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Study of Biomarkers of Immune Activation Associated With Symptoms and Immune Responses After Influenza Vaccination in Adults

Primary Purpose

Prevention of Influenza

Status
Completed
Phase
Phase 4
Locations
Belgium
Study Type
Interventional
Intervention
Seasonal,quadrivalent,influenza vaccine
Sponsored by
University Hospital, Ghent
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Prevention of Influenza

Eligibility Criteria

24 Years - 54 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Healthy male or female subjects aged 24-54 years inclusive. (Healthy in the opinion of the investigator, based on medical history and clinical exam, with no active disease process that could interfere with the study endpoints)
  2. Has a body Mass Index ≥18 and ≤30
  3. Is able to read and understand the Informed Consent Form (ICF), and understand study procedures.
  4. The subject has signed the ICF.
  5. The subject is available for follow-up for the duration of the study.
  6. The subject agrees to abstain from donating blood during their participation in the study, or longer if necessary.
  7. If the subject is a heterosexually active female, she is willing to use an effective method of contraception (e.g. oral contraceptive pill; intrauterine device; injectable or implanted contraceptive; physiological or anatomical sterility) from 30 days prior to study vaccination until the end of the study.
  8. Willing to undergo urine pregnancy tests prior to vaccination at screening.
  9. The subject has venous access sufficient to allow blood sampling as per the protocol.

Exclusion Criteria:

  1. Pregnant or lactating.
  2. Known hypersensitivity to any component of the study vaccine (α-RIX-Tetra®): the active components (vaccine antigens) or any of the excipients (disodium phosphate dodecahydrate, potassium dihydrogen phosphate, magnesium chloride hexahydrate, α-tocopheryl hydrogen succinate, polysorbate 80, octoxinol 10), eggs (chicken proteins, ovalbumin), gentamycin sulphate, formaldehyde, and sodium deoxycholate or those who have had a previous life-threatening reaction to previous influenza vaccinations.
  3. History of influenza infection in the past 5 years, defined here as severe respiratory infection with fever (> 38°C) and preventing normal daily activity during a minimum of 3 days.
  4. Vaccination with the 2016/2017 seasonal influenza vaccine and/or any other seasonal influenza vaccine within the preceding 5 influenza seasons (i.e. since season 2011/2012) before the first study visit.
  5. Presence of primary or acquired immunodeficiency states with a total lymphocyte count less than 1,200 per mm3 or presenting other evidence of lack of cellular immune competence e.g. leukaemias, lymphomas, blood dyscrasias, or patients receiving immunosuppressive therapy (including use of oral or parenteral corticosteroids in a dose ≥ 5 mg prednisone daily or equivalent within one month prior to visit 1or cytotoxic or immunosuppressive or immunomodulating drugs within 6 months prior to visit 1).
  6. Regular use of non-steroidal anti-inflammatory drugs (oral or parenteral route) within 6 months of Visit 1 considered by the study physician as likely to interfere with immune responses.
  7. Current intake of excessive amounts of alcohol (≥ 14 units for women and ≥ 21 units for men) and not willing to adapt this use during the study period.
  8. Currently performing extreme physical activities (as evaluated by the investigator) and not willing to adapt this activity during the study period.
  9. Receipt of a vaccine within 30 days of visit 1, or requirement to receive another vaccine within the study period.
  10. Presence of an acute severe febrile illness at time of immunisation.
  11. History of alcohol, narcotic, benzodiazepine, rilatine, or other substance abuse or dependence within the 12 months preceding Visit 1.
  12. Smoking in the past 6 months OR > 5 pack-year lifetime history
  13. Receipt of blood products or immunoglobulins, or blood donation, within 3 months of study start.
  14. Any condition that, in the investigator's opinion, compromises the subject's ability to meet protocol requirements or to complete the study.
  15. Currently participating in another clinical study with an investigational or non-investigational drug or device, or has participated in a clinical trial within the 3 months preceding Visit 1.
  16. Unable to read and speak Dutch or English to a fluency level adequate for the full comprehension of procedures required in participation and consent.

Sites / Locations

  • University Hospital - Center for Vaccinology

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Seasonal,quadrivalent,influenza vaccine

Arm Description

1 vaccine will be administered to all participants, namely Alfa-Rix Tetra 2016-2017

Outcomes

Primary Outcome Measures

Frequency of local vaccine-related clinical events.
Participants will report these events on a diary, measuring local events or scoring them from 0 (absent) to 3 (severe)
Severity of local vaccine-related clinical events.
Participants will report these events on a diary, measuring local events or scoring them from 0 (absent) to 3 (severe)
Frequency of systemic vaccine-related clinical events.
Participants will report these events on a diary, scoring the events from 0 (absent) to 3 (severe)
Severity of systemic vaccine-related clinical events.
Participants will report these events on a diary, scoring the events from 0 (absent) to 3 (severe)
Change from pre-immunisation baseline values in pulse.
Will be measured during the study visits
Change from pre-immunisation baseline values in body temperature
Will be measured during the study visits
Change from pre-immunisation baseline values in blood pressure
Will be measured during the study visits
Change from pre-immunisation baseline values in haematology (CBC, ESR, phenotyping of WBC) parameters
blood will be collected during the study visits
Change from pre-immunisation baseline values in biochemistry parameters
blood will be collected during the study visits
Change from pre-immunisation baseline values in global gene expression measured on whole blood samples
blood will be collected during the study visits
Change from pre-immunisation baseline values in serum HAI titre in serum samples
blood will be collected during the study visits
Change from pre-immunisation values of adaptive cellular immune response via enumeration of influenza-specific CD4+ T cells expressing activation markers and/or cytokines following in vitro stimulation and analysis by flow cytometry
blood will be collected during the study visits
Change from pre-immunisation baseline values in concentration of selected cytokines and acute phase proteins in serum samples
blood will be collected during the study visits
Change from pre-immunisation baseline values in PBMC cytokine secretion, proliferation or surface markers in response to in vitro stimulation with influenza antigens
blood will be collected during the study visits

Secondary Outcome Measures

Full Information

First Posted
March 24, 2017
Last Updated
January 21, 2022
Sponsor
University Hospital, Ghent
Collaborators
CEVAC Core Lab, University Ghent, Max Planck Institute for Infection Biology (MPIIB), Berlin, Germany, deCODE genetics, Iceland, VisMederi srl, Sienna, Italy
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1. Study Identification

Unique Protocol Identification Number
NCT03160118
Brief Title
Study of Biomarkers of Immune Activation Associated With Symptoms and Immune Responses After Influenza Vaccination in Adults
Official Title
A Clinical Study of Biomarkers of Innate and Adaptive Immune Activation Associated With Symptoms and Immune Responses After Administration of a Single Dose of a Quadrivalent Inactivated Split Virus Influenza Vaccine to Healthy Young Adults.
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
March 27, 2017 (Actual)
Primary Completion Date
May 17, 2017 (Actual)
Study Completion Date
June 28, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Ghent
Collaborators
CEVAC Core Lab, University Ghent, Max Planck Institute for Infection Biology (MPIIB), Berlin, Germany, deCODE genetics, Iceland, VisMederi srl, Sienna, Italy

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This clinical fase IV study, using the administration of a single dose of a quadrivalent, inactivated, split influenza virus vaccine as biological intervention will mirror a study conducted at Imperial College, London, UK that will use a challenge with live virus as intervention. Comparison of the clinical observations and laboratory measurements generated in both studies will inform us about the similarities and differences in innate and adaptive immune responses elicited by both types of exposure to influenza virus antigen(s).
Detailed Description
The study is a monocentric, open label study. All subjects will receive a single dose of alfa-Rix Tetra 2016-2017. The following will be measured - clinical events (recorded adverse events), physiological responses (heart rate, blood pressure, temperature, injection site), innate immune responses (cytokine levels and whole blood gene expression) and adaptive immune responses (serum antibody and antigen-specific cellular responses) at various time points after immunisation. At each study visit, full physiological parameters (including body temperature, heart rate, blood pressure) will be obtained and the injection site will be examined for the presence of any redness or swelling that will be measured and recorded. Standardized diary cards will be used to collect solicited and unsolicited clinical event data. At each visit the diary cards will be examined and any relevant clinical event will be entered into the clinical event form. Participants will be asked to monitor oral temperature from day 0 until day 7 when they wake up and when going to bed. The results of these measurements will be reported in a diary card. Any skin reactions at the site of injection will be evaluated; largest diameter of redness and swelling will be measured with a ruler and data reported on the diary card. Samples of blood (PAXgene tubes, plasma, serum and PBMCs (peripheral blood mononuclear cells)) will be collected for analysis and processing using protocols already in place. Subjects will also have blood obtained for standard safety markers (haematology, biochemistry) as well as acute phase proteins. The purpose of this protocol is to generate a set of data that will be analysed by integrated systems biology approach, for validation in subsequent clinical trials or in animal models. The dataset will broadly characterise: Physiological responses at various time points after immunisation by measuring: Local and systemic vaccine-related clinical events. Physiological assessments: heart rate, body temperature, blood pressure. Haematology (Complete Blood Count (CBC), Erythrocyte Sedimentation Rate (ESR) , phenotyping of White Blood Cells (WBC)), biochemistry parameters. Innate and adaptive immune responses including: Innate immune activation detected by global gene expression in whole blood Adaptive immunity determined by: i. Humoral immune response via serum anti-influenza HAI (Haemagglutination Inhibition) titre ii. Cellular immune response c. Immune activation detected by concentration of selected inflammatory soluble mediators in serum including: i. chemokines and cytokines ii. acute phase proteins Genetic testing of subjects when deemed necessary (genetic testing analysis may be SNIP (Single Nucleotide Polymorphism) analysis or full genome analysis). Correlations in changes in innate and adaptive immune activation with adverse events, haematology and biochemistry panels, genotype and physiological assessments The study team will biobank all samples for the duration of the BIOVACSAFE programme so that different samples and different time points depending on the results generated can selectively be analysed, principally from the gene expression analysis of whole blood.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prevention of Influenza

7. Study Design

Primary Purpose
Other
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Seasonal,quadrivalent,influenza vaccine
Arm Type
Other
Arm Description
1 vaccine will be administered to all participants, namely Alfa-Rix Tetra 2016-2017
Intervention Type
Drug
Intervention Name(s)
Seasonal,quadrivalent,influenza vaccine
Other Intervention Name(s)
Alfa-Rix Tetra 2016-2017
Intervention Description
1 dose to be administered on Day 0, the first visit
Primary Outcome Measure Information:
Title
Frequency of local vaccine-related clinical events.
Description
Participants will report these events on a diary, measuring local events or scoring them from 0 (absent) to 3 (severe)
Time Frame
At all timepoints from vaccination up to 28 days after vaccination
Title
Severity of local vaccine-related clinical events.
Description
Participants will report these events on a diary, measuring local events or scoring them from 0 (absent) to 3 (severe)
Time Frame
At all timepoints from time of vaccination up to 28 days after vaccination
Title
Frequency of systemic vaccine-related clinical events.
Description
Participants will report these events on a diary, scoring the events from 0 (absent) to 3 (severe)
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination
Title
Severity of systemic vaccine-related clinical events.
Description
Participants will report these events on a diary, scoring the events from 0 (absent) to 3 (severe)
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination
Title
Change from pre-immunisation baseline values in pulse.
Description
Will be measured during the study visits
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination
Title
Change from pre-immunisation baseline values in body temperature
Description
Will be measured during the study visits
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination
Title
Change from pre-immunisation baseline values in blood pressure
Description
Will be measured during the study visits
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination
Title
Change from pre-immunisation baseline values in haematology (CBC, ESR, phenotyping of WBC) parameters
Description
blood will be collected during the study visits
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination
Title
Change from pre-immunisation baseline values in biochemistry parameters
Description
blood will be collected during the study visits
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination
Title
Change from pre-immunisation baseline values in global gene expression measured on whole blood samples
Description
blood will be collected during the study visits
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination
Title
Change from pre-immunisation baseline values in serum HAI titre in serum samples
Description
blood will be collected during the study visits
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination
Title
Change from pre-immunisation values of adaptive cellular immune response via enumeration of influenza-specific CD4+ T cells expressing activation markers and/or cytokines following in vitro stimulation and analysis by flow cytometry
Description
blood will be collected during the study visits
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination
Title
Change from pre-immunisation baseline values in concentration of selected cytokines and acute phase proteins in serum samples
Description
blood will be collected during the study visits
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination
Title
Change from pre-immunisation baseline values in PBMC cytokine secretion, proliferation or surface markers in response to in vitro stimulation with influenza antigens
Description
blood will be collected during the study visits
Time Frame
At selected timepoints from time of vaccination up to 28 days after vaccination

10. Eligibility

Sex
All
Minimum Age & Unit of Time
24 Years
Maximum Age & Unit of Time
54 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy male or female subjects aged 24-54 years inclusive. (Healthy in the opinion of the investigator, based on medical history and clinical exam, with no active disease process that could interfere with the study endpoints) Has a body Mass Index ≥18 and ≤30 Is able to read and understand the Informed Consent Form (ICF), and understand study procedures. The subject has signed the ICF. The subject is available for follow-up for the duration of the study. The subject agrees to abstain from donating blood during their participation in the study, or longer if necessary. If the subject is a heterosexually active female, she is willing to use an effective method of contraception (e.g. oral contraceptive pill; intrauterine device; injectable or implanted contraceptive; physiological or anatomical sterility) from 30 days prior to study vaccination until the end of the study. Willing to undergo urine pregnancy tests prior to vaccination at screening. The subject has venous access sufficient to allow blood sampling as per the protocol. Exclusion Criteria: Pregnant or lactating. Known hypersensitivity to any component of the study vaccine (α-RIX-Tetra®): the active components (vaccine antigens) or any of the excipients (disodium phosphate dodecahydrate, potassium dihydrogen phosphate, magnesium chloride hexahydrate, α-tocopheryl hydrogen succinate, polysorbate 80, octoxinol 10), eggs (chicken proteins, ovalbumin), gentamycin sulphate, formaldehyde, and sodium deoxycholate or those who have had a previous life-threatening reaction to previous influenza vaccinations. History of influenza infection in the past 5 years, defined here as severe respiratory infection with fever (> 38°C) and preventing normal daily activity during a minimum of 3 days. Vaccination with the 2016/2017 seasonal influenza vaccine and/or any other seasonal influenza vaccine within the preceding 5 influenza seasons (i.e. since season 2011/2012) before the first study visit. Presence of primary or acquired immunodeficiency states with a total lymphocyte count less than 1,200 per mm3 or presenting other evidence of lack of cellular immune competence e.g. leukaemias, lymphomas, blood dyscrasias, or patients receiving immunosuppressive therapy (including use of oral or parenteral corticosteroids in a dose ≥ 5 mg prednisone daily or equivalent within one month prior to visit 1or cytotoxic or immunosuppressive or immunomodulating drugs within 6 months prior to visit 1). Regular use of non-steroidal anti-inflammatory drugs (oral or parenteral route) within 6 months of Visit 1 considered by the study physician as likely to interfere with immune responses. Current intake of excessive amounts of alcohol (≥ 14 units for women and ≥ 21 units for men) and not willing to adapt this use during the study period. Currently performing extreme physical activities (as evaluated by the investigator) and not willing to adapt this activity during the study period. Receipt of a vaccine within 30 days of visit 1, or requirement to receive another vaccine within the study period. Presence of an acute severe febrile illness at time of immunisation. History of alcohol, narcotic, benzodiazepine, rilatine, or other substance abuse or dependence within the 12 months preceding Visit 1. Smoking in the past 6 months OR > 5 pack-year lifetime history Receipt of blood products or immunoglobulins, or blood donation, within 3 months of study start. Any condition that, in the investigator's opinion, compromises the subject's ability to meet protocol requirements or to complete the study. Currently participating in another clinical study with an investigational or non-investigational drug or device, or has participated in a clinical trial within the 3 months preceding Visit 1. Unable to read and speak Dutch or English to a fluency level adequate for the full comprehension of procedures required in participation and consent.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Geert Leroux-Roels, Prof., PhD
Organizational Affiliation
University Ghent / University Hospital Ghent
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital - Center for Vaccinology
City
Ghent
State/Province
East-Flanders
ZIP/Postal Code
9000
Country
Belgium

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study of Biomarkers of Immune Activation Associated With Symptoms and Immune Responses After Influenza Vaccination in Adults

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