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Repeated Controlled Human Schistosoma Mansoni Infection

Primary Purpose

Schistosomiasis, Schistosoma Mansoni

Status
Completed
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
Schistosoma mansoni infection
Placebo mock infection
Sponsored by
Leiden University Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Schistosomiasis

Eligibility Criteria

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

Inclusion Criteria:

  1. Subject is aged ≥ 18 and ≤ 45 years and in good health.
  2. Subject has adequate understanding of the procedures of the study and agrees to abide strictly thereby.
  3. Subject is able to communicate well with the investigator, is available to attend all study visits.
  4. Subject will remain within Europe (excluding Corsica) during the study period.
  5. Subject agrees to refrain from blood and plasma donation to Sanquin or for other purposes throughout the study period.
  6. For female subjects: subject agrees to use adequate contraception and not to breastfeed for the duration of study.
  7. Subject has signed informed consent.

Exclusion Criteria:

  1. Any history, or evidence at screening, of clinically significant symptoms, physical signs or abnormal laboratory values suggestive of systemic conditions, such as cardiovascular, pulmonary, renal, hepatic, neurological, dermatological, endocrine, malignant, haematological, infectious, immune-deficient, (severe) psychiatric and other disorders, which could compromise the health of the volunteer during the study or interfere with the interpretation of the study results. These include, but are not limited to, any of the following:

    • body weight <50 kg or Body Mass Index (BMI) <18.0 or >35.0 kg/m2 at screening;
    • positive HIV, hepatitis B virus or hepatitis C virus screening tests;
    • the use of immune modifying drugs within three months prior to study onset (inhaled and topical corticosteroids and oral anti-histamines exempted) or expected use of such during the study period;
    • history of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years;
    • any history of treatment for severe psychiatric disease by a psychiatrist in the past year;
    • history of drug or alcohol abuse interfering with normal social function in the period of one year prior to study onset.
  2. The chronic use of any drug known to interact with praziquantel, artesunate or lumefantrine metabolism (e.g. phenytoin, carbamazepine, phenobarbital, primidone, dexamethasone, rifampicin, cimetidine, flecainide, metoprolol, imipramine, amitriptyline, clomipramine, class IA and III anti-arrythmics, antipsychotics, antidepressants, macrolides, fluoroquinolones, imidazole- and triazole antimycotics, antihistamines). Because lumefantrine may cause extension of QT-time, chronic use of drugs with effect on QT interval will result in exclusion from study participation.
  3. For female subjects: positive urine pregnancy test at screening.
  4. Any history of schistosomiasis or treatment for schistosomiasis.
  5. Positive serology for schistosomiasis or elevated serum CAA at screening.
  6. Known hypersensitivity to or contra-indications (including co-medication) for use of praziquantel, artesunate or lumefantrine.
  7. Being an employee or student of the department of Parasitology or Infectious diseases of the LUMC.

Sites / Locations

  • Leiden University Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Reinfection group

Infection control group

Arm Description

Participants will be exposed three times to 20 male Schistosoma mansoni cercariae (weeks 0, 9, and 18)

12 participants who will undergo a placebo mock infection with water twice (weeks 0 and 9) and will be exposed once to 20 male Schistosoma mansoni cercariae (week 18)

Outcomes

Primary Outcome Measures

Protective efficacy
The protective efficacy of repeated exposure to male Sm cercariae measured by the difference in frequency of serum circulating aniodic antigen (CAA) positivity (≥1.0 pg/mL) between the reinfection group and the infection control group at any timepoint after the final infection at week 18 and before week 30
Safety of (repeated) exposure to male Sm cercariae based on self-reported adverse events
Frequency and severity of adverse events after (repeated) human Sm infection with male cercariae

Secondary Outcome Measures

Time to CAA positivity
Comparison of time to positive serum and urine CAA test between the reinfection and infection control groups after the final infection at week 18 and before week 30
Peak serum CAA levels
Comparison of peak serum CAA concentration between the reinfection and infection control group after the final infection at week 18 and before week 30
Eosinophils
Comparison of eosinophil counts between the reinfection and infection control groups after challenge after the final infection at week 18 and before week 30
Antibody responses
Comparison of (glycan) antibody responses directed against Sm antigens between the reinfection and infection control participants as well as between protected and non-protected participants after the final infection at week 18 and before week 30 using protein and glycan arrays
Cellular responses
Comparison of cellular responses directed against Sm antigens between the reinfection and infection control participants as well as between protected and non-protected participants after the final infection at week 18 and before week 30 using flow cytometry
Attack rate
The pooled attack rate after initial exposure to 20 male cercariae, i.e. proportion CAA positivity between week 0-8 for the reinfection participants and between week 18-26 for infection control participants

Full Information

First Posted
August 6, 2021
Last Updated
January 27, 2023
Sponsor
Leiden University Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT05085470
Brief Title
Repeated Controlled Human Schistosoma Mansoni Infection
Official Title
Safety and Protective Efficacy of Repeated Controlled Human Schistosoma Mansoni Infection
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
October 29, 2021 (Actual)
Primary Completion Date
January 11, 2023 (Actual)
Study Completion Date
January 11, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Leiden University Medical Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A group of 24 healthy volunteers are challenged one or three times with 20 male Schistosoma mansoni cercariae to investigate whether this leads to protection and to identify potential correlates of protection

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schistosomiasis, Schistosoma Mansoni

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Reinfection group
Arm Type
Experimental
Arm Description
Participants will be exposed three times to 20 male Schistosoma mansoni cercariae (weeks 0, 9, and 18)
Arm Title
Infection control group
Arm Type
Active Comparator
Arm Description
12 participants who will undergo a placebo mock infection with water twice (weeks 0 and 9) and will be exposed once to 20 male Schistosoma mansoni cercariae (week 18)
Intervention Type
Biological
Intervention Name(s)
Schistosoma mansoni infection
Intervention Description
20 viable male Schistosoma mansoni cercariae of the Puerto Rican strain
Intervention Type
Biological
Intervention Name(s)
Placebo mock infection
Intervention Description
Placebo mock infection with water
Primary Outcome Measure Information:
Title
Protective efficacy
Description
The protective efficacy of repeated exposure to male Sm cercariae measured by the difference in frequency of serum circulating aniodic antigen (CAA) positivity (≥1.0 pg/mL) between the reinfection group and the infection control group at any timepoint after the final infection at week 18 and before week 30
Time Frame
From week 18 until week 30
Title
Safety of (repeated) exposure to male Sm cercariae based on self-reported adverse events
Description
Frequency and severity of adverse events after (repeated) human Sm infection with male cercariae
Time Frame
38 weeks
Secondary Outcome Measure Information:
Title
Time to CAA positivity
Description
Comparison of time to positive serum and urine CAA test between the reinfection and infection control groups after the final infection at week 18 and before week 30
Time Frame
From week 18 until week 30
Title
Peak serum CAA levels
Description
Comparison of peak serum CAA concentration between the reinfection and infection control group after the final infection at week 18 and before week 30
Time Frame
From week 18 until week 30
Title
Eosinophils
Description
Comparison of eosinophil counts between the reinfection and infection control groups after challenge after the final infection at week 18 and before week 30
Time Frame
From week 18 until week 30
Title
Antibody responses
Description
Comparison of (glycan) antibody responses directed against Sm antigens between the reinfection and infection control participants as well as between protected and non-protected participants after the final infection at week 18 and before week 30 using protein and glycan arrays
Time Frame
From week 18 until week 30
Title
Cellular responses
Description
Comparison of cellular responses directed against Sm antigens between the reinfection and infection control participants as well as between protected and non-protected participants after the final infection at week 18 and before week 30 using flow cytometry
Time Frame
From week 18 until week 30
Title
Attack rate
Description
The pooled attack rate after initial exposure to 20 male cercariae, i.e. proportion CAA positivity between week 0-8 for the reinfection participants and between week 18-26 for infection control participants
Time Frame
26 weeks

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: Subject is aged ≥ 18 and ≤ 45 years and in good health. Subject has adequate understanding of the procedures of the study and agrees to abide strictly thereby. Subject is able to communicate well with the investigator, is available to attend all study visits. Subject will remain within Europe (excluding Corsica) during the study period. Subject agrees to refrain from blood and plasma donation to Sanquin or for other purposes throughout the study period. For female subjects: subject agrees to use adequate contraception and not to breastfeed for the duration of study. Subject has signed informed consent. Exclusion Criteria: Any history, or evidence at screening, of clinically significant symptoms, physical signs or abnormal laboratory values suggestive of systemic conditions, such as cardiovascular, pulmonary, renal, hepatic, neurological, dermatological, endocrine, malignant, haematological, infectious, immune-deficient, (severe) psychiatric and other disorders, which could compromise the health of the volunteer during the study or interfere with the interpretation of the study results. These include, but are not limited to, any of the following: body weight <50 kg or Body Mass Index (BMI) <18.0 or >35.0 kg/m2 at screening; positive HIV, hepatitis B virus or hepatitis C virus screening tests; the use of immune modifying drugs within three months prior to study onset (inhaled and topical corticosteroids and oral anti-histamines exempted) or expected use of such during the study period; history of malignancy of any organ system (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years; any history of treatment for severe psychiatric disease by a psychiatrist in the past year; history of drug or alcohol abuse interfering with normal social function in the period of one year prior to study onset. The chronic use of any drug known to interact with praziquantel, artesunate or lumefantrine metabolism (e.g. phenytoin, carbamazepine, phenobarbital, primidone, dexamethasone, rifampicin, cimetidine, flecainide, metoprolol, imipramine, amitriptyline, clomipramine, class IA and III anti-arrythmics, antipsychotics, antidepressants, macrolides, fluoroquinolones, imidazole- and triazole antimycotics, antihistamines). Because lumefantrine may cause extension of QT-time, chronic use of drugs with effect on QT interval will result in exclusion from study participation. For female subjects: positive urine pregnancy test at screening. Any history of schistosomiasis or treatment for schistosomiasis. Positive serology for schistosomiasis or elevated serum CAA at screening. Known hypersensitivity to or contra-indications (including co-medication) for use of praziquantel, artesunate or lumefantrine. Being an employee or student of the department of Parasitology or Infectious diseases of the LUMC.
Facility Information:
Facility Name
Leiden University Medical Center
City
Leiden
ZIP/Postal Code
2333 ZA
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Repeated Controlled Human Schistosoma Mansoni Infection

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