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Probiotics to Enhance Immunogenicity of Influenza Vaccine in Healthy Adults

Primary Purpose

Healthy

Status
Completed
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Lactobacillus rhamnosus
placebo control
Influenza Virus Vaccine Live, Intranasal
Sponsored by
Tufts Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Healthy focused on measuring influenza, vaccines, probiotics, LGG

Eligibility Criteria

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

Inclusion Criteria:

  • Age 18-49 years
  • Available for clinic visits at Tufts-New England Medical Center
  • Written informed consent and Health Insurance Portability and Accountability Act (HIPAA) obtained
  • Ability of participant to understand and comply with the requirements of the protocol

Exclusion Criteria:

  • History of any medical conditions for which the CDC states should not be vaccinated with LAIV (asthma, reactive airways disease, other chronic disorders of the pulmonary or cardiovascular systems; metabolic diseases such as diabetes, renal dysfunction, and hemoglobinopathies; or persons with known or suspected immunodeficiency diseases)
  • Self-reported vaccination with the influenza vaccine for the current influenza season (2007-8); vaccination with any vaccine within the one month period prior to study enrollment or intent to receive any other vaccine during the study period; hypersensitivity to any influenza vaccine components including thimersol or egg or Guillain-Barre syndrome
  • Self-reported treatment with immunomodulator/immunosuppressor drugs (interleukins, corticosteriods (oral or inhaled)), G(M)-CSF in 4 weeks before enrollment or self-reported history of IL-2 administration within 5 years; use of theophylline preparations or warfarin because of the theoretical possibilities of enhanced drug effects and toxicities following influenza vaccination; medication use that might affect the immune response to a vaccine or effects of LGG (no antibiotics during the previous 4 weeks)
  • Current alcohol, substance abuse, or systemic/psychiatric illness that potentially could interfere with compliance and ability to make study visits
  • Health care or day care workers or close contacts with immunosuppressed persons because of the theoretical risk that LAIV could be transmitted to the immunosuppressed person and cause disease, per CDC recommendations
  • Use of LGG or other probiotics in 4 weeks before enrollment. Yogurt consumption is not an exclusion criteria, but subjects will be asked to avoid consumption of other lactobacilli and probiotic organisms during the study period
  • Abnormalities upon physical examination
  • Acute febrile illness on day of intended immunization - immunization deferred until illness resolved
  • Routine laboratory tests outside the limits outlined for this study:

    1. hemoglobin >=11.5g/dL for women; >=13.5 g/dL for men
    2. WBC 3,300-12,000 cells/mm^3
    3. Differential within normal range
    4. Platelets 125,000-550,000 /mm^3
    5. ALT <= upper limit of normal
    6. Serum creatinine <= upper limit of normal
    7. Normal urinalysis (negative glucose, negative or trace protein, and negative or trace hemoglobin)
    8. Negative beta-HCG pregnancy test (urine or serum) for women presumed to be of reproductive potential because LAIV is contraindicated in pregnant women
    9. negative HIV test
    10. negative hepatitis B surface antigen
    11. negative anti-HCV

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Placebo Comparator

    Arm Label

    treatment

    placebo

    Arm Description

    Outcomes

    Primary Outcome Measures

    To measure anti-influenza systemic and mucosal antibody responses 4 weeks after administration of influenza vaccine (LAIV) to healthy subjects aged 18-49 and to compare responses in subjects receiving Lactobacillus GG (LGG) versus placebo

    Secondary Outcome Measures

    To assess time course of antibody response after administration of influenza vaccine (LAIV) and to compare responses in subjects receiving LGG versus placebo

    Full Information

    First Posted
    February 11, 2008
    Last Updated
    January 16, 2011
    Sponsor
    Tufts Medical Center
    Collaborators
    Amerifit Brands Inc
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00620412
    Brief Title
    Probiotics to Enhance Immunogenicity of Influenza Vaccine in Healthy Adults
    Official Title
    Lactobacillus GG to Enhance the Immunogenicity of Influenza Vaccine in Healthy Adults - Proof of Concept Study
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2011
    Overall Recruitment Status
    Completed
    Study Start Date
    September 2007 (undefined)
    Primary Completion Date
    June 2008 (Actual)
    Study Completion Date
    December 2009 (Actual)

    3. Sponsor/Collaborators

    Name of the Sponsor
    Tufts Medical Center
    Collaborators
    Amerifit Brands Inc

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this study is to determine whether the food supplement called Lactobacillus rhamnosus GG (LGG) may help boost the effectiveness of the nasal flu vaccine. Preliminary data from several studies of healthy volunteers suggest that LGG boosts the immune response to vaccines. Fifty-two subjects will be recruited into the study, all will receive the nasal flu vaccine. Twenty-six will receive capsules that contain LGG, 26 will receive placebo capsules. Blood and nasal specimens will be collected weekly for four weeks and at eight weeks to evaluate the initial mucosal and systemic immune response to the immunization. This study will provide preliminary data on whether the immune response of healthy adults to the nasal influenza vaccine can be boosted by LGG.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Healthy
    Keywords
    influenza, vaccines, probiotics, LGG

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    52 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    treatment
    Arm Type
    Active Comparator
    Arm Title
    placebo
    Arm Type
    Placebo Comparator
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    Lactobacillus rhamnosus
    Other Intervention Name(s)
    Culturelle
    Intervention Description
    2 capsules by mouth 2 times a day for 28 days. Each capsule contains 1x10^10 LGG organisms.
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    placebo control
    Intervention Description
    2 capsules by mouth twice a day for 28 days
    Intervention Type
    Biological
    Intervention Name(s)
    Influenza Virus Vaccine Live, Intranasal
    Other Intervention Name(s)
    FluMist
    Intervention Description
    intranasal spray, 0.1ml per nostril, one time dose
    Primary Outcome Measure Information:
    Title
    To measure anti-influenza systemic and mucosal antibody responses 4 weeks after administration of influenza vaccine (LAIV) to healthy subjects aged 18-49 and to compare responses in subjects receiving Lactobacillus GG (LGG) versus placebo
    Time Frame
    4 weeks
    Secondary Outcome Measure Information:
    Title
    To assess time course of antibody response after administration of influenza vaccine (LAIV) and to compare responses in subjects receiving LGG versus placebo
    Time Frame
    2 weeks

    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: Age 18-49 years Available for clinic visits at Tufts-New England Medical Center Written informed consent and Health Insurance Portability and Accountability Act (HIPAA) obtained Ability of participant to understand and comply with the requirements of the protocol Exclusion Criteria: History of any medical conditions for which the CDC states should not be vaccinated with LAIV (asthma, reactive airways disease, other chronic disorders of the pulmonary or cardiovascular systems; metabolic diseases such as diabetes, renal dysfunction, and hemoglobinopathies; or persons with known or suspected immunodeficiency diseases) Self-reported vaccination with the influenza vaccine for the current influenza season (2007-8); vaccination with any vaccine within the one month period prior to study enrollment or intent to receive any other vaccine during the study period; hypersensitivity to any influenza vaccine components including thimersol or egg or Guillain-Barre syndrome Self-reported treatment with immunomodulator/immunosuppressor drugs (interleukins, corticosteriods (oral or inhaled)), G(M)-CSF in 4 weeks before enrollment or self-reported history of IL-2 administration within 5 years; use of theophylline preparations or warfarin because of the theoretical possibilities of enhanced drug effects and toxicities following influenza vaccination; medication use that might affect the immune response to a vaccine or effects of LGG (no antibiotics during the previous 4 weeks) Current alcohol, substance abuse, or systemic/psychiatric illness that potentially could interfere with compliance and ability to make study visits Health care or day care workers or close contacts with immunosuppressed persons because of the theoretical risk that LAIV could be transmitted to the immunosuppressed person and cause disease, per CDC recommendations Use of LGG or other probiotics in 4 weeks before enrollment. Yogurt consumption is not an exclusion criteria, but subjects will be asked to avoid consumption of other lactobacilli and probiotic organisms during the study period Abnormalities upon physical examination Acute febrile illness on day of intended immunization - immunization deferred until illness resolved Routine laboratory tests outside the limits outlined for this study: hemoglobin >=11.5g/dL for women; >=13.5 g/dL for men WBC 3,300-12,000 cells/mm^3 Differential within normal range Platelets 125,000-550,000 /mm^3 ALT <= upper limit of normal Serum creatinine <= upper limit of normal Normal urinalysis (negative glucose, negative or trace protein, and negative or trace hemoglobin) Negative beta-HCG pregnancy test (urine or serum) for women presumed to be of reproductive potential because LAIV is contraindicated in pregnant women negative HIV test negative hepatitis B surface antigen negative anti-HCV
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Patricia L Hibberd, MD, PhD
    Organizational Affiliation
    Tufts Medical Center
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    21285968
    Citation
    Davidson LE, Fiorino AM, Snydman DR, Hibberd PL. Lactobacillus GG as an immune adjuvant for live-attenuated influenza vaccine in healthy adults: a randomized double-blind placebo-controlled trial. Eur J Clin Nutr. 2011 Apr;65(4):501-7. doi: 10.1038/ejcn.2010.289. Epub 2011 Feb 2.
    Results Reference
    derived

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    Probiotics to Enhance Immunogenicity of Influenza Vaccine in Healthy Adults

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