Safety and Immunogenicity Study of Na-GST-1 With or Without CpG
Primary Purpose
Hookworm Infection, Hookworm Disease
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Na-GST-1/Alhydrogel®
CpG 10104
Sponsored by
About this trial
This is an interventional prevention trial for Hookworm Infection focused on measuring Human Hookworm, Necator americanus, Hookworm, Hookworm Disease, Iron-deficiency anemia, Soil-transmitted helminth infection, Neglected Tropical Disease, Na-GST-1, CpG
Eligibility Criteria
Inclusion Criteria:
- Males or females between 18 and 50 years, inclusive.
- Good general health as determined by means of the screening procedure.
- Available for the duration of the trial (68 weeks).
- Willingness to participate in the study as evidenced by signing the informed consent document.
- Able to understand and comply with planned study procedures.
Exclusion Criteria:
- Pregnancy as determined by a positive urine human choriogonadotropin (hCG) test (if female).
- Participant unwilling to use reliable contraception up until one month following the third immunization (if female and not surgically sterile, abstinent, at least 2 years post-menopausal, or determined otherwise by medical evaluation to be sterile).
- Currently lactating and breast-feeding (if female).
- Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, rheumatologic, autoimmune, diabetes, or renal disease by history, physical examination, and/or laboratory studies. A history of essential hypertension that is well controlled by medication will not be considered exclusionary.
- Has a diagnosis of schizophrenia, bipolar disease or other major psychiatric condition that would make compliance with study visits/procedures difficult (e.g., subject with psychoses or history of suicide attempt or gesture in the 3 years before study entry, ongoing risk for suicide).
- Known or suspected immunodeficiency.
- Laboratory evidence of liver disease (alanine aminotransferase [ALT] greater than 1.25-times the upper reference limit).
- Laboratory evidence of renal disease (serum creatinine greater than 1.25-times the upper reference limit, or more than trace protein or blood on urine dipstick testing with the exception of greater than 1+ blood detected in females during menses).
- Laboratory evidence of hematologic disease (hemoglobin <11.1 g/dl [females] or <12.5 g/dl [males]; absolute leukocyte count <3400/mm3 or >10.8 x 103/mm3; or platelet count <140,000/mm3).
- Laboratory evidence of a coagulopathy (activated PTT or PT INR greater than 1.1-times the upper reference limit).
- Serum glucose greater than 1.2-times the upper reference limit.
- Other condition that in the opinion of the investigator would jeopardize the safety or rights of a volunteer participating in the trial or would render the subject unable to comply with the protocol.
- Planned participation in another investigational vaccine or drug trial within 30 days of starting this study or until Visit #17 (6 months after the third vaccination).
- Volunteer has had medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months.
- History of a severe allergic reaction or anaphylaxis.
- Severe asthma as defined by the need for daily use of inhalers, or emergency clinic visit or hospitalization within 6 months of the volunteer's expected first vaccination in the study.
- Positive test for hepatitis B surface antigen (HBsAg).
- Positive confirmatory test for HIV infection.
- Positive confirmatory test for hepatitis C virus (HCV) infection.
- Use of corticosteroids (excluding topical or nasal) or immunosuppressive drugs within 30 days of the volunteer's expected first vaccination in this study or planned use up to one month following the last vaccination.
- Receipt of a live vaccine within 4 weeks or a killed vaccine within 2 weeks prior to the volunteer's expected first vaccination in the study.
- Previous receipt of the Na-GST-1/Alhydrogel® hookworm vaccine.
- History of a surgical splenectomy.
- Receipt of blood products within the past 6 months.
- Pre-existing autoimmune or antibody-mediated diseases including but not limited to: systemic lupus erythematosis, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, autoimmune thrombocytopenia; or laboratory evidence of possible autoimmune disease determined by a positive anti-dsDNA titer, positive rheumatoid factor, proteinuria and/or a positive ANA.
- History of previous infection with hookworm or residence for more than 6 months in a community where hookworm is endemic.
Sites / Locations
- George Washington University Medical Faculty Associates
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Experimental
Arm Label
100 µg Na-GST-1/Alhydrogel
30 µg Na-GST-1/Alhydrogel + CpG 10104
100 µg Na-GST-1/Alhydrogel + CpG 10104
Arm Description
High Dose Na-GST-1/Alhydrogel® Only
Low Dose Na-GST-1/Alhydrogel® Plus 500 µg CpG 10104
High Dose Na-GST-1/Alhydrogel® Plus 500 µg CpG 10104
Outcomes
Primary Outcome Measures
Vaccine-related Adverse Events
The frequency of immediate, systemic, and local injection site adverse events, graded by severity, for Na-GST-1/Alhydrogel administered alone or in combination with CpG 10104
Secondary Outcome Measures
IgG antibody response to Na-GST-1
Dose and formulation of Na-GST-1 that generates the highest IgG antibody response at Day 126 (14 days after final vaccination), as determined by an indirect enzyme-linked immunosorbent assay (ELISA)
B cell response to Na-GST-1
Dose and formulation of the Na-GST-1 vaccine that results in the highest production of Na-GST-1 specific B cells and subtypes (memory or plasma)
Exploratory cellular immune response to Na-GST-1
Exploratory studies of the cellular immune responses to the Na-GST-1 antigen both before and after immunization.
Full Information
NCT ID
NCT02143518
First Posted
May 14, 2014
Last Updated
May 30, 2017
Sponsor
Baylor College of Medicine
Collaborators
George Washington University
1. Study Identification
Unique Protocol Identification Number
NCT02143518
Brief Title
Safety and Immunogenicity Study of Na-GST-1 With or Without CpG
Official Title
Phase 1 Study of the Safety and Immunogenicity of Na-GST-1/Alhydrogel, With or Without a CpG ODN Adjuvant, in Healthy Adults
Study Type
Interventional
2. Study Status
Record Verification Date
May 2017
Overall Recruitment Status
Completed
Study Start Date
October 2014 (undefined)
Primary Completion Date
June 2016 (Actual)
Study Completion Date
October 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Baylor College of Medicine
Collaborators
George Washington University
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Na-GST-1 is a protein expressed during the adult stage of the hookworm life cycle that is thought to play a role in the parasite's degradation of host hemoglobin for use as an energy source. Vaccination with recombinant GST-1 has protected dogs and hamsters from infection in challenge studies. This study will evaluate the safety and immunogenicity of two formulations of Na-GST-1 in healthy adult volunteers when co-administered with the immunostimulant CpG 10104, a Toll-like Receptor-9 agonist.
Detailed Description
This is a Phase 1 randomized double-blind dose-escalation clinical trial in healthy hookworm-naïve adults conducted at the George Washington Medical Faculty Associates, Washington, DC, and the George Washington University School of Medicine and Health Sciences, Department of Microbiology, Immunology and Tropical Medicine, Washington, DC. In total, 24 subjects will be progressively enrolled into 2 cohorts of 12 subjects each. In the first cohort 8 subjects will receive 30µg Na-GST-1/Alhydrogel co-administered with 500µg CpG 10104 and 4 subjects will receive 100µg Na-GST-1/Alhydrogel® only, in a randomized, double-blinded fashion. In the second cohort 8 subjects will receive 100µg Na-GST-1/Alhydrogel co-administered with 500µg CpG 10104 and 4 volunteers will receive 100µg Na-GST-1/Alhydrogel only, in a randomized, double-blinded fashion. Vaccinations will be administered intramuscularly in the deltoid muscle according to a 0, 2, 4-month schedule. Each subject will participate in the study for 68 weeks (16 months) and the total duration of the study is estimated at approximately 19 months.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hookworm Infection, Hookworm Disease
Keywords
Human Hookworm, Necator americanus, Hookworm, Hookworm Disease, Iron-deficiency anemia, Soil-transmitted helminth infection, Neglected Tropical Disease, Na-GST-1, CpG
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
24 (Actual)
8. Arms, Groups, and Interventions
Arm Title
100 µg Na-GST-1/Alhydrogel
Arm Type
Experimental
Arm Description
High Dose Na-GST-1/Alhydrogel® Only
Arm Title
30 µg Na-GST-1/Alhydrogel + CpG 10104
Arm Type
Experimental
Arm Description
Low Dose Na-GST-1/Alhydrogel® Plus 500 µg CpG 10104
Arm Title
100 µg Na-GST-1/Alhydrogel + CpG 10104
Arm Type
Experimental
Arm Description
High Dose Na-GST-1/Alhydrogel® Plus 500 µg CpG 10104
Intervention Type
Biological
Intervention Name(s)
Na-GST-1/Alhydrogel®
Other Intervention Name(s)
Na-GST-1, Necator americanus glutathione S-transferase-1
Intervention Description
The Na-GST-1 candidate vaccine contains the recombinant Na-GST-1 protein expressed by Pichia pastoris. Purified Na-GST-1 was subsequently adsorbed onto aluminum hydroxide gel (Alhydrogel®) and suspended in a solution containing 10% glucose and 10 mM imidazole. The final concentration of Na-GST-1 in the drug product is 0.1 mg/ml whereas that of Alhydrogel® is 0.8 mg/ml. Different doses of Na-GST-1 will be delivered by injecting different volumes of the 0.1 mg/ml Na-GST-1 preparation.
Intervention Type
Biological
Intervention Name(s)
CpG 10104
Other Intervention Name(s)
Cytosine-phosphate-Guanine oligodeoxynucleotide, CpG ODN 101014, CpG ODN
Intervention Description
Unmethylated cytosine-guanine dinucleotides (CpGs) are found in bacterial DNA in the expected frequency predicted by random usage, whereas their occurrence is suppressed 4-fold in vertebrate DNA. In vertebrate DNA CpG motifs are also usually methylated. Bacterial CpG-DNA motifs are recognized by the human innate immune system via Toll-like Receptor-9 (TLR-9), a pathogen-associated molecular pattern (PAMP) receptor that is expressed, in particular, by antigen-presenting dendritic cells. Interactions between CpG-DNA and TLR9 rapidly activate antigen-presenting dendritic cells to upregulate co-stimulatory molecules and to produce Th1-polarizing cytokines such as interleukin-12 and interferon gamma. CpG 10104 is a short synthetic oligodeoxynucleotide of the following sequence: 5'-TCG TCG TTT CGT CGT TTT GTC GTT-3'.
Primary Outcome Measure Information:
Title
Vaccine-related Adverse Events
Description
The frequency of immediate, systemic, and local injection site adverse events, graded by severity, for Na-GST-1/Alhydrogel administered alone or in combination with CpG 10104
Time Frame
Up to study day 470
Secondary Outcome Measure Information:
Title
IgG antibody response to Na-GST-1
Description
Dose and formulation of Na-GST-1 that generates the highest IgG antibody response at Day 126 (14 days after final vaccination), as determined by an indirect enzyme-linked immunosorbent assay (ELISA)
Time Frame
14 days after final vaccination
Title
B cell response to Na-GST-1
Description
Dose and formulation of the Na-GST-1 vaccine that results in the highest production of Na-GST-1 specific B cells and subtypes (memory or plasma)
Time Frame
Up to study day 290
Title
Exploratory cellular immune response to Na-GST-1
Description
Exploratory studies of the cellular immune responses to the Na-GST-1 antigen both before and after immunization.
Time Frame
Up to study day 290
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Males or females between 18 and 50 years, inclusive.
Good general health as determined by means of the screening procedure.
Available for the duration of the trial (68 weeks).
Willingness to participate in the study as evidenced by signing the informed consent document.
Able to understand and comply with planned study procedures.
Exclusion Criteria:
Pregnancy as determined by a positive urine human choriogonadotropin (hCG) test (if female).
Participant unwilling to use reliable contraception up until one month following the third immunization (if female and not surgically sterile, abstinent, at least 2 years post-menopausal, or determined otherwise by medical evaluation to be sterile).
Currently lactating and breast-feeding (if female).
Evidence of clinically significant neurologic, cardiac, pulmonary, hepatic, rheumatologic, autoimmune, diabetes, or renal disease by history, physical examination, and/or laboratory studies. A history of essential hypertension that is well controlled by medication will not be considered exclusionary.
Has a diagnosis of schizophrenia, bipolar disease or other major psychiatric condition that would make compliance with study visits/procedures difficult (e.g., subject with psychoses or history of suicide attempt or gesture in the 3 years before study entry, ongoing risk for suicide).
Known or suspected immunodeficiency.
Laboratory evidence of liver disease (alanine aminotransferase [ALT] greater than 1.25-times the upper reference limit).
Laboratory evidence of renal disease (serum creatinine greater than 1.25-times the upper reference limit, or more than trace protein or blood on urine dipstick testing with the exception of greater than 1+ blood detected in females during menses).
Laboratory evidence of hematologic disease (hemoglobin <11.1 g/dl [females] or <12.5 g/dl [males]; absolute leukocyte count <3400/mm3 or >10.8 x 103/mm3; or platelet count <140,000/mm3).
Laboratory evidence of a coagulopathy (activated PTT or PT INR greater than 1.1-times the upper reference limit).
Serum glucose greater than 1.2-times the upper reference limit.
Other condition that in the opinion of the investigator would jeopardize the safety or rights of a volunteer participating in the trial or would render the subject unable to comply with the protocol.
Planned participation in another investigational vaccine or drug trial within 30 days of starting this study or until Visit #17 (6 months after the third vaccination).
Volunteer has had medical, occupational, or family problems as a result of alcohol or illicit drug use during the past 12 months.
History of a severe allergic reaction or anaphylaxis.
Severe asthma as defined by the need for daily use of inhalers, or emergency clinic visit or hospitalization within 6 months of the volunteer's expected first vaccination in the study.
Positive test for hepatitis B surface antigen (HBsAg).
Positive confirmatory test for HIV infection.
Positive confirmatory test for hepatitis C virus (HCV) infection.
Use of corticosteroids (excluding topical or nasal) or immunosuppressive drugs within 30 days of the volunteer's expected first vaccination in this study or planned use up to one month following the last vaccination.
Receipt of a live vaccine within 4 weeks or a killed vaccine within 2 weeks prior to the volunteer's expected first vaccination in the study.
Previous receipt of the Na-GST-1/Alhydrogel® hookworm vaccine.
History of a surgical splenectomy.
Receipt of blood products within the past 6 months.
Pre-existing autoimmune or antibody-mediated diseases including but not limited to: systemic lupus erythematosis, rheumatoid arthritis, multiple sclerosis, Sjogren's syndrome, autoimmune thrombocytopenia; or laboratory evidence of possible autoimmune disease determined by a positive anti-dsDNA titer, positive rheumatoid factor, proteinuria and/or a positive ANA.
History of previous infection with hookworm or residence for more than 6 months in a community where hookworm is endemic.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Diemert, MD
Organizational Affiliation
George Washington University
Official's Role
Principal Investigator
Facility Information:
Facility Name
George Washington University Medical Faculty Associates
City
Washington, D.C.
State/Province
District of Columbia
ZIP/Postal Code
20036
Country
United States
12. IPD Sharing Statement
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Safety and Immunogenicity Study of Na-GST-1 With or Without CpG
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