First-in-human randomised trial and follow-up study of Plasmodium falciparum blood-stage malaria vaccine BK-SE36 with CpG-ODN(K3). Issue 46 (27th October 2020)

• Record Type: Journal Article
• Authors: Ezoe, Sachiko; Palacpac, Nirianne Marie Q.; Tetsutani, Kohhei; Yamamoto, Kouji; Okada, Kiyoshi; Taira, Masaki; Nishida, Sumiyuki; Hirata, Haruhiko; Ogata, Atsushi; Yamada, Tomomi; Yagi, Masanori; Edula, Jyotheeswara R.; Oishi, Yuko; Tougan, Takahiro; Ishii, Ken J.; Myoui, Akira; Horii, Toshihiro
• Is Part Of: Vaccine. Volume 38:Issue 46(2020)
• Page Start: 7246
• Page End: 7257
• Publication Date: 2020-10-27
• Subjects: AHG aluminium hydroxide gel -- CpG-ODN Cytosine triphosphate deoxynucleotide phosphodiester link to Guanine triphosphate deoxynucleotide DNA -- GCP Good clinical practice -- GMP Good manufacturing practice -- GSK GlaxoSmithKline -- GLP Good laboratory practice -- JMACCT Japan Medical Association Center for Clinical Trials -- SE36 N-terminal domain of SERA5 without serine repeats -- SERA5 Serine Repeat Antigen 5; Malaria blood-stage vaccine -- BK-SE36 -- CpG-ODN(K3) -- BK-SE36/CpG -- Plasmodium falciparum -- SERA5; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2020.09.056
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: BK-SE36/CpG is a candidate blood-stage malaria vaccine against P. falciparum. In healthy Japanese adults, BK-SE36/CpG has an acceptable safety profile. No indication of autoimmune condition was observed in BK-SE36/CpG vaccinees. Two dosing, 21-days apart, of full-dose BK-SE36/CpG was highly immunogenic. Abstract: Background: BK-SE36 is blood-stage malaria vaccine candidate that is undergoing clinical trials. Here, the safety and immunogenicity of BK-SE36 with a novel adjuvant, CpG-ODN(K3) (thus, BK-SE36/CpG) was assessed in a phase 1a trial in Japan. Methods: An investigator-initiated, randomised, single-blind, placebo-controlled, dose-escalation study was conducted at Osaka University Hospital with 26 healthy malaria naïve Japanese male adults. The trial was conducted in two stages: Stage/Group 1, half-dose (n = 7 for BK-SE36/CpG and n = 3 for control) and Stage/Group 2, full-dose (n = 11 for BK-SE36/CpG and n = 5 for control). There were two intramuscular vaccinations 21 days apart for both half-dose (0.5 ml: 50 µg SE36 + 500 µg aluminum + 500 µg K3) and full-dose (1.0 ml: 100 µg SE36 + 1000 µg aluminum + 1000 µg K3). A one-year follow-up was done to monitor changes in autoimmune markers and vaccine-induced antibody response. Results: BK-SE36/CpG was well tolerated. Vaccination site reactions were similar to those observed with BK-SE36. During the trial and follow-up period, no subject had clinical evidence of autoimmune disease. The full-dose group had significantly higher titres than the half-dose group (Student's t -test, p = 0.002) at 21 days post-second vaccination. Antibody titres remained above baseline values during 12 months of follow-up. The vaccine induced antibody was mostly composed of IgG1 and IgM, and recognised epitopes close to the polyserine region located in the middle of SE36. Conclusions: BK-SE36/CpG has an acceptable safety profile. Use of CpG-ODN(K3) greatly enhanced immunogenicity in malaria naïve Japanese adults when compared to BK-SE36 alone. The utility of BK-SE36/CpG is currently under evaluation in a malaria endemic setting in West Africa. Trial Registration . JMACCT Clinical Trial Registry JMA-IIA00109.