Randomized, double-blind, placebo-controlled trial to evaluate the safety and immunogenicity of live oral cholera vaccine 638 in Cuban adults.

A randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the safety, reactogenicity and the immunogenicity of a 2 x 10(9)CFU dose of the 638 lyophilized live attenuated cholera vaccine for oral administration, formulated and produced at Finlay Institute, City of Havana, Cuba. Thirty-six healthy female and male adult volunteers from 18 to 40 years old were involved, clinically examined and laboratory tested after the informed consent signature. Adverse events were monitored and seroconversion rates and geometrical mean titer (GMT) of vibriocidal antibodies were tested in volunteer's sera samples. Neither serious adverse events nor other damages to the volunteers due to vaccine or placebo feeding were reported during the clinical follow-up period of this study; none of the adverse events registered within the first 72 h after inoculation were life-threatening for volunteers. Neither severe nor moderate adverse events were reported. Sixty-one percent of subjects showed mild expected adverse events in an interval lower than 24h up to the first 72 h, 75% of these in the vaccinated group and 18% in the placebo group. Fourteen days after inoculation the GMT of vibriocidal antibodies in the vaccine group significantly increased in comparison to the placebo group. All subjects in the vaccine group (24) seroconverted (100%). Results show that this vaccine is safe, well tolerated and immunogenic in healthy female and male volunteers.

Phase I clinical evaluation of a synthetic oligosaccharide-protein conjugate vaccine against Haemophilus influenzae type b in human adult volunteers.

Since 1989, we have been involved in the development of a vaccine against Haemophilus influenzae type b. The new vaccine is based on the conjugation of synthetic oligosaccharides to tetanus toxoid. Our main goals have been (i) to verify the feasibility of using the synthetic antigen and (ii) to search for new production alternatives for this important infant vaccine. Overall, eight trials have already been conducted with adults, children (4 to 5 years old), and infants. We have described herein the details from the first two phase I clinical trials conducted with human adult volunteers under double blind, randomized conditions. The participants each received a single intramuscular injection to evaluate safety and initial immunogenicity. We have found an excellent safety profile and an antibody response similar to the one observed for the control vaccine.

Phase I Clinical Evaluation of a Synthetic Oligosaccharide-Protein Conjugate Vaccine against Haemophilus influenzae Type b in Human Adult Volunteers

Since 1989, we have been involved in the development of a vaccine against Haemophilus influenzae type b. The new vaccine is based on the conjugation of synthetic oligosaccharides to tetanus toxoid. Our main goals have been (i) to verify the feasibility of using the synthetic antigen and (ii) to search for new production alternatives for this important infant vaccine. Overall, eight trials have already been conducted with adults, children (4 to 5 years old), and infants. We have described herein the details from the first two phase I clinical trials conducted with human adult volunteers under double blind, randomized conditions. The participants each received a single intramuscular injection to evaluate safety and initial immunogenicity. We have found an excellent safety profile and an antibody response similar to the one observed for the control vaccine(AU)

Desde 1989, hemos participado en el desarrollo de una vacuna contra el Haemophilus influenzae tipo b. La nueva vacuna se basa en la conjugación de oligosacáridos sintéticos a toxoide tetánico. Nuestros principales objetivos han sido (i) para verificar la viabilidad de la utilización de la síntesis de antígenos y (ii) búsqueda de nuevas alternativas de producción para este importante vacuna infantil. En total, ocho ensayos ya se han realizado con adultos, niños (de 4 a 5 años), y los lactantes. Hemos descrito en este documento los detalles de los dos primeros ensayos clínicos de fase I realizado con voluntarios adultos humanos en virtud de doble ciego, randomizado condiciones. Los participantes recibieron una única inyección intramuscular para evaluar la seguridad y la inmunogenicidad inicial. Hemos encontrado un excelente perfil de seguridad y una respuesta de anticuerpos similar a la observada para el control de vacunas

Safety and preliminary immunogenicity of MenC/P64k, a meningococcal serogroup C conjugate vaccine with a new recombinant carrier.

This study reports the preliminary assessment of the safety and immunogenicity of the first serogroup C conjugate vaccine candidate that includes meningococcal P64k recombinant protein as the carrier (MenC/P64k). Twenty volunteers were recruited for a double-blind, randomized, controlled phase I clinical trial, receiving a single dose of MenC/P64k (study group) and a single dose of the commercial polysaccharide vaccine AC (control group). Only mild reactions were observed. No statistical differences were detected between the antipolysaccharide C IgG responses of both groups as well as between bactericidal serum titre (P > 0.05). The MenC/P64k vaccine was found to have a good safety profile, to be well tolerated and immunogenic.

The vaccine candidate Vibrio cholerae 638 is protective against cholera in healthy volunteers.

Vibrio cholerae 638 is a living candidate cholera vaccine strain attenuated by deletion of the CTXPhi prophage from C7258 (O1, El Tor Ogawa) and by insertion of the Clostridium thermocellum endoglucanase A gene into the hemagglutinin/protease coding sequence. This vaccine candidate was previously found to be well tolerated and immunogenic in volunteers. This article reports a randomized, double-blind, placebo-controlled trial conducted to test short-term protection conferred by 638 against subsequent V. cholerae infection and disease in volunteers in Cuba. A total of 45 subjects were enrolled and assigned to receive vaccine or placebo. The vaccine contained 10(9) CFU of freshly harvested 638 buffered with 1.3% NaHCO(3), while the placebo was buffer alone. After vaccine but not after placebo intake, 96% of volunteers had at least a fourfold increase in vibriocidal antibody titers, and 50% showed a doubling of at least the lipopolysaccharide-specific immunoglobulin A titers in serum. At 1 month after vaccination, five volunteers from the vaccine group and five from the placebo group underwent an exploratory challenge study with 10(9) CFU of DeltaCTXPhi attenuated mutant strain V. cholerae 81. Only two volunteers from the vaccine group shed strain 81 in their feces, but none of them experienced diarrhea; in the placebo group, all volunteers excreted the challenge strain, and three had reactogenic diarrhea. An additional 12 vaccinees and 9 placebo recipients underwent challenge with 7 x 10(5) CFU of virulent strain V. cholerae 3008 freshly harvested from a brain heart infusion agar plate and buffered with 1.3% NaHCO(3). Three volunteers (25%) from the vaccine group and all from the placebo group shed the challenge agent in their feces. None of the 12 vaccinees but 7 volunteers from the placebo group had diarrhea, and 2 of the latter exhibited severe cholera (>5,000 g of diarrheal stool). These results indicate that at 1 month after ingestion of a single oral dose (10(9) CFU) of strain 638, volunteers remained protected against cholera infection and disease provoked by the wild-type challenge agent V. cholerae 3008. We recommend that additional vaccine lots of 638 be prepared under good manufacturing practices for further evaluation.

Induction of neutralizing antibodies and partial protection from viral challenge in Macaca fascicularis immunized with recombinant dengue 4 virus envelope glycoprotein expressed in Pichia pastoris.

A recombinant vaccine that expresses the envelope (E) gene of dengue virus type 4 was tested for immunogenicity and protection in Macaca fascicularis. One hundred micrograms of semipurified recombinant E protein (E4rec) expressed in Pichia pastoris was used to immunize three animals. Neutralizing antibodies to dengue 4 virus with a titer of 1:30 were detected in all immunized monkeys prior to challenge. Animals were challenged with 10(5) plaque-forming units of dengue 4 virus. One vaccine-immunized monkey was protected from viremia, while the other two were partially protected. Monkeys immunized with E4rec elicited the highest neutralizing antibody titers (P < 0.05) ranging from 1:85 to 1:640 at day 30. In both immunized and control animals, the longest duration of viremia correlated with earliest and highest level of IgM antibody to dengue virus. The vaccinated animals showed anamnestic antibody responses upon virus challenge, indicating successful priming by the recombinant vaccine. Our results suggest that E4rec expressed in P. pastoris can provide partial protection against viremia. However, the results were not effective enough to use it as a vaccine candidate. Further work is required to improve the quality of the immunogen.

Evaluación de los reactivos hemoclasificadores monoclonales cubanos HEMO CIM ANTI-A y HEMO CIM ANTI-B en pacientes VIH/SIDA / Evaluation of the Cuban anti-A Hemo CIM and anti-B Hemo CIM monoclonal hemoclassifiers in HIV/AIDS patients

Se describe un estudio realizado con los hemoclasificadores monoclonales cubanos Hemo CIM anti-A y anti-B producidos por el Centro de Inmunología Molecular (CIM) y comercializados por CIMAB S.A, para ser evaluados en pacientes VIH/SIDA. Se analizaron un total de 130 pacientes en el Servicio de Transfusiones del Instituto "Pedro Kourí". Se utilizaron en paralelo los antisueros policlonales de producción nacional (Laboratorios Betera) y los reactivos monoclonales comerciales producidos y donados por International Blood Group Reference Laboratory; Bristol, UK. Se demostró que los reactivos Hemo CIM anti-A y Hemo CIM anti-B se comportaron de forma similar a sus homólogos comerciales y policlonales. Al comparar la efectividad de la aglutinación para los 3 reactivos pudimos comprobar que con el reactivo monoclonal, Hemo CIM anti-A y anti-B se obtuvieron los mejores resultados expresados en cruces.

A study conducted with the Cuban anti-A and anti-B Hemo CIM monoclonal hemoclassifiers produced by the Center of Molecular Immunology (CMI) and commercialized by CIMAB S.A. to be evaluated in HIV/AIDS patients is described. 130 patients were analyzed at the Service of Transfusions of "Pedro Kouri" Institute. The polyclonal antisera of national production (Betera Laboratories) and the commercial monoclonal reagents produced and donated by the International Blood Group Reference Laboratory; Bristol, UK, were used at the same time. It was proved that the anti-A Hemo CIM and anti-B Hemo CIM reagents behaved similarly to their commercial and polyclonal homologues. On comparing the effectiveness of the agglutination for the 3 reagents, we were able to verify that the best results expressed in crosses were obtained with the anti-A and anti-B Hemo CIM monoclonal reagents.

Evaluación de los reactivos hemoclasificadores monoclonales cubanos HEMO CIM ANTI-A y HEMO CIM ANTI-B en pacientes VIH/SIDA / Evaluation of the reagents hemoclasificadores Cuban monoclonales HEMO CIM ANTI-TO and HEMO CIM ANTI-B in patient VIH/SIDA

Se describe un estudio realizado con los hemoclasificadores monoclonales cubanos Hemo CIM anti-A y anti-B producidos por el Centro de Inmunología Molecular (CIM) y comercializados por CIMAB S.A, para ser evaluados en pacientes VIH/SIDA. Se analizaron un total de 130 pacientes en el Servicio de Transfusiones del Instituto Pedro Kourí. Se utilizaron en paralelo los antisueros policlonales de producción nacional (Laboratorios Betera) y los reactivos monoclonales comerciales producidos y donados por International Blood Group Reference Laboratory; Bristol, UK. Se demostró que los reactivos Hemo CIM anti-A y Hemo CIM anti-B se comportaron de forma similar a sus homólogos comerciales y policlonales. Al comparar la efectividad de la aglutinación para los 3 reactivos pudimos comprobar que con el reactivo monoclonal, Hemo CIM anti-A y anti-B se obtuvieron los mejores resultados expresados en cruces(AU)