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There is a pressing need for a better experimental system to understand flavivirus antibody responses, beyond dengue, to make sure the investigators are using current vaccines to greatest effect and to inform the development of next-generation vaccines. This study will use live chimeric JE vaccine IMOJEV® as a tool for flavivirus epitope discovery. This will allow experimental JEV infection using replication competent, live, attenuated virus as a model, in a setting where the flavivirus infection history of humans can be tightly controlled.
This study will test the hypothesis that in previously flavivirus-exposed individuals, the antibody response is more broadly cross neutralising, and that this will lead to the identification of conserved virion surface epitopes that could be the target of second generation vaccines.
Exploratory Primary Objectives/Specific aims:
Exploratory Secondary Objectives:
Experimentally the fine specificity and cross-reactivity of the antibody response will be studied by cloning antibodies from plasmablasts (B cells responding to the vaccine) that have been single cell sorted by flow cytometry then sequenced at one week post vaccine. These human monoclonal antibodies will then be mapped on to the surface of the virus particle using established approaches, and tested to look for cross-reactive antibodies. T cell responses to the vaccine will be studied using custom pools of synthetic peptides by ELISpot and flow cytometry.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 - Any status | Other | Up to 3-4 healthy adults |
|
| Group 2 - FlaviPrime Naive | Other | Up to 6-8 healthy adults who have never travelled to a flavivirus endemic area and are negative in screening tests for flavivirus immunity. |
|
| Group 3 - Flavivirus Exposed | Other | Up to 8-10 healthy adults who have had JE vaccine and/or are previously flavivirus exposed, either through receiving yellow fever vaccine up to 5 years before the study, or from being diagnosed with a flavivirus illness (e.g. dengue or Zika). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| IMOJEV | Biological | live attenuated Japanese encephalitis (JE) vaccine IMOJEV® |
|
| Measure | Description | Time Frame |
|---|---|---|
| Primary: Plasmablast Percentage of Total B Cells at 7 Days Post Vaccine | Plasmablast percentage of total B cells at 7 days post vaccine Number of plasmablasts sorted by flow cytometry at 7 days post vaccine | 1 week |
| Primary: Neutralisation Titre, Measured by 50% of Viral Plaque Reduction at One and Two Months Post Vaccine | Neutralising antibody titre, measured by 50% of viral plaque reduction at one and two months post vaccine | two months |
| Measure | Description | Time Frame |
|---|---|---|
| Secondary: Number of Adverse Events Occurring in All Participants in One Month Post Vaccine | Number of adverse events occurring in all participants in one month post vaccine | one month |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lance Turtle, Dr | University of Liverpool | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Liverpool University Hospitals NHS Foundation Trust | Liverpool | L7 8XP | United Kingdom |
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There was difficult in recruiting naïve participants. Therefore the target was changed to 4-8. The total number of participants was not fixed, there was flexibility across the groups, up to a total of 22 participants. The protocol allowed participant replacement if the week 1 blood sample was not collected. This happened to one participant in group 3 who had already received the vaccine, then discontinued. therefore the total number enrolled in this group was 11.
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| ID | Title | Description |
|---|---|---|
| FG000 | Group 1 - Any Status | Up to 3-4 healthy adults. Participants will be replaced if they withdraw before the one week protocol blood sample. IMOJEV: live attenuated Japanese encephalitis (JE) vaccine IMOJEV® |
| FG001 | Group 2 - FlaviPrime Naive | Up to 4-8 healthy adults who have never travelled to a flavivirus endemic area and are negative in screening tests for flavivirus immunity. Participants will be replaced if they withdraw before the one week protocol blood sample. IMOJEV: live attenuated Japanese encephalitis (JE) vaccine IMOJEV® |
| FG002 | Group 3 - Flavivirus Exposed | Up to 8-10 healthy adults who have had JE vaccine and/or are previously flavivirus exposed, either through receiving yellow fever vaccine up to 5 years before the study, or from being diagnosed with a flavivirus illness (e.g. dengue or Zika). Participants will be replaced if they withdraw before the one week protocol blood sample.. IMOJEV: live attenuated Japanese encephalitis (JE) vaccine IMOJEV® |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Group 1 - Any Status | Up to 3-4 healthy adults IMOJEV: live attenuated Japanese encephalitis (JE) vaccine IMOJEV® |
| BG001 | Group 2 - FlaviPrime Naive | Up to 6-8 healthy adults who have never travelled to a flavivirus endemic area and are negative in screening tests for flavivirus immunity. IMOJEV: live attenuated Japanese encephalitis (JE) vaccine IMOJEV® |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Primary: Plasmablast Percentage of Total B Cells at 7 Days Post Vaccine | Plasmablast percentage of total B cells at 7 days post vaccine Number of plasmablasts sorted by flow cytometry at 7 days post vaccine | Percentage of total B cells that are plasmablasts. | Posted | Median | Full Range | percent plasmablasts of B cells | 1 week |
|
one month post vaccination
Number of adverse events
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Group 1 - Any Status | Up to 3-4 healthy adults IMOJEV: live attenuated Japanese encephalitis (JE) vaccine IMOJEV® |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Rhinorrhoea | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr Lance Turtle | University of Liverpool | 01517957554 | lance.turtle@liverpool.ac.uk |
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jul 8, 2021 | May 10, 2023 | Prot_000.pdf |
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| ID | Term |
|---|---|
| D004672 | Encephalitis, Japanese |
| ID | Term |
|---|---|
| D004671 | Encephalitis, Arbovirus |
| D018792 | Encephalitis, Viral |
| D020805 | Central Nervous System Viral Diseases |
| D002494 | Central Nervous System Infections |
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| BG002 | Group 3 - Flavivirus Exposed | Up to 8-10 healthy adults who have had JE vaccine and/or are previously flavivirus exposed, either through receiving yellow fever vaccine up to 5 years before the study, or from being diagnosed with a flavivirus illness (e.g. dengue or Zika). IMOJEV: live attenuated Japanese encephalitis (JE) vaccine IMOJEV® |
| BG003 | Total | Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG002 | Group 3 - Flavivirus Exposed | Up to 8-10 healthy adults who have had JE vaccine and/or are previously flavivirus exposed, either through receiving yellow fever vaccine up to 5 years before the study, or from being diagnosed with a flavivirus illness (e.g. dengue or Zika). IMOJEV: live attenuated Japanese encephalitis (JE) vaccine IMOJEV® |
|
|
| Primary | Primary: Neutralisation Titre, Measured by 50% of Viral Plaque Reduction at One and Two Months Post Vaccine | Neutralising antibody titre, measured by 50% of viral plaque reduction at one and two months post vaccine | geometric mean +/- 95% confidence interval | Posted | Geometric Mean | 95% Confidence Interval | 50% neutralisation titre | two months |
|
|
|
| Secondary | Secondary: Number of Adverse Events Occurring in All Participants in One Month Post Vaccine | Number of adverse events occurring in all participants in one month post vaccine | Posted | Number | Number of adverse events | one month |
|
|
|
| 0 |
| 4 |
| 0 |
| 4 |
| 1 |
| 4 |
| EG001 | Group 2 - FlaviPrime Naive | Up to 4-8 healthy adults who have never travelled to a flavivirus endemic area and are negative in screening tests for flavivirus immunity. IMOJEV: live attenuated Japanese encephalitis (JE) vaccine IMOJEV® | 0 | 4 | 0 | 4 | 0 | 4 |
| EG002 | Group 3 - Flavivirus Exposed | Up to 8-10 healthy adults who have had JE vaccine and/or are previously flavivirus exposed, either through receiving yellow fever vaccine up to 5 years before the study, or from being diagnosed with a flavivirus illness (e.g. dengue or Zika). IMOJEV: live attenuated Japanese encephalitis (JE) vaccine IMOJEV® | 0 | 11 | 0 | 11 | 6 | 11 |
| Cough | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
| Neutropenia | Blood and lymphatic system disorders | Non-systematic Assessment |
|
| Diarrhoea | Gastrointestinal disorders | Non-systematic Assessment |
|
| Tooth Infection | Infections and infestations | Non-systematic Assessment |
|
| Parasthesia | Nervous system disorders | Non-systematic Assessment |
|
| Pulled Right Hamstring | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
|
| Right Leg Superficial Thrombophlebitis | Vascular disorders | Non-systematic Assessment |
|
| Malaise | General disorders | Non-systematic Assessment |
|
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| D007239 | Infections |
| D000069544 | Infectious Encephalitis |
| D001102 | Arbovirus Infections |
| D000079426 | Vector Borne Diseases |
| D000096724 | Mosquito-Borne Diseases |
| D014777 | Virus Diseases |
| D012327 | RNA Virus Infections |
| D018177 | Flavivirus Infections |
| D018178 | Flaviviridae Infections |
| D004660 | Encephalitis |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D000090862 | Neuroinflammatory Diseases |
| Antibody titre at 8 weeks post vaccine |
|