Transcutaneous Immunization With an Attenuated Listeria Monocytogenes Vector Vaccine

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Elizabeth L. Hohmann, MD, Massachusetts General Hospital
ClinicalTrials.gov Identifier:
NCT01311817
First received: March 8, 2011
Last updated: August 23, 2012
Last verified: August 2012
  Purpose

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.


Condition Intervention Phase
Immunological Stimulation
Attenuated Vaccine
Biological: BMB72 (actA/plcB-deleted Listeria monocytogenes expressing influenza A nucleoprotein)
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Factorial Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Prevention
Official Title: Transcutaneous Immunization With actA/plcB-Deleted Listeria Monocytogenes Expressing Influenza A Nucleoprotein (BMB72) and Cholera Toxin Adjuvant

Resource links provided by NLM:


Further study details as provided by Massachusetts General Hospital:

Primary Outcome Measures:
  • Vaccine Safety [ Time Frame: 1 year +/- ] [ Designated as safety issue: Yes ]
    Safety is measured primarily by clinical findings (VS, cutaneous exams, and systemic reactions

  • Immunogenicity [ Time Frame: 1 year +/- ] [ Designated as safety issue: No ]
    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.


Enrollment: 8
Study Start Date: January 2011
Study Completion Date: July 2012
Primary Completion Date: July 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: Saline Patch
1mL saline applied to the vaccine patch
Experimental: Bacteria plus CT
0.95mL bacterial vector plus 0.05mL cholera toxin
Biological: BMB72 (actA/plcB-deleted Listeria monocytogenes expressing influenza A nucleoprotein)
1mL liquid contained in an adhesive skin patch
Other Name: Lot ELH072910

  Eligibility

Ages Eligible for Study:   18 Years to 55 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • 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.

Exclusion Criteria:

  • 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.
  • Chronic pain syndromes like headaches or back pain requiring use (more than once per week) of over-the-counter medications like Tylenol or NSAIDs.
  • Elevated iron stores, evidence of chronic hemolysis such as abnormal blood smear, elevated transferrin or transferrin saturation >50% (Iron overload predisposes to listeriosis and asymptomatic elevated iron level may indicate early iron overload state, i.e. hemochromatosis).
  • Any evidence of immunosuppressive illness (e.g. HIV or malignancy) or seropositive for HIV or hepatitis B (sAg positive) or C, or history of frequent infections especially sino-pulmonary, skin or soft tissue or GI infections. Hepatitis B serologies consistent with vaccination or resolved prior infection (surface antibody positive and surface antigen negative) is not a reason for exclusion.
  • Subjects who live with immunosuppressed individuals, children under 4 years of age, or people with chronic skin disorders in the household are excluded.
  • Alcohol or substance abuse (immunosuppressive affects of alcohol and altered immune responses) by history. Occasional recreational use of marijuana, or social alcohol use are not exclusion criteria. Drug testing is not performed.
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01311817

Locations
United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
Sponsors and Collaborators
Massachusetts General Hospital
Investigators
Principal Investigator: Elizabeth L Hohmann, MD Massachusetts General Hospital
  More Information

No publications provided by Massachusetts General Hospital

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Elizabeth L. Hohmann, MD, Associate Professor, Massachusetts General Hospital
ClinicalTrials.gov Identifier: NCT01311817     History of Changes
Other Study ID Numbers: 2008P-0002296
Study First Received: March 8, 2011
Last Updated: August 23, 2012
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Cholera Toxin
Adjuvants, Immunologic
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions

ClinicalTrials.gov processed this record on August 28, 2014