Transcutaneous Immunization With an Attenuated Listeria Monocytogenes Vector Vaccine

NCT01311817 | Completed Phase 1 DMC

• 1 other identifier: 2008P-0002296
• Study Type: interventional
• Target: 8
• Locations: 1 country
• Sites: 1

Brief Summary

This project is a pilot safety and immunogenicity study of transcutaneous vaccination with live attenuated Listeria monocytogenes BMB72 bacteria (actA/plcB-deleted, expressing influenza A nucleoprotein) and a cutaneous adjuvant, native purified cholera toxin. Transcutaneous vaccination is needle-less application of materials directly to the skin. Healthy adult volunteers (4 per group) will receive either:

• Saline (placebo)
• Cholera toxin adjuvant alone
• L. monocytogenes BMB72 bacteria alone
• L. monocytogenes BMB72 bacteria plus Cholera toxin adjuvant Vaccine solutions will be applied to the upper deltoid area under a standard Tegaderm dressing. Key primary endpoints include: safety as measured primarily by clinical findings (VS, cutaneous exams, and systemic reactions), and immune responses as measured by serological responses to L. monocytogenes, influenza A nucleoprotein, CT, and IFN gamma ELISPOT responses to listeriolysin and nucleoprotein peptides. Local skin immune responses will be evaluated by skin biopsy in subjects who agree to that (optional). The study will begin with 2 "roll-in" subjects receiving both L. monocytogenes and CT.

Conditions

Healthy Volunteers

Outcome Measures

Primary Outcomes (2)

• Vaccine Safety

  Safety is measured primarily by clinical findings (VS, cutaneous exams, and systemic reactions

  1 year +/-

• Immunogenicity

  Immune responses are measured by serological responses to L. monocytogenes, influenza A nucleoprotein, cholera toxin, and IFN gamma ELISPOT responses to listeriolysin and nucleoprotein peptides.

  1 year +/-

Study Arms (2)

Saline Patch

PLACEBO COMPARATOR

1mL saline applied to the vaccine patch

Biological: BMB72 (actA/plcB-deleted Listeria monocytogenes expressing influenza A nucleoprotein)

Bacteria plus CT

EXPERIMENTAL

0.95mL bacterial vector plus 0.05mL cholera toxin

Biological: BMB72 (actA/plcB-deleted Listeria monocytogenes expressing influenza A nucleoprotein)

Interventions

BMB72 (actA/plcB-deleted Listeria monocytogenes expressing influenza A nucleoprotein) BIOLOGICAL

1mL liquid contained in an adhesive skin patch

Also known as: Lot ELH072910

Bacteria plus CT; Saline Patch

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Healthy adult 18-55 years old, male or female.
• Adequate venous access by inspection for frequent blood draws.
• Must have normal physical exam and laboratory values within the normal range for age/gender in screening studies (see details below).
• Be willing to return for 3 vaccinations, and the needed follow-up visits.
• Not pregnant (WOCBP have pregnancy testing prior to vaccination, on a standard schedule over the course of the study, and must use contraception).
• Non-smokers (altered immunity).
• Body mass index (BMI) less than or equal to 32.5 (the obese have impaired responses to some vaccines).
• Normal skin exam.
• Volunteers must be feeling well and be afebrile (T\<99.5) at the time of vaccination.

You may not qualify if:

• History of allergy to any penicillin (including penicillin G, penicillin V, ampicillin, amoxicillin) or sulfa drugs (trimethoprim/sulfamethoxazole is the second line agent for therapy of listeriosis).
• Any chronic medical illness or problem requiring chronic medical care. Exceptions:
• Subjects on one antihypertensive prescribed for essential hypertension, with seated BP in the normal range at screening will be accepted. These are immunologically normal adults and we do not believe treated essential hypertension as a single illness puts these individuals at any greater risk than other healthy adults.
• Subjects using only PRN beta agonists for mild asthma, or cold or exercise-induced bronchospams, will be allowed (those with any prior or current inhaled or systemic steroids for asthma are excluded).
• Any chronic or current skin disorder, e.g. eczema, dermatitis, psoriasis, rosacea, or acne. Prescription medications more than 5 years ago for teenage acne without current acne on exam or current use of those medications does not exclude subjects.
• Any acute skin break or problem at the planned vaccination site (deltoid).
• Upper extremity lymphedema, deformity (e.g. large burn or poorly-healed fracture), swelling or vascular abnormality on exam. A history of a distant isolated arm, wrist or hand fracture (more than 5 years earlier) with no residual functional deficit or visible deformity will not exclude a subject.
• History of allergy to medical bandages, tape, or adhesives (a Tegaderm patch is used for application.)
• No history of bleeding disorder, or anticoagulant medications. (The protocol has an optional skin biopsy).
• Pregnancy, attempting pregnancy, or unwillingness to use medically acceptable contraception for entire study period if sexually active. Women of childbearing potential will have serum pregnancy testing. Women who are menopausal (over 50 years of age with no menses for more than one year) or surgically sterilized are not considered of child-bearing potential and will not require pregnancy testing or contraception. Acceptable contraception includes: condoms/spermicide, prescription hormonal contraceptive pills, patches, rings, and implants; IUDs.
• Any type of chronic prescription medication use for any reason, including acne or skin conditions. Exceptions: oral contraceptives, depo contraceptives, patch contraceptives, one antihypertensive agent is allowed, if BP is normal on exam as noted above.
• History of keloid scars, or poor wound healing.
• Previous splenectomy or abdominal procedure where splenectomy was possibly performed - e.g. laparotomy for trauma. (Not a known risk factor for listeriosis, but might conceivably result in more serious illness, or alter immune responses to a bacterial pathogen).
• Any biomedical implants: cranial plates, joint prostheses, bone screws, pacemakers, CNS clips, and heart valves. (Exceptions: K wires or 3 or fewer dental implants more than 2 years post implantation in an otherwise healthy individual with no functional deficit or deformity will not exclude an individual.)
• Mitral valve click or prolapse or heart murmur beyond a typical flow murmur.

Sponsors & Collaborators

• Massachusetts General Hospital: lead

Study Sites (1)

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

Related Publications (1)

• Eypper EH, Johnson PV, Purro EI, Hohmann EL. Transcutaneous immunization of healthy volunteers with an attenuated Listeria monocytogenes vaccine strain and cholera toxin adjuvant. Vaccine. 2013 Jul 11;31(32):3257-61. doi: 10.1016/j.vaccine.2013.05.028. Epub 2013 May 22.

  PMID: 23707162 DERIVED

Study Officials

• Elizabeth L Hohmann, MD

  Massachusetts General Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: March 8, 2011
• First Posted: March 10, 2011
• Study Start: January 1, 2011
• Primary Completion: July 1, 2012
• Study Completion: July 1, 2012
• Last Updated: October 2, 2015

Record last verified: 2015-09

Locations

US (1)