LMN-101 in a Campylobacter Human Challenge Model
Palavras-chave
Resumo
Descrição
Healthy subjects will be randomized within one of the following sequential dose cohorts:
- LMN-101, six 500-mg capsules orally three times daily for 28 days (n=21), or identical-appearing placebo (n=7); or
- LMN-101, two 500-mg capsules and four 500-mg placebo capsules orally three times daily for 28 days (n=21), or identical-appearing placebo (n=7); or
- LMN-101, one 300-mg capsule and five 500-mg placebo capsules orally three times daily for 28 days (n=21), or identical-appearing placebo (n=7).
Campylobacter jejuni CG8421, 1.5 x 10e5 colony-forming units challenge will be administered orally as a single challenge after 7 days of dosing.The C. jejuni CG8421 (capsule type 23, 36) challenge strain lacks all ganglioside mimicry and the genes needed for synthesis of N-acetyl neuraminic acid, necessary for glycolipid mimicry associated with Guillain-Barré (Poly et al. 2008; Tribble et al. 2009).The C. jejuni challenge will be followed 144 hours later by antibiotics for 5 days. Earlier antibiotic treatment will be initiated if subjects meet the criteria to start antibiotics or have any illness that necessitates early treatment in the opinion of the study physician. Additional treatment will be given if microbial recrudescence is observed.
datas
Última verificação: | 06/30/2020 |
Enviado pela primeira vez: | 09/18/2019 |
Inscrição estimada enviada: | 11/26/2019 |
Postado pela primeira vez: | 12/01/2019 |
Última atualização enviada: | 07/02/2020 |
Última atualização postada: | 07/06/2020 |
Data real de início do estudo: | 01/31/2021 |
Data Estimada de Conclusão Primária: | 12/31/2021 |
Data Estimada de Conclusão do Estudo: | 03/31/2022 |
Condição ou doença
Intervenção / tratamento
Biological: LMN-101
Fase
Grupos de Armas
Braço | Intervenção / tratamento |
---|---|
Active Comparator: 3000-mg cohort LMN-101, six 500-mg capsules orally three times daily for 28 days (n=21), or identical-appearing placebo (n=7) | |
Active Comparator: 1000-mg cohort LMN-101, two 500-mg capsules and four 500-mg placebo capsules orally three times daily for 28 days (n=21), or identical-appearing placebo (n=7) | |
Active Comparator: 300-mg cohort LMN-101, one 300-mg capsule and five 500-mg placebo capsules orally three times daily for 28 days (n=21), or identical-appearing placebo (n=7) |
Critério de eleição
Idades qualificadas para estudar | 18 Years Para 18 Years |
Sexos elegíveis para estudo | All |
Aceita Voluntários Saudáveis | sim |
Critério | Inclusion Criteria 1. Male or non-pregnant female between 18 and 50 years of age, inclusive, at time of informed consent 2. Willingness to participate after written informed consent obtained 3. Available for all planned follow-up visits and anticipated to remain available for clinic visits (for examination, blood draws and stool collection) and follow-up monitoring (90 days post-challenge and by phone for 182 days post-challenge) 4. Demonstrated comprehension of the protocol procedures including knowledge of campylobacter illness by passing a written examination (passing grade ≥ 70%) 5. Willingness to ingest LMN-101 or placebo capsules 3 times a day for 28 days 6. General good health, without significant medical illness, abnormal physical examination findings or clinically significant laboratory abnormalities, as determined by the Principal Investigator (PI; may consult with the Medical Monitor on a case-by-case basis) 7. Adequate bone marrow reserve, renal and liver function: 1. Absolute neutrophil count ≥ 1225/µL 2. Lymphocyte count ≥ 750/µL 3. Platelet count ≥ 125,000/µL 4. Hemoglobin ≥ 11 g/dL in males (>10.5 g/dL in females) 5. Serum creatinine ≤1.7x upper limit of normal (ULN) 6. ALT and/or AST ≤ 3x ULN 7. Total bilirubin ≤ 1.5x ULN 8. Females of childbearing potential should be using and committed to continue one of the following acceptable birth control methods consistently for at least 1 month prior to screening through study completion: 1. Sexual abstinence (inactivity); or 2. Condoms with spermicide; or 3. Diaphragm with spermicide, 4. Intrauterine device (IUD); or 5. Stable hormonal contraception; or 6. Surgical sterilization (vasectomy) of male partner at least 6 months prior to study. 9. To be considered of non-childbearing potential, females should be surgically sterilized (bilateral tubal ligation, hysterectomy, or bilateral oophorectomy at least 2 months prior to study) or be post-menopausal and at least 1 year since last menses. Exclusion Criteria: General health/issues 1. Presence of a significant medical condition (e.g., psychiatric condition; gastrointestinal disease, such as peptic ulcer, symptoms or evidence of active gastritis/dyspepsia, inflammatory bowel disease, irritable bowel syndrome (as defined by the Rome III criteria or medical diagnosis); alcohol or illicit drug abuse/dependency) or laboratory abnormalities which in the opinion of the Principal Investigator preclude participation in the study 2. Positive serology results for HIV, HBsAg, or HCV with confirmatory assays 3. Positive urine toxicology screen for opioids, benzodiazepines or amphetamines 4. Significant abnormalities in screening laboratory hematology or serum chemistry, as determined by PI or PI in consultation with the Medical Monitor 5. Use of any medication known to affect the immune function (e.g., corticosteroids and others) within 30 days preceding receipt of the challenge inoculum or planned to be used during the active study period 6. Pregnancy or breastfeeding Study-specific exclusionary conditions based on potential increased risk or complicating outcome ascertainment 7. Personal or documented family history of Guillain-Barré syndrome or neuromuscular disease; or an inflammatory arthritis such as reactive arthritis, Reiter's syndrome, ankylosing spondylitis, or rheumatoid arthritis (not including osteoarthritis or vague history of arthritis relatively late in adulthood) 8. Evidence of neurological abnormalities 9. Evidence of inflammatory arthritis on exam 10. Fever within the 2 weeks prior to time of enrollment 11. Evidence of IgA deficiency (serum IgA < 7 mg/dL or below the limit of detection of assay) 12. HLA-B27 positive (flow cytometry) 13. Allergy or prior intolerance to two or more of the following antibiotics: azithromycin, ciprofloxacin, levofloxacin, erythromycin, doxycycline, ampicillin, or amoxicillin-clavulanate 14. Fewer than 3 stools per week or more than 3 stools per day as the usual frequency 15. History of moderate to serious diarrhea while traveling in a developing country within the last 3 years 16. Regular use of antidiarrheal, antacids, loperamide, bismuth subsalicylate diphenoxylate or similar medication (regular defined as at least weekly) 17. Use of proton pump inhibitors, H2 blockers, or other antacids within 48 hours preceding initiation of LMN-101 or placebo 18. Use of antibiotics during the 7 days preceding initiation of LMN-101 or placebo 19. Use of spirulina other than the study drug in the 30 days preceding initiation of LMN-101 or placebo 20. Use of any investigational product within 30 days preceding initiation of LMN-101 or placebo or planned use during the active study period 21. Use of any medication known to affect the immune system (e.g., systemic corticosteroids) within 30 days preceding initiation of LMN-101 or placebo or planned use during the active study period (excluding inhaled steroids with spacer) 22. History of prior exposure to campylobacter including by vaccination or infection in previous trials, or serum immunoglobulin A (IgA) titer to C. jejuni CG8421 glycine extract >1:4000 23. Other dietary or environmental exposures that may place the subject at high risk for prior campylobacter exposure (to be determined on a case-by-case basis by the PI) 24. Employment as a food handler 25. Any other criteria which, in the Principal Investigator's opinion, would compromise the ability of the subject to participate in the study, the safety of the study or the results of the study |
Resultado
Medidas de Resultado Primário
1. Safety and tolerability of LMN-101 [First dose to 28 days after last dose]
Medidas de Resultado Secundário
1. Incidence of campylobacteriosis versus placebo [0 to 144 hours after challenge]
2. Dose-response relationship [0 to 144 hours after challenge]
3. Duration of diarrhea [0 to 144 hours after challenge]
4. Amount of diarrhea, number [0 to 144 hours after challenge]
5. Amount of diarrhea, weight [0 to 144 hours after challenge]
6. Illness Severity Index [0 to 144 hours after challenge]
7. Campylobacter stool titer [0 to 144 hours after challenge]
8. Peak serum drug concentration [Day -7 to Day 21]
9. Area under the curve serum drug concentration [Day -7 to Day 21]
10. Anti-drug antibodies [Day -7 to Day 56]