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Induction of Gut Permeability by an Oral Vaccine

Primary Purpose

Intestinal Permeability, Inflammation, Vaccine

Status
Active
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Vivotif Typhoid Oral Vaccine
Aspirin (Positive Control)
Sponsored by
USDA, Western Human Nutrition Research Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Intestinal Permeability focused on measuring Gastrointestinal Health, Intestinal Permeability, Inflammation, Vaccine Response, Ty21a Typhoid Vaccine, Typhoid Fever

Eligibility Criteria

18 Years - 49 Years (Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Body Mass Index (BMI) 18.5 - 29.9 kg/m2

Exclusion Criteria:

  • Has HIV/AIDS or another disease that affects the immune system
  • Has any kind of cancer
  • Decline to take an HIV blood test
  • Blood pressure greater than or equal to 140/90 mmhg
  • Pregnant or lactating women
  • Refusal to take a pregnancy test prior to the study
  • Refusal to use a method of birth control during the study
  • Allergy to vaccine components, i.e. Thimerosal and enteric-coated capsules
  • Allergy to oral typhoid vaccine
  • Allergy to aspirin
  • Daily use of blood thinners
  • Use of anti-inflammatory medications, i.e. nonsteroidal anti-inflammatory drugs (NSAID), aspirin, 3 or more times per month
  • Use of sulfonamides or antibiotics in the past 30 days
  • Use of anti-hypertensive drugs, i.e. beta blockers, diuretics, calcium channel blockers
  • Use of anti-malaria drugs, i.e. Mefloquine, chloroquine, and proguanil
  • Use of drugs that affect the immune system, i.e. immunosuppressants, immune-modifying drugs, corticosteroids, i.e. cortisone, prednisone, methylprednisolone, for 2 weeks or longer
  • Is taking cancer treatment with radiation or drugs
  • Greater than ten years residence in a typhoid-endemic area
  • Receipt of typhoid vaccine in the last 5 years
  • Receipt of any vaccine two weeks prior to receipt of Ty21a vaccine
  • Individuals at increased risk of developing complications from a live, bacterial vaccine
  • History of typhoid fever
  • History of primary immune deficiency or autoimmune disease
  • History of acute or chronic gastrointestinal (GI) disorder, i.e. Crohn's disease, irritable bowel syndrome, gastric ulcer
  • Diarrheal illness (defined as passing 3 or more abnormally loose or watery stool in a 24 hour period) or persistent vomiting 2 weeks prior to the study
  • History of bleeding disorder, including bleeding from the GI tract
  • History of chronic illnesses, i.e. diabetes, cardiovascular disease, cancer, gastrointestinal malabsorption or inflammatory diseases, kidney disease, autoimmune disorders, HIV, liver disease, including hepatitis B and C.
  • Asthma if taking medication on a daily basis
  • Recent surgery (within 3 months)
  • History of GI surgery
  • Recent hospitalization (within 3 months)
  • Acute febrile illness (within 2 weeks)
  • Unwillingness to discontinue consumption of artificial sweeteners in foods or drinks, i.e. sport drinks, coconut water, "diet" drinks and foods (possibly containing sucralose)
  • Not having at least one arm vein suitable for blood drawing
  • Unwilling or uncomfortable with blood draws seven times in 29 days
  • Regular blood or blood product donation and refusal to suspend donation
  • Current participation in another research study
  • Unable to fast for 12-16 hours

Sites / Locations

  • USDA, ARS, Western Human Nutrition Research Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single group

Arm Description

All participants will receive the vaccine and aspirin.

Outcomes

Primary Outcome Measures

Change in intestinal permeability
Measurement of sugar (lactulose, D-mannitol, and sucralose) excretion in urine.

Secondary Outcome Measures

Antibody response to typhoid vaccination
Measurement of Typhi-specific immunoglobulin G (IgG) and immunoglobulin A (IgA) plasma cells in peripheral blood using the antibody in lymphocyte supernatant assay.
T-cell response to typhoid vaccination
Measurement of vaccine-specific cluster of differentiation 4 (CD4) and cluster of differentiation 8 (CD8) T-cells in peripheral blood mononuclear cells.
Change in markers of inflammation
Measurement of plasma cytokines, chemokines, and acute phase proteins by a multiplex immunoassay.
Change in intestinal fatty acid binding protein (iFABP)
Measurement of plasma iFABP.
Change in D-lactate
Measurement of plasma D-lactate.
Change in diamine oxidase
Measurement of plasma diamine oxidase.
Change in lipopolysaccharide binding protein (LBP)
Measurement of plasma LBP.
Change in citrulline
Measurement of plasma citrulline.

Full Information

First Posted
September 5, 2019
Last Updated
January 10, 2023
Sponsor
USDA, Western Human Nutrition Research Center
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1. Study Identification

Unique Protocol Identification Number
NCT04083950
Brief Title
Induction of Gut Permeability by an Oral Vaccine
Official Title
Induction of Gut Permeability by an Oral Vaccine
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 4, 2019 (Actual)
Primary Completion Date
January 31, 2022 (Actual)
Study Completion Date
September 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
USDA, Western Human Nutrition Research Center

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
This study evaluates the effect of an oral typhoid vaccine on disruption of the intestinal barrier and response of the immune system. Intestinal and whole-body responses will be measured in all participants before and after the vaccine.
Detailed Description
The licensed Ty21a vaccine strain of S. enterica Typhi is routinely used by travelers to countries where typhoid is common. It is not known whether the vaccine causes measurable changes in intestinal permeability and whether changes in permeability are correlated with the magnitude of the vaccine response. In the current study, gut permeability will be measured in participants at baseline and after an aspirin challenge, which is known to disrupt intestinal permeability, and after the first, second, and fourth doses of a the Ty21a vaccine. Intestinal permeability will be measured using a three-sugar absorption test composed of lactulose, mannitol, and sucralose and by several plasma markers. Vaccine response will be measured by quantitating T cells and newly developed IgG-or IgA-secreting plasma cells specific for Ty21a.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intestinal Permeability, Inflammation, Vaccine, Typhoid Fever
Keywords
Gastrointestinal Health, Intestinal Permeability, Inflammation, Vaccine Response, Ty21a Typhoid Vaccine, Typhoid Fever

7. Study Design

Primary Purpose
Basic Science
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Single group
Arm Type
Experimental
Arm Description
All participants will receive the vaccine and aspirin.
Intervention Type
Biological
Intervention Name(s)
Vivotif Typhoid Oral Vaccine
Other Intervention Name(s)
Ty21a Typhoid Oral Vaccine
Intervention Description
One capsule is swallowed on alternate days, e.g. days 15, 17, 19, and 21, for a total of 4 capsules.
Intervention Type
Drug
Intervention Name(s)
Aspirin (Positive Control)
Other Intervention Name(s)
Aspirin Challenge
Intervention Description
Three tablets (325 mg aspirin in each tablet or 975 mg total) are swallowed on days 2 and 3.
Primary Outcome Measure Information:
Title
Change in intestinal permeability
Description
Measurement of sugar (lactulose, D-mannitol, and sucralose) excretion in urine.
Time Frame
Day 1, 3, 16, 18, and 22
Secondary Outcome Measure Information:
Title
Antibody response to typhoid vaccination
Description
Measurement of Typhi-specific immunoglobulin G (IgG) and immunoglobulin A (IgA) plasma cells in peripheral blood using the antibody in lymphocyte supernatant assay.
Time Frame
Day 1, 18, 22, 24, and 29
Title
T-cell response to typhoid vaccination
Description
Measurement of vaccine-specific cluster of differentiation 4 (CD4) and cluster of differentiation 8 (CD8) T-cells in peripheral blood mononuclear cells.
Time Frame
Day 1, 22, and 29
Title
Change in markers of inflammation
Description
Measurement of plasma cytokines, chemokines, and acute phase proteins by a multiplex immunoassay.
Time Frame
Day 1, 3, 16, 18, 22, and 24
Title
Change in intestinal fatty acid binding protein (iFABP)
Description
Measurement of plasma iFABP.
Time Frame
Day 1, 3, 16, 18, and 22
Title
Change in D-lactate
Description
Measurement of plasma D-lactate.
Time Frame
Day 1, 3, 16, 18, and 22
Title
Change in diamine oxidase
Description
Measurement of plasma diamine oxidase.
Time Frame
Day 1, 3, 16, 18, and 22
Title
Change in lipopolysaccharide binding protein (LBP)
Description
Measurement of plasma LBP.
Time Frame
Day 1, 3, 16, 18, and 22
Title
Change in citrulline
Description
Measurement of plasma citrulline.
Time Frame
Day 1, 3, 16, 18, and 22

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
49 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Body Mass Index (BMI) 18.5 - 29.9 kg/m2 Exclusion Criteria: Has HIV/AIDS or another disease that affects the immune system Has any kind of cancer Decline to take an HIV blood test Blood pressure greater than or equal to 140/90 mmhg Pregnant or lactating women Refusal to take a pregnancy test prior to the study Refusal to use a method of birth control during the study Allergy to vaccine components, i.e. Thimerosal and enteric-coated capsules Allergy to oral typhoid vaccine Allergy to aspirin Daily use of blood thinners Use of anti-inflammatory medications, i.e. nonsteroidal anti-inflammatory drugs (NSAID), aspirin, 3 or more times per month Use of sulfonamides or antibiotics in the past 30 days Use of anti-hypertensive drugs, i.e. beta blockers, diuretics, calcium channel blockers Use of anti-malaria drugs, i.e. Mefloquine, chloroquine, and proguanil Use of drugs that affect the immune system, i.e. immunosuppressants, immune-modifying drugs, corticosteroids, i.e. cortisone, prednisone, methylprednisolone, for 2 weeks or longer Is taking cancer treatment with radiation or drugs Greater than ten years residence in a typhoid-endemic area Receipt of typhoid vaccine in the last 5 years Receipt of any vaccine two weeks prior to receipt of Ty21a vaccine Individuals at increased risk of developing complications from a live, bacterial vaccine History of typhoid fever History of primary immune deficiency or autoimmune disease History of acute or chronic gastrointestinal (GI) disorder, i.e. Crohn's disease, irritable bowel syndrome, gastric ulcer Diarrheal illness (defined as passing 3 or more abnormally loose or watery stool in a 24 hour period) or persistent vomiting 2 weeks prior to the study History of bleeding disorder, including bleeding from the GI tract History of chronic illnesses, i.e. diabetes, cardiovascular disease, cancer, gastrointestinal malabsorption or inflammatory diseases, kidney disease, autoimmune disorders, HIV, liver disease, including hepatitis B and C. Asthma if taking medication on a daily basis Recent surgery (within 3 months) History of GI surgery Recent hospitalization (within 3 months) Acute febrile illness (within 2 weeks) Unwillingness to discontinue consumption of artificial sweeteners in foods or drinks, i.e. sport drinks, coconut water, "diet" drinks and foods (possibly containing sucralose) Not having at least one arm vein suitable for blood drawing Unwilling or uncomfortable with blood draws seven times in 29 days Regular blood or blood product donation and refusal to suspend donation Current participation in another research study Unable to fast for 12-16 hours
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Danielle Lemay, PhD
Organizational Affiliation
USDA, ARS, Western Human Nutrition Research Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
USDA, ARS, Western Human Nutrition Research Center
City
Davis
State/Province
California
ZIP/Postal Code
95616
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Induction of Gut Permeability by an Oral Vaccine

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