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Measuring Responses to Sublingual Antigens

Primary Purpose

Sexually Transmitted Diseases, Viral

Status
Completed
Phase
Not Applicable
Locations
United Kingdom
Study Type
Interventional
Intervention
Human Papillomavirus 6,11,16,18 Vaccine Recombinant alum ads
Human Papillomavirus 6,11,16,18 Vaccine Recombinant alum ads
Sponsored by
St George's, University of London
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Sexually Transmitted Diseases, Viral focused on measuring mucosal immunity, immunization, sublingual

Eligibility Criteria

18 Years - 35 Years (Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  • A female adult volunteer aged between 18 and 35 years old.
  • Subjects who the investigator believes can and will comply with the requirements of the protocol.
  • Provide written informed consent following a detailed written explanation of participation in the protocol.
  • They are in good health as determined by medical history, physical examination, haematology testing, and clinical judgement before entering into the study.
  • They are available for the whole duration of the study.
  • If of childbearing potential, must have a negative pregnancy test before each immunisation.
  • They have not donated blood during 3 months prior to study entry and agree to not donate for 3 months after the end of their participation in the study.
  • They are eligible for free medical treatment

Exclusion Criteria:

  • They have already been vaccinated with an HPV vaccine
  • They have participated in a clinical trial in the last 6 months in which they have been exposed to an investigational product (pharmaceutical product or placebo or device) or concurrent participation in another clinical research study at the time of enrolment.
  • Use of any investigational or non-registered product (drug or vaccine) within 30 days preceding the first dose of challenge agent, or planned use during the study period.
  • They are pregnant or breast-feeding.
  • They have a known or suspected ongoing cervico-vaginal disease, malignancy or abnormality discovered at time of screening.
  • They present in the samples obtained at the screening visit: positive results for HIV, HBs Ag, anti-HBc and anti-HCV antibody, a clinically significant abnormality in haematology. Normal ranges will be defined by the pathology laboratory undertaking assays.
  • They have a clinically significant acute or chronic pulmonary, cardiovascular, hepatic or renal functional abnormality, blood or neurological disorders, immune dysfunction, autoimmune diseases, diabetes (excluding history of gestational diabetes), or malignancy at the time of enrolment, as determined by medical history, physical examination or laboratory screening tests.
  • They have received any form of immunosuppressive therapy in the past 6 months.
  • They are receiving any medications via vaginal route (as this may interfere with collection of samples).
  • They have any tongue or frenulum piercings or oral jewellery that may interfere with sublingual delivery.
  • They have received blood products or immunoglobulins 120 days prior to enrolment.
  • They have thrombocytopaenia or any coagulation disorder (because bleeding may occur following an intramuscular administration in these individuals).
  • Any other medical, psychiatric or social condition, drug treatment, occupational or other responsibility that, in the judgement of the investigator, would interfere with or serve as a contradiction to adherence to the study protocol or ability to give informed consent.
  • Individuals who cannot read or speak fluent English.

Sites / Locations

  • St George's Vaccine Institute, St George's University of London

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Intramuscular administration

Sublingual administration

Arm Description

Intramuscular injection of HPV vaccine proteins

Sublingual administration of HPV vaccine proteins

Outcomes

Primary Outcome Measures

Concentration and isotype profile of antigen-specific antibody in cervico-vaginal secretions measured by ELISA and/or LUMINEX assay

Secondary Outcome Measures

Concentration and isotype profile of antigen-specific antibody in serum measured by ELISA and/or LUMINEX assay
Frequency and isotype profile of antigen-specific antibody secreting cells in blood
Frequency and expression profile of mucosa-associated homing, memory and regulatory markers on antigen-specific T cells in blood in response to in vitro antigen stimulation
Profile of cytokine secretion by peripheral blood mononuclear cells in response to in vitro antigen stimulation measured by ELISA

Full Information

First Posted
July 29, 2009
Last Updated
January 26, 2011
Sponsor
St George's, University of London
Collaborators
European Union
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1. Study Identification

Unique Protocol Identification Number
NCT00949572
Brief Title
Measuring Responses to Sublingual Antigens
Official Title
Characterisation of Human Disseminated Cellular and Humoral Immune Responses Following Sublingual or Intramuscular Deposition of Antigens
Study Type
Interventional

2. Study Status

Record Verification Date
January 2010
Overall Recruitment Status
Completed
Study Start Date
September 2009 (undefined)
Primary Completion Date
June 2010 (Actual)
Study Completion Date
January 2011 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
St George's, University of London
Collaborators
European Union

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is a preliminary investigation of immune responses, in the blood and in cervical & vaginal secretions, to proteins ("antigens") taken up across the undersurface of the tongue.
Detailed Description
Animal studies have shown that this "sublingual" surface can take up antigens and stimulate immune responses, which may have a different character to responses induced by injecting the same antigens. In previous studies of nasal and oral delivery, we used licensed vaccine preparations as pure and well-characterised model antigens safe for use in humans. We will use a licensed "HPV" vaccine as the source of antigens in this study. The quantity and character of responses (lymphocyte number and pattern of surface proteins, concentration and type of antibodies in fluids) will be measured in detail in various anatomical sites (blood, vaginal secretions) before and after delivery of antigens on three occasions. As well as using established immune assays to characterise the responses, we will develop new research assays to detect populations of lymphocytes and antibodies present in secretions. To ensure we have positive samples to include in our assays and validate new techniques, we will recruit some subjects to receive a standard intramuscular injection, as this is known to be nearly 100% reliable in inducing measurable immune responses. As this is a preliminary study we will recruit enough subjects (based on our previous experience with nasal, oral and injected delivery) to ensure we generate sufficient responses we can measure. We may be able to draw some tentative conclusions about differences in character of immune responses following sublingual or injected delivery, but it is not the intention of this initial study to formally compare these two routes. If we observe that sublingual delivery in humans can induce immune responses, we can select assays to test any differences more formally in subsequent bigger and more focused studies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sexually Transmitted Diseases, Viral
Keywords
mucosal immunity, immunization, sublingual

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Intramuscular administration
Arm Type
Experimental
Arm Description
Intramuscular injection of HPV vaccine proteins
Arm Title
Sublingual administration
Arm Type
Experimental
Arm Description
Sublingual administration of HPV vaccine proteins
Intervention Type
Biological
Intervention Name(s)
Human Papillomavirus 6,11,16,18 Vaccine Recombinant alum ads
Other Intervention Name(s)
Gardasil
Intervention Description
1 intramuscular dose (0.5 ml) on month 0, 1 and 4 containing approximately: Human Papillomavirus Type 6 L1 protein 20 micrograms Human Papillomavirus Type 11 L1 protein 40 micrograms Human Papillomavirus Type 16 L1 protein 40 micrograms Human Papillomavirus Type 18 L1 protein 20 micrograms
Intervention Type
Biological
Intervention Name(s)
Human Papillomavirus 6,11,16,18 Vaccine Recombinant alum ads
Other Intervention Name(s)
Gardasil
Intervention Description
1 sublingual application on month 0, 1 and 4 of 0.5 ml containing approximately: Human Papillomavirus Type 6 L1 protein 20 micrograms Human Papillomavirus Type 11 L1 protein 40 micrograms Human Papillomavirus Type 16 L1 protein 40 micrograms Human Papillomavirus Type 18 L1 protein 20 micrograms
Primary Outcome Measure Information:
Title
Concentration and isotype profile of antigen-specific antibody in cervico-vaginal secretions measured by ELISA and/or LUMINEX assay
Time Frame
0, 1, 4 and 5 months after first immunization
Secondary Outcome Measure Information:
Title
Concentration and isotype profile of antigen-specific antibody in serum measured by ELISA and/or LUMINEX assay
Time Frame
0, 1, 4 & 5 months after first immunization
Title
Frequency and isotype profile of antigen-specific antibody secreting cells in blood
Time Frame
0 and 1 week after each immunization
Title
Frequency and expression profile of mucosa-associated homing, memory and regulatory markers on antigen-specific T cells in blood in response to in vitro antigen stimulation
Time Frame
0 and 4 weeks after each immunization
Title
Profile of cytokine secretion by peripheral blood mononuclear cells in response to in vitro antigen stimulation measured by ELISA
Time Frame
0 and 4 weeks after each immunization

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
35 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: A female adult volunteer aged between 18 and 35 years old. Subjects who the investigator believes can and will comply with the requirements of the protocol. Provide written informed consent following a detailed written explanation of participation in the protocol. They are in good health as determined by medical history, physical examination, haematology testing, and clinical judgement before entering into the study. They are available for the whole duration of the study. If of childbearing potential, must have a negative pregnancy test before each immunisation. They have not donated blood during 3 months prior to study entry and agree to not donate for 3 months after the end of their participation in the study. They are eligible for free medical treatment Exclusion Criteria: They have already been vaccinated with an HPV vaccine They have participated in a clinical trial in the last 6 months in which they have been exposed to an investigational product (pharmaceutical product or placebo or device) or concurrent participation in another clinical research study at the time of enrolment. Use of any investigational or non-registered product (drug or vaccine) within 30 days preceding the first dose of challenge agent, or planned use during the study period. They are pregnant or breast-feeding. They have a known or suspected ongoing cervico-vaginal disease, malignancy or abnormality discovered at time of screening. They present in the samples obtained at the screening visit: positive results for HIV, HBs Ag, anti-HBc and anti-HCV antibody, a clinically significant abnormality in haematology. Normal ranges will be defined by the pathology laboratory undertaking assays. They have a clinically significant acute or chronic pulmonary, cardiovascular, hepatic or renal functional abnormality, blood or neurological disorders, immune dysfunction, autoimmune diseases, diabetes (excluding history of gestational diabetes), or malignancy at the time of enrolment, as determined by medical history, physical examination or laboratory screening tests. They have received any form of immunosuppressive therapy in the past 6 months. They are receiving any medications via vaginal route (as this may interfere with collection of samples). They have any tongue or frenulum piercings or oral jewellery that may interfere with sublingual delivery. They have received blood products or immunoglobulins 120 days prior to enrolment. They have thrombocytopaenia or any coagulation disorder (because bleeding may occur following an intramuscular administration in these individuals). Any other medical, psychiatric or social condition, drug treatment, occupational or other responsibility that, in the judgement of the investigator, would interfere with or serve as a contradiction to adherence to the study protocol or ability to give informed consent. Individuals who cannot read or speak fluent English.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David JM Lewis, MD
Organizational Affiliation
St George's, University of London
Official's Role
Principal Investigator
Facility Information:
Facility Name
St George's Vaccine Institute, St George's University of London
City
London
State/Province
England
ZIP/Postal Code
SW17 0RE
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
22438987
Citation
Huo Z, Bissett SL, Giemza R, Beddows S, Oeser C, Lewis DJ. Systemic and mucosal immune responses to sublingual or intramuscular human papilloma virus antigens in healthy female volunteers. PLoS One. 2012;7(3):e33736. doi: 10.1371/journal.pone.0033736. Epub 2012 Mar 16.
Results Reference
derived
Links:
URL
http://www.vaccine.ac.uk
Description
Website of St George's Vaccine Institute
URL
http://www.sgul.ac.uk
Description
Website of St George's University of London
URL
http://ec.europa.eu/research/health/infectious-diseases/poverty-diseases/projects/200_en.htm
Description
European Commission EURONEUT41 funding body website

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Measuring Responses to Sublingual Antigens

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