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Dose-finding Study of WS6788A, DS37-4 and H10407 Enterotoxigenic Escherichia Coli (ETEC) Challenge Strains

Primary Purpose

Diarrhea

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
H10407
Sponsored by
Johns Hopkins Bloomberg School of Public Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional screening trial for Diarrhea

Eligibility Criteria

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

Inclusion Criteria: Healthy adults age 18 to 45 years old who are willing to participate, complete training on ETEC and diarrhea and procedures of the protocol, pass the test documenting knowledge of the study, and give informed consent. Exclusion Criteria: age<18 or >45 years Chronic illness, chemical dependency, or significant medical illness as determined by the investigator. immunosuppressive condition or IgA (Immunoglobulin A) deficiency HIV antibody positive hepatitis B surface antigen positive hepatitis C antibody positive travel to ETEC endemic area within 2 years vaccination or other exposure to ETEC, cholera, or heat labile toxin (LT) toxin within 3 years pregnancy as defined by + serum or urine - human chorionic gonadotropin (HCG) on the day before immunization inability to pass the written examination use of antibiotic, H2 blocking agent or proton pump inhibitor within 7 days of challenge regular use of laxatives antacids or other agents to lower stomach acidity significant abnormality in screening lav hematology and chemistry tests as determined by the investigator. significant abnormality on EKG for those 40 to 50 years old as determined by the investigator. allergy to quinolones, penicillin's and Bactrim. abnormal stool pattern (fewer than 3 stools per week or more than 3 stools per day).

Sites / Locations

  • General Clinical Research Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

H10407

Arm Description

H10407

Outcomes

Primary Outcome Measures

To validate a dose for ETEC H10407 that will cause diarrhea in 50% or more of subjects without causing high output diarrhea, as determined by stool output volumes or signs and symptoms associated with hypovolemia.

Secondary Outcome Measures

To measure mucosal and systemic immune response to the somatic and toxin antigens of the H10407 strain.

Full Information

First Posted
September 13, 2005
Last Updated
April 7, 2017
Sponsor
Johns Hopkins Bloomberg School of Public Health
Collaborators
Henry M. Jackson Foundation for the Advancement of Military Medicine, Naval Medical Research Center, Walter Reed Army Institute of Research (WRAIR), U.S. Army Medical Research and Development Command
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1. Study Identification

Unique Protocol Identification Number
NCT00198796
Brief Title
Dose-finding Study of WS6788A, DS37-4 and H10407 Enterotoxigenic Escherichia Coli (ETEC) Challenge Strains
Official Title
Dose-finding Study of WS6788A, DS37-4 and H10407 Enterotoxigenic E. Coli (ETEC) Challenge Strains That Express Colonization Factors CS17 and CFA/I
Study Type
Interventional

2. Study Status

Record Verification Date
April 2017
Overall Recruitment Status
Completed
Study Start Date
September 2005 (Actual)
Primary Completion Date
February 22, 2007 (Actual)
Study Completion Date
May 30, 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Johns Hopkins Bloomberg School of Public Health
Collaborators
Henry M. Jackson Foundation for the Advancement of Military Medicine, Naval Medical Research Center, Walter Reed Army Institute of Research (WRAIR), U.S. Army Medical Research and Development Command

4. Oversight

5. Study Description

Brief Summary
Five subjects will be admitted to the General Clinical Research Center (GCRC). The next day they will eat a light breakfast, fast for 90 minutes, ingest ETEC strain H10407, and fast for 90 more minutes. After this challenge they will be monitored closely , and all stools will be collected, graded and weighed. On Day 5, or sooner if indicated, they will begin antibiotics to eradicate the challenge strain. They will be scheduled for discharge on Day 7 but may leave a few days earlier if early antibiotic treatment is given. Hypothesis: A challenge dose of 10(9) colony forming unit (CFU) of ETEC strain H10407, will cause diarrhea in at least 60% of subjects.
Detailed Description
The rationale for validation H10407 in the challenge study proposed at Johns Hopkins University is that this initial challenge study will support additional challenge studies planned for the future. In these future studies, a bovine milk immunoglobulin containing high levels of antibodies specific for colonization factor antigen (CFA/I) or CFA/I-derived colonization factor will be investigated as a potential oral prophylaxis to neutralize subsequent challenge against CFA/I-expressing H10407 in the clinical setting. The goal here is therefore to validate a challenge dose of 1x109 h10407 organisms in the hands of the Johns Hopkins investigative team and to then use this dose in the future prophylaxis/challenge studies. Challenge doses equal to or comparable to the 1x109 dose proposed for the Johns Hopkins University (JHU) study have been used in 6 of the 9 challenge studies that have been done with the H10407 strain. The subsequent challenge studies using H10407 will be registered as part of other protocols.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diarrhea

7. Study Design

Primary Purpose
Screening
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
We will initially study the effects of a 1x109 dose of H10407 (in 5 subjects) and then proceed to the dose-finding portion of the trial to study the effects of low (5x108) or higher doses (5x109) of the CS17 expressing strains (total of 20 subjects)
Masking
None (Open Label)
Allocation
N/A
Enrollment
5 (Actual)

8. Arms, Groups, and Interventions

Arm Title
H10407
Arm Type
Experimental
Arm Description
H10407
Intervention Type
Biological
Intervention Name(s)
H10407
Other Intervention Name(s)
Experimental
Intervention Description
The primary objective of the proposed clinical investigation is to validate a dose for ETEC H10407 that will cause diarrhea in 50% or more of subjects without causing high output diarrhea
Primary Outcome Measure Information:
Title
To validate a dose for ETEC H10407 that will cause diarrhea in 50% or more of subjects without causing high output diarrhea, as determined by stool output volumes or signs and symptoms associated with hypovolemia.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
To measure mucosal and systemic immune response to the somatic and toxin antigens of the H10407 strain.
Time Frame
6 months

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: Healthy adults age 18 to 45 years old who are willing to participate, complete training on ETEC and diarrhea and procedures of the protocol, pass the test documenting knowledge of the study, and give informed consent. Exclusion Criteria: age<18 or >45 years Chronic illness, chemical dependency, or significant medical illness as determined by the investigator. immunosuppressive condition or IgA (Immunoglobulin A) deficiency HIV antibody positive hepatitis B surface antigen positive hepatitis C antibody positive travel to ETEC endemic area within 2 years vaccination or other exposure to ETEC, cholera, or heat labile toxin (LT) toxin within 3 years pregnancy as defined by + serum or urine - human chorionic gonadotropin (HCG) on the day before immunization inability to pass the written examination use of antibiotic, H2 blocking agent or proton pump inhibitor within 7 days of challenge regular use of laxatives antacids or other agents to lower stomach acidity significant abnormality in screening lav hematology and chemistry tests as determined by the investigator. significant abnormality on EKG for those 40 to 50 years old as determined by the investigator. allergy to quinolones, penicillin's and Bactrim. abnormal stool pattern (fewer than 3 stools per week or more than 3 stools per day).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robin McKenzie, M.D.
Organizational Affiliation
Johns Hopkins University
Official's Role
Principal Investigator
Facility Information:
Facility Name
General Clinical Research Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Dose-finding Study of WS6788A, DS37-4 and H10407 Enterotoxigenic Escherichia Coli (ETEC) Challenge Strains

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