Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02398396
Other study ID # OVG 2014/12
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date April 2015
Est. completion date June 13, 2019

Study information

Verified date October 2018
Source University of Oxford
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study will be an open label, exploratory immunogenicity study conducted by the Oxford Vaccine Group, University of Oxford. This study will investigate the breadth of protective activity of serum anti-FHbp antibody responses of adults immunized with 4CMenB (Bexsero®) vaccine as well as investigating the nature of the B-cell and T-cell responses induced by vaccination. The investigators aim to enroll 15 to 20 healthy adults aged 18 to 60, who will be immunized with two doses of 4CMenB (Bexsero®) two months apart according to the licensed schedule. Blood samples will be obtained at baseline and after each dose of vaccine.


Description:

Neisseria meningitidis (N. meningitidis, meningococcus) is a leading cause of bacterial meningitis and septicaemia worldwide. The introduction of serotype specific glycoconjugate vaccines into the routine infant immunization schedule, in countries such as the United Kingdom, has led to dramatic reductions in the burden of disease. The development of effective vaccines against capsular group B N. meningitidis has long been an unmet need and has necessitated the development of novel approaches to vaccine design. In 2013, the first capsular group B meningococcal vaccine was licensed in the UK. The new vaccine (4CMenB, trade name Bexsero ®), is manufactured by Novartis Vaccines and contains four components - a recombinant Factor H binding protein (FHbp), Neisseria meningitidis capsular group B Neisseria Heparin Binding Antigen (NHBA) fusion protein, recombinant Neisseria meningitidis group B Neisserial adhesin A (NadA) protein and Outer membrane vesicles (OMV) from Neisseria meningitidis group B strain NZ98/254 containing PorA P1.4. This multicomponent vaccine is also referred to as the "four component meningococcal B" or "4CMenB" vaccine. Factor H binding protein is an important virulence factor expressed on the surface of N. meningitidis and is a key component of the 4CMenB vaccine. It has been established that the function of FHbp is to bind human complement factor H, whose physiological function in turn is to act as an important down-regulator of the host alternative complement pathway. Binding of human factor H to the bacterial surface via FHbp is thought to interfere with complement mediated lysis and is an important immune evasion strategy of N. meningitidis. Consequently, FHbp is a logical target for a protective vaccine against capsular group B N. meningitidis. There remain several gaps in our knowledge about the underlying mechanisms by which human antibodies to FHbp elicit complement mediated bactericidal activity. In humans immunised with vaccines containing FHbp, the antigen (FHbp) is expected to form a complex with human factor H. The precise epitopes targeted by anti-FHbp antibodies in vaccinees have not been fully elucidated. Conceivably, the formation of a FHbp-factor H complex following vaccination may prevent the exposure of key FHbp epitopes. Therefore, it is not known whether the interaction between FHbp and human Factor H affects the bactericidal activity of antibodies produced following vaccination with 4CMenB. This study will investigate the breadth of protective activity of serum anti-FHbp antibody responses of adults immunized with 4CMenB (Bexsero®) vaccine as well as investigating the nature of the B-cell and T-cell responses induced by vaccination. We aim to enroll 15 to 20 healthy adults aged 18 to 60, who will be immunized with two doses of 4CMenB (Bexsero®) two months apart according to the licensed schedule. Sera will be obtained at baseline and after each dose of vaccine, which will be assayed for IgG antibody responses to FHbp by ELISA, as well as for bactericidal activity against a panel of genetically diverse meningococcal strains and for the ability to inhibit binding of FH to FHbp. Other assays for meningococcal immunity may also be performed such as antibody binding to live bacteria measured by flow cytometry, and the ability of the serum antibodies to confer passive protection in an infant rat bacteraemia model. Laboratory analyses to quantify the B- and T-cell responses specific to the 4CMenB vaccine will be performed using peripheral blood mononuclear cells (PBMCs) derived from study participants sampled before, and after each dose. We will also explore whether the formation of the FH-FHbp complex results in the generation of cross-reactive antibodies directed against Factor H. This will be the first study in humans to explore in detail the anti-FHbp characteristics generated following immunization with 4CMenB (Bexsero®) and offers a unique opportunity to use a licensed vaccine to improve our understanding of how to induce efficient protective responses. It is hoped that the results obtained from this study will contribute to our understanding of the host response to vaccination against capsular group B N. meningitidis.


Recruitment information / eligibility

Status Completed
Enrollment 15
Est. completion date June 13, 2019
Est. primary completion date November 2015
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 18 Years to 60 Years
Eligibility Inclusion Criteria: - Participant is willing and able to give informed consent for participation in the study. - Male or Female, aged 18 years to 60 years inclusive on the day of first vaccination. - To be in good health as determined by medical history, physical examination and clinical judgment of the investigators. - Agree (in the Investigator's opinion) to comply with all study requirements - Agree to allow his or her General Practitioner (and/or Consultant if appropriate), to be notified of participation in the study - Agree to provide their National Insurance/Passport number for the purposes of TOPS registration and bank account information for the purpose of reimbursement for the duration of their participation. Exclusion Criteria: - Have any known or suspected impairment or alteration of immune function, resulting from, for example: - Congenital or acquired immunodeficiency (including IgA deficiency) - Human Immunodeficiency Virus (HIV) infection or symptoms/signs suggestive of an HIV-associated condition - Autoimmune disease - Receipt of immunosuppressive therapy such as anti-cancer chemotherapy or radiation therapy within the preceding 12 months or long-term systemic corticosteroid therapy. - Chronic illness that could interfere with immunological function or donation of the required volumes of blood (e.g. cardiac or renal disease, diabetes, or auto-immune disorders). - Receipt of a live vaccine within 4 weeks prior to vaccination or a killed vaccine within 7 days prior to vaccination. - History of group B meningococcal vaccination - Have received a dose of a meningococcal groups A, C, W, Y conjugate vaccine within 30 days of enrolment or wish to receive a dose of this vaccine during the study period. - Plan to receive any vaccine other than the study vaccine within 4 weeks following vaccination. - History of severe allergic reaction after vaccination or known hypersensitivity to any vaccine component - History of meningococcal disease - Receipt of blood, blood products, or plasma derivatives within the past 3 months. - Recent significant blood donation (e.g., to the National Blood Service) within 8 weeks of enrolment, or plans to donate blood during the study period. - Thrombocytopenia or any bleeding disorder. - Pregnancy as confirmed by a positive pregnancy test, or currently breastfeeding. - Enrolled in another study, which, in the opinion of the investigator, could compromise the integrity of either study being conducted. - A member of staff on the delegation log - According to the TOPS database, have recently taken part in a significant number of other studies, which, in the opinion of the investigator, warrant exclusion from further studies. - Have any condition, which, in the opinion of the investigator, might interfere with the evaluation of the study objectives.

Study Design


Related Conditions & MeSH terms


Intervention

Biological:
4CMenB (Bexsero®) - Novartis Vaccines and Diagnostics
4CMenB vaccine (Bexsero - Novartis Vaccines and Diagnostics) 0.5ml intra-muscularly; two doses, administered 2 months apart. Each dose of vaccine contains recombinant Neisseria meningitidis group B NHBA fusion protein (50 micrograms); recombinant Neisseria meningitidis group B NadA protein (50 micrograms); recombinant Neisseria meningitidis group B FHbp fusion protein (50 micrograms) and Outer membrane vesicles (OMV) from Neisseria meningitidis group B strain NZ98/254 (25 micrograms measured as amount of total protein containing the PorA P1.4)

Locations

Country Name City State
United Kingdom Centre for Clinical Vaccinology and Tropical Medicine (CCVTM) Oxford Oxfordshire

Sponsors (1)

Lead Sponsor Collaborator
University of Oxford

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Other Exploratory immunology to investigate the role of anti-FHBp antibodies in meningococcal immunity Exploratory assays including Factor H (FH) - FHbp binding inhibition assays, antibody binding to live bacteria measured by flow cytometry, passive transfer experiments using infant rat bacteraemia model. 3 months
Primary To characterise the breadth of protective activity of serum anti-FHbp antibody responses of adults immunised with 4CMenB (Bexsero) vaccine As measured by IgG antibody responses to FHbp as measured by serum bactericidal activity against a panel of genetically diverse meningococcal strains 3 months
Secondary To investigate the nature of the B-cell response that supports the induction of antibody with functional activity following vaccination with 4CMenB Quantification of circulating vaccine-induced memory B-cells specific for vaccine antigens before and after each, dose. 3 months
Secondary To investigate the nature of the T-cell response that supports the induction of antibody with functional activity following vaccination with 4CMenB Quantification of vaccine-induced, antigen specific T-cell responses and associated cytokine production before and after each dose. 3 months
Secondary Determine whether adults immunised with 4CMenB develop serum IgG and IgM antibodies to human FH Serum IgG and IgM antibodies to human FH will as measured by ELISA 3 months
See also
  Status Clinical Trial Phase
Completed NCT00774384 - Regulation of Mucosal Immune Response to Systemic MenB Vaccine Phase 2
Completed NCT00450632 - Creation of a Biotheque of Patients of Seine-Maritime With Meningococcal Infection N/A
Completed NCT00874549 - Exploratory Trial to Evaluate the Safety and Immunogenicity of Menactra® and Menomune® Vaccines in Subjects ≥ 56 Years Phase 1/Phase 2
Completed NCT00850603 - Safety and Immunogenicity of Intradermal Versus Subcutaneous Doses of Menomune® Phase 4
Completed NCT02591290 - Immunogenicity and Safety of Two-Dose Series of Menactra® in Japanese Healthy Adult Subjects Phase 4
Completed NCT03378258 - Petechiae In Children (PIC) Study: Defining A Clinical Decision Rule for The Management Of Fever and Non-Blanching Rashes In Children Including The Role Of Point Of Care Testing For Procalcitonin & Neisseria Meningitidis DNA.
Completed NCT01482052 - Safety Study of Group A, C, Y & W-135 Meningococcal Polysaccharide Diphtheria Toxoid Conjugate Vaccine for Meningitis Phase 1
Completed NCT01239043 - Antibody Persistence and Response to Re-vaccination With Either Menactra® or Menomune® 3 Years After Initial Vaccination Phase 2
Completed NCT01732627 - Study of a Quadrivalent Meningococcal Conjugate Vaccine in Subjects Aged 56 and Older Phase 2
Not yet recruiting NCT05212935 - A Surveillance Study on Timing and Coverage Of Rotavirus and MenB Vaccine Co-administration in Campania Region, Italy
Completed NCT00474487 - A Study to Evaluate Safety and Immune Response of Novartis Meningococcal ACWY Vaccine In Healthy Adults Phase 3
Completed NCT02041663 - Septic cArdiac Deficiency and MenIngococcal seveRe Sepsis N/A
Completed NCT03205358 - Immunogenicity and Safety of an Investigational Quadrivalent Meningococcal Conjugate Vaccine in Healthy Toddlers Phase 2
Completed NCT00616421 - Safety and Immune Response of Novartis of MenACWY Conjugate Vaccine When Given to Healthy Children Phase 3
Completed NCT00450437 - A Study to Evaluate Safety and Immune Response of Novartis Meningococcal ACWY Conjugate Vaccine In US Adolescents and Adults Phase 3
Completed NCT03798574 - The Long-term Impact of Invasive Meningococcal Disease in Australian Adolescents and Young Adults
Completed NCT02640404 - Safety of a Meningococcal (Groups A, C, Y and W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine in Healthy Subjects in Vietnam Phase 2
Recruiting NCT05981599 - Epidemiological, Clinical and Biological Caracteristics of Patients Presenting With Invasive Meningococcal Disease
Completed NCT02500511 - Persistence of Protective Antibody Titers 12-24 Months After NmVac4-A/C/Y/W-135-DT Vaccination: Follow Up Study N/A
Completed NCT02199691 - Immunogenicity and Safety of an Investigational Quadrivalent Meningococcal Conjugate Vaccine in Healthy Adolescents Phase 2

External Links