Influenza Clinical Trial
Official title:
Evaluation of Anti-Hemagglutinin Antibodies as a Correlate of Protection in an H1N1 Influenza Healthy Human Challenge Model
Background:
- Researchers want to know if a certain type of antibody in the blood affects whether people
get influenza (the flu). They will study 2 different groups with different levels of anti-HA
antibodies and expose them to the flu virus. They will study how the flu develops in a
healthy person. This may lead to future studies to develop new vaccines and treatments for
the flu.
Objective:
- To study how people can be protected from flu infection.
Eligibility:
- Healthy volunteers 18 to 50 years of age.
Design:
- Participants will be screened through the use of a medical history, physical exam, and
laboratory tests.
- Groups of 7 participants will stay in an isolation unit in a hospital for at least 9
days with no visitors.
- Participants will be screened again upon admission. They will also have:
- ECG: soft electrodes will be stuck to the skin. A machine will record the heart s
electrical signals.
- Echocardiogram: a small probe will be held to the chest to take pictures of the heart.
- Lung tests: participants will blow into a machine.
- They will also have nasal fluid collected. This will be done either with a swab or with
a tube of water washing out the nose. This will be done once every day.
- The flu virus will be sprayed into the participant s nose. This will be done only once.
- Participants will complete a questionnaire on day 1 and twice a day after that for 14
days.
- A medical team will watch participants 24 hours a day. They will go home after 2 days
of negative flu tests.
- Participants will have 4 follow-up visits over 8 weeks.
The high morbidity and mortality associated with both pandemic and seasonal influenza, and
the threat of new pandemic strains emerging, continues to keep influenza at the forefront of
infectious disease and public health research. Mean annual estimates of influenza deaths due
to seasonal influenza alone, attributes 36,000 deaths in the US and 250,000 to 500,000
deaths in industrialized countries to influenza. Pandemics can have an even more devastating
effect, and we must continue to be prepared by making attempts to reduce the public health
impact of this important virus.
Currently, influenza vaccination is the cornerstone of prophylaxis and most effective method
available to reduce the impact of influenza on the world s population each year. Data from
the 2013 influenza season suggest that current seasonal vaccines held to these standards are
greatly underperforming especially in those that really need protection such as the elderly,
young, and infirmed.
Multiple factors could play a role in defining the true correlates of protection to
influenza infection and disease and many of these factors are yet to be clearly defined. In
our own influenza challenge study, protocol 12-I-0077, we have clearly seen evidence that
not everyone with a low HAI titer is susceptible to influenza, and that there must be other
factors protecting certain individuals. There are many examples like this that demonstrate
that there may be much more to immune protection to influenza than just anti-HA antibodies.
Live virus challenge studies have played an important role in defining the correlates of
protection of influenza in the past, and we believe they can continue to do so in the
future. Since the last time a wild-type influenza challenge has been performed to
investigate correlates of protection over 20 years ago, many new scientific tools and a
significant increase in knowledge of the immune system have developed. In this study we will
enroll participants at different hemagglutinin inhibition titer levels and evaluate this as
a correlate of protection to the 2009 H1N1 while exploring the other possible correlates of
protection that may be identified. This study represents the first opportunity to examine
the correlates of protection of influenza in a fully validated and described wild-type virus
challenge model. We believe that studies like this are an ideal use of a wild-type influenza
challenge study and can lead to intelligent universal vaccine design as well as a basis to
begin evaluating novel vaccine strategies in wild-type challenge studies in the future.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Basic Science
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