Healthy Clinical Trial
Official title:
A Phase I Clinical Trial Immunizing Healthy Adults With the NMRC-M3V-Ad-PfCA Vaccine to Generate Biologic Reagents for Refining Immunologic Assays Supporting the Development of the Protective Malaria Vaccine NMRC-M3V-D/Ad-PfCA (AdBa)
This is an open label Phase 1 study of the Ad-PfCA vaccine designed to 1) provide reagents for the development and refinement of cell-mediated immunoassays for measuring the human immune response to candidate malaria vaccines (especially protective malaria vaccines such as DNA/Ad-PfCA where better assays are needed to identify the correlates of protective immunity) and 2) to provide a repository of antigen-specific PBMCs that can be used as positive and negative controls in cell mediated immunoassays.
This is an open label Phase 1 study of the Ad-PfCA vaccine designed to 1) provide reagents
for the development and refinement of cell-mediated immunoassays for measuring the human
immune response to candidate malaria vaccines (especially protective malaria vaccines such
as DNA/Ad-PfCA where better assays are needed to identify the correlates of protective
immunity) and 2) to provide a repository of antigen-specific PBMCs that can be used as
positive and negative controls in cell mediated immunoassays. The study group will consist
of up to 35 healthy adults aged 18 to 50 years who have been screened to meet inclusion and
exclusion criteria.
Subjects will be eligible for participation regardless of baseline adenovirus 5 serostatus.
At least 6 subjects will be "malaria naïve", meaning that 1) they have not been the
recipient of a malaria vaccine, 2) they have no history of malaria infection or travel to a
malaria endemic region within 6 months of first leukapheresis procedure or 60mL blood draw,
3) they have no history of long-term residence (>5 years) in an area known to have
significant transmission of P. falciparum, and 4) they have a negative P. falciparum
circumsporozoite (PfCSP) ELISpot assay at baseline. (From herein, for simplicity, we refer
to PfCSP simply as CSP). The remaining subjects will have no restrictions regarding receipt
of malaria vaccines, travel history or baseline CSP ELISpot results. Although it is more
difficult to recruit "malaria-naïve" subjects, the inclusion of at least 6 such subjects
should provide a more varied array of immune responses; this may be helpful for assay
development.
Eligible subjects will receive a single administration of the Ad-PfCA malaria candidate
vaccine at a dose of 2 x 1010 pu by intramuscular injection. Approximately 1 month
pre-immunization, study subjects will either have a large number of PBMCs collected by means
of leukapheresis, or a simple 60 mL blood draw, dependent upon initial pre-screening.
Pre-immunization samples designated for the repository do not require large volume sampling
of PBMCs. Rather, a 60 mL whole blood draw is sufficient for repository purposes. Thus,
subjects will be separated into sub-groups, dependent upon initial pre-screening. Subjects
whose samples are designated for the repository will undergo a simple, 60 mL blood draw in
lieu of leukapheresis #1 (sub-group A). Samples assigned for assay development will be
obtained from sub-group B.
Approximately 1 month post-immunization, study subjects in both sub-groups will have PBMCs
collected by means of leukapheresis. Consultation with immunology experts after
post-immunization screening will assist to identify those subjects whose samples do not meet
assay development or repository needs. In an effort to eliminate unnecessary procedures for
subjects, these individuals will not undergo a second leukapheresis, but will return for
their safety visit on day 84.
Prior to each leukapheresis/60 mL blood draw, a sample will be tested by CSP-ELISpot and
AMA1 ELISpot; the results will be used to categorize samples (see below). Follow up visits
will occur 2, 7, 14, 21, and 84 days following immunization. Depending on guidance from the
FDA, subjects will then be followed annually by phone, email, or mailings up to five years
from the time of immunization per FDA recommendation.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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