Safety and Immunogenicity Study of Plasmodium Vivax CS Derived Synthetic Peptides Formulated in Two Adjuvants (Fase1B)

This study has been completed.
Sponsor:
Collaborators:
Centro médico Imbanaco
Asoclinic Laboratorio de Inmunología
Information provided by:
Malaria Vaccine and Drug Development Center
ClinicalTrials.gov Identifier:
NCT01081847
First received: March 3, 2010
Last updated: March 5, 2010
Last verified: March 2010
  Purpose

This was a phase I double blind controlled vaccine trial, evaluating safety, tolerability and immunogenicity of mixtures of N, R and C LSP derived from the P. vivax CS protein formulated in two adjuvants Montanide ISA 720 and Montanide ISA 51.

The primary objective was to assess in malaria-naïve adults, the safety and reactogenicity of these peptides formulated in the two adjuvants

We recruited 40 healthy men and women volunteers from Cali, Colombia, a city non-endemic for malaria. Volunteers were 19--41 years of age and had no history of malaria. During a period of three months a total of 100 volunteers were assessed for eligibility criteria in order to select a total of 40 volunteers willing to participate in the clinical trial. By consecutive allocation, eight participants were allocated to each of the five experimental groups (A--E): four groups (A--D) were immunized with the vaccine formulations at two different dose concentrations and formulated in two different adjuvants. A control group (E) was injected with placebo (saline solution)


Condition Intervention Phase
Malaria, Vivax
Drug: Peptides (N,R&C) formulated in Montanide ISA 720
Drug: Peptides (N,R&C) formulated in Montanide ISA 51
Other: Placebo
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Official Title: Malaria Vaccine Phase IB Clinical Trial: Safety and Immunogenicity Study of Plasmodium Vivax CS Derived Synthetic Peptides Formulated in Two Adjuvants

Resource links provided by NLM:


Further study details as provided by Malaria Vaccine and Drug Development Center:

Primary Outcome Measures:
  • Safety and Immunogenicity of Plasmodium vivax CS Derived Long Synthetic Peptides Adjuvanted with Montanide ISA 720 or Montanide ISA 51 [ Time Frame: 9 months ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Immunogenicity assessment [ Time Frame: 9 month ] [ Designated as safety issue: Yes ]
    Specific anti CS antibodies determination (B cell response) and specific induction of IFNγ production (T cell response). All sera samples will be kept at -70° in Immunology Institute, FCVL or Asoclinic until use.

  • Adverse Events [ Time Frame: 9 month ] [ Designated as safety issue: Yes ]
    Each AE will be written on CRF forms and will be immediately be informed to the clinical monitor and IRB. All volunteers will be followed until recovering it the initial condition. Additional physical examination and laboratory tests will be performed in case any relation between the AE and the immunogen needs to be established.

  • Safety Laboratories [ Time Frame: 8 month ] [ Designated as safety issue: Yes ]
    Complete blood cell count, hepatic and renal function tests will be made on months 1, 2, 3, 6, 7 y 9 after the first immunization. Every change in the laboratory results will be reported on the corresponding CRF´s; severity associated with vaccination will be established. Specific studies will be made if it is necessary the AE end will be determined when these parameters will be normal.

  • B-cell response [ Time Frame: 8 month ] [ Designated as safety issue: Yes ]
    Specific antibody titers will be measured by ELISA technique using the corresponding peptide (N, R, C) as coating antigen and the recognition of the native protein will be assessed by Immunofluorescence technique (IFAT) using P vivax sporozoites obtained by dissection of experimentally infected Anopheles mosquitoes [91] Antibody titers will be considered as positive at 1:100 dilution by ELISA and 1:40 by IFAT.

  • T-cell response evaluation [ Time Frame: 8 month ] [ Designated as safety issue: Yes ]
    Cell mediated immune (CMI) responses will be evaluated will be made by the cytokines IFN-γ production using peripheral blood mononuclear cells (PBMC) using both ELIspot and ELISA techniques.

  • Cytokine Production Evaluation by ELISA [ Time Frame: 8 month ] [ Designated as safety issue: Yes ]
    PBMC will be stimulated with each of the three peptides (N, R or C) in a concentration of 10ug/ml and cells cultures without the peptide will be used as negative control. PBMC stimulated with phyto-hemaglutinin (PHA) will be used as positive controls.

  • Cytokine Production by ELIspot [ Time Frame: 8 month ] [ Designated as safety issue: Yes ]
    This evaluation will be made in two phases: First the cytokine production in total PBMC, which will be stimulated with CS protein derived peptides of different length. Second, positive samples for cytokine will be used to evaluate the production of cytokines by purified T lymphocytes subpopulations CD4+ or CD8+. This will determine the subpopulation responsible for cytokine production. A positive selection of cell subpopulations will be performed using anti-CD4+ / CD8+ coated pearls using MACS, and will be further used for ELIspot.


Enrollment: 40
Study Start Date: July 2005
Study Completion Date: April 2006
Primary Completion Date: March 2006 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Group A
Montanide ISA 720 Dose by peptide 50ug
Drug: Peptides (N,R&C) formulated in Montanide ISA 720
50 ug
Other Name: Peptides (N, R & C) from P. vivax CS protein
Active Comparator: Group B
Montanide ISA 51 Dose by peptide 50ug
Drug: Peptides (N,R&C) formulated in Montanide ISA 51
50 ug
Other Name: Peptides (N, R & C) from P. vivax CS protein.
Active Comparator: Group C
Montanide ISA 720 Dose by peptide 100ug
Drug: Peptides (N,R&C) formulated in Montanide ISA 720
100 ug
Other Name: Peptides (N, R & C) from P. vivax CS protein.
Active Comparator: Group D
Montanide ISA 51 Dose by peptide 100ug
Drug: Peptides (N,R&C) formulated in Montanide ISA 51
100 ug
Other Name: Peptides (N, R & C) from P. vivax CS protein
Placebo Comparator: Group E
Control Group. no peptide. Isotonic saline solution
Other: Placebo
PLacebo: Isotonic saline solution
Other Name: Placebo

Detailed Description:

The study corresponds to a clinical trial, randomized double-blind, controlled, dose escalation, Phase IB, which will assess the safety and immunogenicity of a mixture of synthetic peptides derived from CS protein of P. vivax, formulated in adjuvant Montanide ISA 720 and 51; in healthy men and nonpregnant women without previous history of malaria infection.

In order to optimize the vaccine dose, eligible participants were enrolled to receive three doses of vaccine containing peptide mixtures at a dose of 50 ug or 100 ug of each individual peptide, for a final dose of 150 ug or 300 ug respectively, in a volume of 0.5 mL. The previous clinical trial had indicated that doses between 30 ug and 100 ug produced better responses than lower doses. The first immunization dose (given at Month 0) contained the peptides N and C only, whereas the two boosting doses (given at Months 2 and 4) contained all three (N, R, and C) peptides (Table 1). Vaccination was performed by intramuscular injection in the deltoid muscle, alternating arms with each injection.

For safety reasons, participants assigned to the low vaccine dose groups were immunized first and only two weeks after initiation when no serious adverse events (SAE) had occurred, immunization of participants in the high-dose was started. Half of the participants assigned to receive placebo were immunized along with each dose level group. Clinical monitors and the IRBs of the University of Valle and IMC, evaluated the occurrence and severity of adverse events (AE) associated with immunization. The occurrence of more than three AE (severity grade 2 or higher) or one SAE related to the vaccine would have led to study termination. Participants who left the study were not replaced.

  Eligibility

Ages Eligible for Study:   18 Years to 45 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Healthy adults (male and non-pregnant female) 18- 45 years old, without previously malaria infection (naïve volunteers), capable to pass a comprehension test on the study and able to provide written informed consent to participate in the trial.
  • Use of adequate contraceptive method since the initiation of the study and until two months after the end of the study.
  • No plans to travel to a malaria endemic area during the course of the study.
  • Reachable by phone during the study period (1 year).
  • No use of other vaccines since 3 months before the beginning of the study and during it.

Exclusion Criteria:

  • Females who intend to become pregnant within the 3 months following the screening visit or who are pregnant at screening time, ascertained by urine or serum pregnancy test (B-HCG). Women who are breast-feeding will also be excluded. Reason for exclusion: The immunological changes accompanying pregnancy and lactation could alter the results of the assays performed. If a pathological condition appear, it could be carried to the vaccine.
  • Duffy negative phenotype. Justification: Individuals with this phenotype are refractory to P. vivax infection.
  • G-6-PD deficiency or any genetic defect (hemoglobinopathy). Justification: These conditions influence the development of P. vivax infection.
  • History of previous experimental malaria vaccination. Justification: Individuals who have been previously immunized may show a response due to the past immunization and not to the present one.
  • Clinical or laboratory evidence of significant systemic disease, including hepatic, renal, cardiac, immunologic or hematological disease.

Justification: The results of the study could have a negative impact on the study if volunteers are suffering from any of these diseases.

  • Evidence of active hepatitis B or C or HIV infection. Justification: Serious underlying medical condition could affect the immunological responses of volunteers or could increase the risk or severity of adverse events associated with participation in this study.
  • Clinically significant laboratory abnormalities as determined by the investigator(s).

Justification: Baseline abnormal laboratory values may indicate a serious underlying medical condition and also will make it difficult to evaluate AE´s during the conduct of the study.

• Known history of autoimmune (including inflammatory bowel disease, rheumatoid arthritis, lupus) or connective tissue disease.

Justification: Autoimmune diseases could affect the immunological responses of volunteers and could increase the risk to the volunteer.

• Individuals receiving treatment with steroids or non-steroidal anti-inflammatory drugs or any immunosuppressive therapy.

Justification: These drugs could affect the immunological responses of volunteers and could increase the risk to the volunteer.

  • Known history of drug or alcohol abuse interfering with normal social function. Justification: Pharmaco-dependency alters the capacity of free decision and produce physical or psychiatric undesirable condition that could affect the study.
  • Volunteers unable to give written informed consent or with difficulties to understand the study.

Justification: Volunteers must have the capacity to provide informed consent in order to participate in any research involving humans

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01081847

Locations
Colombia
Malaria Vaccine and Drug Testing Center
Cali, Valle, Colombia
Malaria Vaccine of Develepmente Center
Cali, Valle, Colombia
Sponsors and Collaborators
Malaria Vaccine and Drug Development Center
Centro médico Imbanaco
Asoclinic Laboratorio de Inmunología
Investigators
Study Director: Myriam Arevalo-Herrera, PhD MVDC
  More Information

Additional Information:
Publications:

Responsible Party: Myriam Arévalo,PhD, Malaria Vaccine and Drug Development Center
ClinicalTrials.gov Identifier: NCT01081847     History of Changes
Other Study ID Numbers: MVDC 2003-002, MVDC 2003-002
Study First Received: March 3, 2010
Last Updated: March 5, 2010
Health Authority: Colombia: INVIMA Instituto Nacional de Vigilancia de Medicamentos y Alimentos

Keywords provided by Malaria Vaccine and Drug Development Center:
Malaria
Synthetic peptides
Plasmodium vivax
Human volunteers

Additional relevant MeSH terms:
Malaria
Malaria, Vivax
Parasitic Diseases
Protozoan Infections
Freund's Adjuvant
Mannitol
Adjuvants, Immunologic
Cardiovascular Agents
Diuretics
Diuretics, Osmotic
Immunologic Factors
Natriuretic Agents
Pharmacologic Actions
Physiological Effects of Drugs
Therapeutic Uses

ClinicalTrials.gov processed this record on October 20, 2014