contact after placing notices in the Department of Microbiology at Colorado State University. There are approximately 40 faculty/staff/students in this population and all are routinely tested (PPD skin-testing or chest X-ray) by the staff at the Hartshorn Health Service Center in the context of the Department's tuberculosis research. Five individuals will be selected for testing MLSA-LAM and five will receive MLCwA. Each will receive single 0.1 ml intracutaneous injections of three titrated doses (1, 10 and 25 )lg/ml) of the skin-test antigen, one of mock antigen (i.e., physiological saline), and one of control antigen (the product now in use; Rees MLSA, 10 )lg), divided equally between the subject's two arms. Results will be recorded at 15 min, 48 h, 72 h, and 28 days post-injection. The test dose will be administered with a sterile1 ml syringe calibrated in tenths and fitted with a sterile, one-half inch, 26 or 27 gauge needle. The rubber stopper of the vial will be wiped with a sterile piece of cotton moistened with alcohol and allowed to dry.It is expected that all concentrations of the two leprosy skin test antigens will evoke similar negative responses. If so, all three concentrations will be used for subsequent studies. This protocol is linked to study 98-202.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Leprosy
    Keywords
    Leprosy, skin test, MLSA-LAM, MLCwA, diagnosis, Protocol 98-202

    7. Study Design

    Primary Purpose
    Diagnostic
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    10 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Group 2
    Arm Type
    Experimental
    Arm Description
    5 subjects will receive d single 0.1 ml intracutaneous injections of 3 titrated doses (1, 10, and 25 grams/ml) of MLCwA and one of mock antigen equally in two arms
    Arm Title
    Group 1
    Arm Type
    Experimental
    Arm Description
    5 subjects received single 0.1 ml intracutaneous injections of 3 titrated doses (1, 10, and 25 grams/ml) of MLSA-LAM and one of mock antigen equally in two arms
    Intervention Type
    Biological
    Intervention Name(s)
    MLCwA
    Intervention Description
    Antigen MLSA-LAM is a pellet extracted 3x followed by removal of SDS by column chromatography. Contains many of the same proteins
    Intervention Type
    Biological
    Intervention Name(s)
    MLSA-LAM
    Intervention Description
    Antigen MLSA-LAM is derived from M. leprae extract following sonication and centrifugation, leaving the cytosol (MLSA). Contains soluble protein antigens of M. leprae
    Intervention Type
    Other
    Intervention Name(s)
    Mock Antigen
    Intervention Description
    Physiological saline
    Primary Outcome Measure Information:
    Title
    Range of concentration (1, 10, and 25 micrograms/ml) responses in the two leprosy skin test antigens in the control and mock antigens
    Time Frame
    Up to 28 days post injection
    Title
    Incidence of leprosy
    Time Frame
    Up to 28 days post injection

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    40 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Born in the United States (less chance of previous exposure to tuberculosis or leprosy) Healthy individuals who are free of any evidence of leprosy or tuberculosis by established clinical examinations Between the ages of 18 and 40 years old Females of child-bearing age (defined from the period of menarche to menopause, usually between the ages of 15 to 45), certified as not pregnant (as determined by a pregnancy test performed within 7 days prior to admission into the study) Agreement to participate in the study after verbal explanation by the physician and nurses and signing of an informed consent form. Weight greater than 100 lbs. (female) and.140 lbs. (male) No known hypersensitivities or allergies Negative tuberculin skin test (as determined by skin tests performed 3 weeks prior to study entry) Exclusion Criteria: Pregnant or lactating females Oral corticosteroid treatment Chronic illness Immunosuppressive condition Tuberculosis Leprosy Age <18 or >40 Weight <100 lbs. (female) or <140 lbs. (male) Positive tuberculin skin test Extensive travel (2-3 trips/year) in leprosy/tuberculosis endemic regions

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    24874401
    Citation
    Rivoire BL, Groathouse NA, TerLouw S, Neupane KD, Ranjit C, Sapkota BR, Khadge S, Kunwar CB, Macdonald M, Hawksworth R, Thapa MB, Hagge DA, Tibbals M, Smith C, Dube T, She D, Wolff M, Zhou E, Makhene M, Mason R, Sizemore C, Brennan PJ. Safety and efficacy assessment of two new leprosy skin test antigens: randomized double blind clinical study. PLoS Negl Trop Dis. 2014 May 29;8(5):e2811. doi: 10.1371/journal.pntd.0002811. eCollection 2014. Erratum In: PLoS Negl Trop Dis. 2014 Jul;8(7):e3065. Kunwar, Chatra B [corrected to Kunwar, Chhatra B].
    Results Reference
    result

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