Influenza, Avian Clinical Trial
Official title:
A Randomised, Controlled, Phase 1 Study in Healthy Adults to Evaluate the Immunogenicity and Safety of a Recombinant H7 Hemagglutinin Influenza Vaccine
Recombinant H7 (rH7) vaccine has been shown to be poorly immunogenic in previous human clinical trials. This study will test approaches to improve the immunogenicity of H7 vaccine, namely use of a three dose regimen, use of a modified H7 HA sequence from which the Tregitope has been removed (rH7m), and inclusion of delta inulin adjuvant adjuvant in the vaccine
Because antibody responses to experimental H7 vaccine have been low even with high antigen
doses, there is a need to find ways to enhance the effectiveness of H7 vaccines. Protein
Sciences Corporation (PSC) produces an FDA approved seasonal recombinant trivalent influenza
vaccine consisting of influenza hemagglutinin proteins (HA) which are full length uncleaved
glycoproteins (rHA0) produced using baculovirus expression vectors in cultured insect cells
grown in serum-free media (FluBlok®). The mechanism of action of FluBlok is the same as that
of traditional inactivated seasonal influenza vaccines.
PanBlok H7 is a pandemic influenza vaccine produced by PSC in the same way as Flublok but it
is directed against H7 rather than seasonal influenza virus strains. The vaccine candidate
consists of a full-length recombinant monovalent hemagglutinin (rHA) derived from H7N9 virus,
in a sterile solution for intramuscular injection. PanBlok H7 rHA is manufactured using the
same production process as previously used for Panblok H1/2009pdm ("swine flu") and Panblok
H5 pandemic vaccines, both of which vaccines have been previously successfully trialled by us
in clinical protocols, FLU005 and FLU003. In both these trials the Panblok antigen was
combined with Advax adjuvant formulations. In the FLU005 trial of Panblok H1N1/2009pdm
vaccine, the inclusion of Advax adjuvant doubled the seroconversion rate of the vaccine and
provided major antigen-sparing effects (Gordon et al, 2012). Whilst the FLU003 trial is
ongoing, preliminary data again shows the importance of the Advax adjuvants to vaccine
effectiveness. This provides a strong rationale for inclusion of Advax adjuvants in the
Panblok H7 vaccine.
It has also been recently recognised that at least one of the reasons for the low
immunogenicity of H7 vaccines in human trials to date is that the H7 antigen from this virus
contains a T-cell regulatory epitope (Tregitope) in the HA stem region which suppresses the
immune response to the vaccine. It was recently demonstrated in humanised animal studies
undertaken by collaborators in Japan that removing this Tregitope by modifying 3 amino acids
in the H7 stem was able to significantly increase the ability of the H7 vaccine to induce
antibody production by human immune cells. This trial will provide the first opportunity to
confirm this approach is able to enhance the immunogenicity of H7 in humans, which if
confirmed would represent a major breakthough in pandemic influenza vaccine design.
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