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Immunologic Responses to a Live Attenuated Oral Cholera Vaccine

Primary Purpose

Cholera

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Vaxchora
Sponsored by
Emory University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Cholera focused on measuring Vaccination, Contagious Diseases, Tropical Medicine, Infectious Diseases

Eligibility Criteria

18 Years - 49 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Capable of informed consent and provision of written informed consent before any study procedures
  • Capable of attending all study visits according to the study schedule
  • Are in good health, as determined by medical history and targeted physical exam related to this history
  • Female subjects of childbearing* age must have a negative urine pregnancy test before study vaccination, and must use two forms of contraception** to avoid pregnancy within one month of Vaxchora administration.

Exclusion Criteria:

  • Have an acute illness within 72 hours before vaccination
  • Have any acute or chronic medical condition that, in the opinion of the principal investigator, would make vaccination unsafe or interfere with the evaluation of immune response to study vaccination
  • Have a suppressed immune system as a result of illness, immunosuppressive medication, chemotherapy, or radiation therapy within 3 years prior to study vaccination
  • Have taken oral or parenteral corticosteroids of any dose within 30 days before study vaccination
  • Reside with individuals under the age of 2 or with an immunocompromised individuals
  • Have a known history of autoimmune disease
  • Have a history of Guillain-Barre Syndrome
  • Have plans to receive any vaccine from 28 days prior to study vaccination until Day 29
  • Has previously received a cholera vaccine or have a known history of V. Cholerae.
  • Have donated blood or blood products within 56 days before study vaccination, plan to donate blood at any time during the 56-day duration of subject study participation, or plan to donate blood within 56 days after the last blood draw
  • Have known hypersensitivity or allergy to any component of the vaccine or history of anaphylaxis with a vaccine or vaccine component
  • Have allergy to tetracycline and/or ciprofloxacin
  • Are pregnant or breastfeeding or plan to within one month of vaccination
  • Travelled to a cholera endemic area and had traveler's diarrhea in the previous 5 years
  • Have abnormal stool pattern (fewer than 3 stools/ week or greater than 2 stools/ day) or regular use of laxatives in the last 6 months
  • Have current or recent antibiotic use in the past 14 days
  • Are healthcare workers who have direct contact with patients who are immunocompromised, have unstable medical conditions, or are under the age of 2
  • Are childcare caregivers who have direct contact with children who are 2 years or younger.
  • Are employed in the food industry
  • Have received any vaccine within the previous 21 days
  • History of bleeding disorders or current use of warfarin, aspirin, heparin, nonsteroidal anti-inflammatory drugs (NSAIDs) or other blood thinner/ anticoagulant medications in the past week for subjects undergoing intestinal biopsies.
  • Use of benzodiazepines or narcotics for subjects undergoing intestinal biopsies 4 weeks prior to the procedure
  • Any contraindications to endoscopy/concerns of the anesthesiologist for subjects who agree for EGD/biopsies.
  • BMI > 35 kg/m2
  • Have a diagnosis of any small bowel disease. This includes but is not limited to inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis, indeterminate colitis, or microscopic colitis), small bowel obstruction, celiac disease, h/o small bowel resection, small bowel lymphoma, Whipple's disease, primary Intestinal lymphangiectasis, abdominal radiation.
  • Current medications for the treatment of Gastroesophageal reflux disease (GERD) or dyspepsia
  • History of Helicobacter pylori (H. pylori) infection

Sites / Locations

  • The Hope Clinic of Emory UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Vaxchora Vaccination

Arm Description

Healthy subjects will receive a single dose of oral live cholera vaccine.

Outcomes

Primary Outcome Measures

Percentage of Positive Responders
Antibody titers will be collected to assess the level of immune response to vaccination. A positive responder is defined as a participant with a titer above 40 at day 29, or that shows a four-fold increase over baseline.

Secondary Outcome Measures

Plasmablast Levels
Plasmablasts will be collected via blood draw and isolated and assessed for counts by the study team. A positive response is defined as a four-fold increase over the baseline measure.
Activated B Cell Levels
Activated B cells will be collected via blood draw and isolated and assessed for counts by the study team. A positive response is defined as a four-fold increase over the baseline measure.
Memory B-Cell Levels
Memory B-cells will be collected via blood draw and isolated and assessed for counts by the study team. A positive response is defined as a four-fold increase over the baseline measure.
Memory T-Cell Levels
T-cells will be collected via blood draw and isolated and assessed for counts by the study team. A positive response is defined as a four-fold increase over the baseline measure.
Number of Samples from which Monoclonal Antibodies Produced
The ability to isolate monoclonal antibodies will be assessed by study lab personnel.
Number of Adverse Events
The number of solicited and unsolicited adverse events will be collected.
Number of Serious Adverse Events
The number of serious adverse events will be collected.

Full Information

First Posted
August 14, 2017
Last Updated
June 1, 2023
Sponsor
Emory University
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT03251495
Brief Title
Immunologic Responses to a Live Attenuated Oral Cholera Vaccine
Official Title
Immunologic Responses to a Live Attenuated Oral Cholera Vaccine
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 29, 2017 (Actual)
Primary Completion Date
June 30, 2024 (Anticipated)
Study Completion Date
June 30, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Emory University
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective of this study is to evaluate the antibody response to the cholera vaccine, Vaxchora®, in healthy subjects. Investigators also seek to evaluate additional markers of the adaptive immune response including plasmablasts, activated B cells, memory B cells, and T cell responses in healthy subjects receiving cholera vaccine, produce monoclonal antibodies against cholera, and evaluate the safety and reactogenicity in healthy subjects receiving cholera vaccine.
Detailed Description
Cholera is a life-threatening illness that causes diarrhea. Cholera is caused by eating or drinking the Vibrio cholera bacteria. Each year, there are about 1.3 to 4.0 million cases of cholera worldwide, resulting in 21,000 to 143,000 deaths. The bacteria is spread through water or food that has stool in it. Up to 50 countries with limited access to clean water are more likely to have outbreaks. In the United States most cases are linked to travel to these countries; however, there are 10-15 cases acquired in the United States each year because of undercooked seafood. Cholera spreads very easily. Illness from Cholera can vary from no symptoms to severe watery diarrhea that can cause death by dehydration in a healthy person within hours. Vaxchora is a live attenuated cholera vaccine that protects against some cholera strains. It has been approved by the FDA since June 2016. Since October, 2016, this vaccine has been recommended for certain travelers 18 through 64 years of age going to cholera-affected areas. The purpose of this study is to look at the immune responses to the FDA approved cholera vaccine (Vaxchora®).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cholera
Keywords
Vaccination, Contagious Diseases, Tropical Medicine, Infectious Diseases

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Vaxchora Vaccination
Arm Type
Experimental
Arm Description
Healthy subjects will receive a single dose of oral live cholera vaccine.
Intervention Type
Drug
Intervention Name(s)
Vaxchora
Intervention Description
Vaxchora is a live attenuated cholera vaccine that provides immunity against V. cholerae serogroup O1. Participants will receive one single oral dose of 100 mL.
Primary Outcome Measure Information:
Title
Percentage of Positive Responders
Description
Antibody titers will be collected to assess the level of immune response to vaccination. A positive responder is defined as a participant with a titer above 40 at day 29, or that shows a four-fold increase over baseline.
Time Frame
Day 29
Secondary Outcome Measure Information:
Title
Plasmablast Levels
Description
Plasmablasts will be collected via blood draw and isolated and assessed for counts by the study team. A positive response is defined as a four-fold increase over the baseline measure.
Time Frame
Day 29
Title
Activated B Cell Levels
Description
Activated B cells will be collected via blood draw and isolated and assessed for counts by the study team. A positive response is defined as a four-fold increase over the baseline measure.
Time Frame
Day 29
Title
Memory B-Cell Levels
Description
Memory B-cells will be collected via blood draw and isolated and assessed for counts by the study team. A positive response is defined as a four-fold increase over the baseline measure.
Time Frame
Day 29
Title
Memory T-Cell Levels
Description
T-cells will be collected via blood draw and isolated and assessed for counts by the study team. A positive response is defined as a four-fold increase over the baseline measure.
Time Frame
Day 29
Title
Number of Samples from which Monoclonal Antibodies Produced
Description
The ability to isolate monoclonal antibodies will be assessed by study lab personnel.
Time Frame
Day 29
Title
Number of Adverse Events
Description
The number of solicited and unsolicited adverse events will be collected.
Time Frame
Duration of Study (Up to 29 Days)
Title
Number of Serious Adverse Events
Description
The number of serious adverse events will be collected.
Time Frame
Duration of Study (Up to 29 Days), Day 365

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
49 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Capable of informed consent and provision of written informed consent before any study procedures Capable of attending all study visits according to the study schedule Are in good health, as determined by medical history and targeted physical exam related to this history Female subjects of childbearing age must have a negative urine pregnancy test before study vaccination, and must use two forms of contraception to avoid pregnancy within one month of Vaxchora administration Exclusion Criteria: Have an acute illness within 72 hours before vaccination Have any acute or chronic medical condition that, in the opinion of the principal investigator, would make vaccination unsafe or interfere with the evaluation of immune response to study vaccination Have a suppressed immune system as a result of illness, immunosuppressive medication, chemotherapy, or radiation therapy within 3 years prior to study vaccination Have taken oral or parenteral corticosteroids of any dose within 30 days before study vaccination Reside with individuals under the age of 2 or with an immunocompromised individuals Have a known history of autoimmune disease Have a history of Guillain-Barre Syndrome Have plans to receive any vaccine from 28 days prior to study vaccination until Day 29 Has previously received a cholera vaccine or have a known history of V. Cholerae. Have donated blood or blood products within 56 days before study vaccination, plan to donate blood at any time during the 56-day duration of subject study participation, or plan to donate blood within 56 days after the last blood draw Have known hypersensitivity or allergy to any component of the vaccine or history of anaphylaxis with a vaccine or vaccine component Have allergy to tetracycline and/or ciprofloxacin Are pregnant or breastfeeding or plan to within one month of vaccination Traveled to a cholera endemic area and had traveler's diarrhea in the previous 5 years Have abnormal stool pattern (fewer than 3 stools/ week or greater than 2 stools/ day) or regular use of laxatives in the last 6 months Have current or recent antibiotic use in the past 14 days Are healthcare workers who have direct contact with patients who are immunocompromised, have unstable medical conditions, or are under the age of 2 Are childcare caregivers who have direct contact with children who are 2 years or younger. Are employed in the food industry Have received any vaccine within the previous 21 days History of bleeding disorders or current use of warfarin, aspirin, heparin, nonsteroidal anti-inflammatory drugs (NSAIDs) or other blood thinner/ anticoagulant medications in the past week for subjects undergoing intestinal biopsies. Use of benzodiazepines or narcotics for subjects undergoing intestinal biopsies 4 weeks prior to the procedure Any contraindications to endoscopy/concerns of the anesthesiologist for subjects who agree for esophagogastroduodenoscopy (EGD)/biopsies. BMI > 35 kg/m2 Have a diagnosis of any small bowel disease. This includes but is not limited to inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis, indeterminate colitis, or microscopic colitis), small bowel obstruction, celiac disease, h/o small bowel resection, small bowel lymphoma, Whipple's disease, primary Intestinal lymphangiectasis, abdominal radiation. Current medications for the treatment of Gastroesophageal reflux disease (GERD) or dyspepsia History of Helicobacter pylori (H. pylori) infection
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Nadine Rouphael, MD
Phone
404-712-1370
Email
nroupha@emory.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nadine Rouphael, MD
Organizational Affiliation
Emory University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Hope Clinic of Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nadine Rouphael, MD
Phone
404-712-1370
Email
nroupha@emory.edu

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34478460
Citation
Adekunle O, Dretler A, Kauffman RC, Cho A, Rouphael N, Wrammert J. Longitudinal analysis of human humoral responses after vaccination with a live attenuated V. cholerae vaccine. PLoS Negl Trop Dis. 2021 Sep 3;15(9):e0009743. doi: 10.1371/journal.pntd.0009743. eCollection 2021 Sep.
Results Reference
derived

Learn more about this trial

Immunologic Responses to a Live Attenuated Oral Cholera Vaccine

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