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Keitel WA, Potter GE, Diemert D, Bethony J, El Sahly HM, Kennedy JK, Patel SM, Plieskatt JL, Jones W, Deye G, Bottazzi ME, Hotez PJ, Atmar RL. A phase 1 study of the safety, reactogenicity, and immunogenicity of a Schistosoma mansoni vaccine with or without glucopyranosyl lipid A aqueous formulation (GLA-AF) in healthy adults from a non-endemic area. Vaccine 2019; 37:6500-6509. [PMID: 31515141 DOI: 10.1016/j.vaccine.2019.08.075] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 08/27/2019] [Accepted: 08/28/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Schistosomiasis caused by Schistosoma mansoni (Sm) is a chronic, debilitating and potentially deadly neglected tropical disease. The licensure of a vaccine to prevent schistosomiasis would represent a major breakthrough in public health. METHODS The safety and immunogenicity of a candidate Sm vaccine were assessed in this phase I, double-blind, dose-escalation trial. Seventy-two healthy Sm-naïve 18-50 year olds were randomized to receive 3 doses ∼ 8 weeks apart of saline placebo, or 10 µg, 30 µg, or 100 µg of recombinant Sm-Tetraspanin-2 vaccine formulated on aluminum hydroxide adjuvant (Sm-TSP-2/Al) with or without 5 µg of glucopyranosyl lipid A aqueous formulation (GLA-AF). Clinical and serologic responses were assessed for 1 year after dose 3. RESULTS Vaccines were safe and well-tolerated. The most common reactions were injection site tenderness and pain, and headache and fatigue. Tenderness and pain were more frequent in groups receiving vaccine with GLA-AF than placebo (p = 0.0036 and p = 0.0014, respectively). Injection site reactions among those given Sm-TSP-2/Al with GLA-AF lasted 1.22 and 1.33 days longer than those receiving Sm-TSP-2/Al without GLA-AF or placebo (p < 0.001 for both). Dose- and adjuvant-related increases in serum IgG against Sm-TSP-2 were observed. Peak IgG levels occurred 14 days after dose 3. Seroresponse frequencies were low among recipients of Sm-TSP-2/Al without GLA-AF, but higher among subjects receiving 30 µg or 100 µg of Sm-TSP-2/Al with GLA-AF. More seroresponses were observed among those given 30 µg or 100 µg of Sm-TSP-2/Al with GLA-AF compared to placebo (p = 0.023 and p < 0.001, respectively). Seroresponse frequencies were 0%, 30%, 50%, and 89%, respectively, among those given placebo, or 10 µg, 30 µg or 100 µg of Sm-TSP-2/Al with GLA-AF, suggesting a dose-response relationship for Sm-TSP-2/Al with GLA-AF (p = 0.0001). CONCLUSIONS Sm-TSP-2/Al with or without GLA-AF was safe and well tolerated in a Sm-naïve population. A vaccine like the one under development may represent our best hope to eliminating this neglected tropical disease.
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Affiliation(s)
- W A Keitel
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States.
| | | | - D Diemert
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University, Washington, DC, United States
| | - J Bethony
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University, Washington, DC, United States
| | - H M El Sahly
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States
| | | | - S M Patel
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States
| | - J L Plieskatt
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University, Washington, DC, United States
| | - W Jones
- Division of Microbiology and Infectious Diseases (DMID), National Institutes of Allergy and Infectious. Diseases (NIAID), National Institutes of Health (NIH), United States
| | - G Deye
- Division of Microbiology and Infectious Diseases (DMID), National Institutes of Allergy and Infectious. Diseases (NIAID), National Institutes of Health (NIH), United States
| | - M E Bottazzi
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States; Texas Children's Hospital Center for Vaccine Development, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - P J Hotez
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States; Texas Children's Hospital Center for Vaccine Development, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - R L Atmar
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States
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