Last updated: 09/04/2020 10:10:05

Characterisation of T-cell response to Keyhole Limpet Hemocyanin (KLH) and Tuberculin Purified Protein Derivative (PPD)

GSK study ID
117249
See study documents
Clinicaltrials.gov ID
NCT01910662
EudraCT ID
Not applicable
EU CT Number
Not applicable
Trial status
Study complete
Study complete
Overview
Eligibility
Locations
Study documents
Results summary
Plain language summaries
Additional information

Trial overview

Official title: Characterisation of the T-cell response in Delayed Type Hypersensitivity reactions to Keyhole Limpet Hemocyanin (KLH) and Tuberculin Purified Protein Derivative (PPD) in Healthy Volunteers
Trial description: This is an exploratory study to develop methodologies for the assessment of T-cell mediated therapies via skin immune challenges studies in healthy volunteers. The study will investigate what is the most appropriate; skin challenge agent, time and methodology to sample and characterise T-cells in the delayed type hypersensitivity (DTH) skin reaction. The skin challenge agents to be used in this study will be the neoantigen Keyhole Limpet Hemocyanin (KLH) and recall antigen Tuberculin Purified Protein Derivative (PPD). Part A of the study will assess an intradermal (ID) KLH challenge in three subjects to assess if the immune response to KLH is initiated by the innate or adaptive immune system. Each subject will receive one ID dose of 0.1 milligram (mg) KLH and will be assessed for a skin inflammatory response. Part B of the study will assess repeat ID challenges 28 days apart; the objective will be to characterise the T-cell response to each challenge and the kinetics of that response.
For Cohorts 1A and 1B, 16 subjects will receive an initial subcutaneous (SC) 5 mg dose of KLH. Fifteen days later the subjects will receive 0.1 mg ID KLH dose and the response will then be assessed 48 and 120 hours after the initial challenge. The ID KLH challenge will then be repeated 28 days later and the response will be assessed at 48 hours (Cohort 1A, 8 subjects) and at 120 hours (Cohort 1B, 8 subjects) post challenge. For Cohort 2, a repeat challenge of either 2 tuberculin Unit (TU) or 10 TU ID PPD will be administered 28 days apart, to 8 subjects. The first challenge response will be assessed 48 and 120 hours post challenge. The second challenge will be administered 28 days after the first and will be assessed at the same timepoints. The repeat challenge 28 days later will allow an intra-subject analysis and will determine if a subject can be used as their own control. Part C of the study will assess repeat ID challenges of PPD and PBS; the objective will be to characterise the T-cell response to each challenge and the kinetics of that response. For Cohort 1, 6 subjects will receive a 0.1ml ID dose of PBS and another dose 24 hours later. Each challenge will be assessed 48 hours post challenge. Approximately 2 subjects will have an assessment of their normal skin as a control. For Cohort 2, a repeat challenge of either 2TU or 10TU ID PPD will be administered 28 days apart, to 6 subjects. The first challenge response will be assessed 48 post challenge. The second challenge will be administered 28 days after the 1st and will be assessed at the same timepoint. The repeat challenge 28 days later will allow an intra-subject analysis and will determine if a subject can be used as their own control.
The total duration of this study for Part A is 14-18 days plus up to 30 days screening. The total duration of this study for Cohort 1A is 56-60 days plus up to 30 days screening. The total duration of this study for Cohort 1B is 59-63 days plus up to 30 days screening. The total duration of this study for Cohort 2 if 2TU is used is 45-49 days plus up to 30 day screening. The total duration of this study for Cohort 2 if 10TU is used is 48-51 days plus up to 30 days screening. The total duration of this study for Part C Cohort 1 is 15-19 days plus up to 30 day screening. The total duration of this study for Cohort 2 if 2TU is used is 42-46 days plus up to 30 day screening. The total duration of this study for Cohort 2 if 10TU is used is 45-49 days plus up to 30 days screening.
Primary purpose:
Diagnostic
Trial design:
Parallel Assignment
Masking:
None (Open Label)
Allocation:
Non-randomized
Primary outcomes:

Part A: Skin inflammatory response measurement as induration by the ball point pen technique

Timeframe: Over a four day period after challenge

Part A: Skin inflammatory response measurement as erythema diameter by Laser Doppler Imaging (LDI) and ruler measurement

Timeframe: Over a four day period after challenge

Part A: Skin inflammatory response measurement as induration by characterisation and measurement of the T-cells in skin biopsies

Timeframe: Over a three day period after challenge

Part B: Characterisation of T-cells in a skin DTH response

Timeframe: Cohort 1: Over a five day period after first challenge. Cohort 2: Over a five day period after first challenge

Part C: Characterisation of T-cells in a skin DTH response

Timeframe: Cohort 1: Over a five day period after first challenge. Cohort 2: Over a three day period after first challenge

Secondary outcomes:

Part A: Characterisation and measurement of the T-cells in skin biopsies.

Timeframe: At 48hrs (Day 3) after challenge

Part B: Skin inflammatory response measurement in Cohort 1 by the ball point pen technique

Timeframe: Cohort 1A: At 48hrs (Day 17) and 120hrs (Day 20) after first challenge. At Day 44 and 48hrs (Day 45) after second challenge. Cohort 1B: At 48hrs (Day 17) and 120hrs (Day 20) after first challenge. At Day 44, 45 and 120hrs (Day 48) after second challenge

Part B: Skin inflammatory response measurement in Cohort 2 by the ball point pen technique

Timeframe: Cohort 2: At 48hrs (Day3) and 120hrs (Day 6) after first challenge. At 48hrs (Day 31) and 120hrs (Day 34) after second challenge.

Part B: Erythema diameter measured in Cohort 1 by Laser Doppler Imaging (LDI) and ruler measurement.

Timeframe: Cohort 1A: At 48hrs (Day 17) and 120hrs (Day 20) after first challenge. At Day 44 and 48hrs (Day 45) after second challenge. Cohort 1B: At 48hrs (Day 17) and 120hrs (Day 20) after first challenge. At Day 44, 45 and 120hrs (Day 48) after second challenge

Part B: Erythema diameter measured in Cohort 2 by Laser Doppler Imaging (LDI) and ruler measurement.

Timeframe: Cohort 2: At 48hrs (Day3) and 120hrs (Day 6) after first challenge. At 48hrs (Day 31) and 120hrs (Day 34) after second challenge.

Part B: Characterisation and measurement of the T-cells in skin biopsies in Cohort 1.

Timeframe: Cohort 1A: At 48hrs (Day 17) and 120hrs (Day 20) after first challenge. At 48hrs (Day 45) after second challenge. Cohort 1B: At 48hrs (Day 17) and 120hrs (Day 20) after first challenge. At 120hrs (Day 48) after second challenge.

Part B: Characterisation and measurement of the T-cells in skin biopsies in Cohort 2.

Timeframe: Cohort 2: At 48hrs (Day3) and 120hrs (Day 6) after first challenge. At 48hrs (Day 31) and 120hrs (Day 34) after second challenge.

Part A and B: Number of subjects with adverse events as a measure of safety and tolerability

Timeframe: Part A: Day 1 to Day 4, Part B: Cohort 1A: Day 1 to Day 46.Part B: Cohort 1B:Day 1 to Day 49.Part B Cohort 2: Day 1 to 35.

Part A and B: changes in clinical laboratory measurements to access safety and tolerability

Timeframe: Screening and up to 14 days post last visit

Part A and B: Trends in and change from baseline for blood pressure measurements

Timeframe: Screening and up to 14 days post last visit

Trends in and change from baseline in measure of 12-lead ECG to access safety and tolerability

Timeframe: Screening and up to 14 days post last visit

Immediate local hypersensitivity assessment

Timeframe: 15-30 minutes after each SC and ID challenge immunization in each Study part/Cohort

Part A and B: Trends in and change from baseline for heart rate measurements

Timeframe: Screening and up to 14 days post last visit

Part C: Skin inflammatory response measurement in Cohort 2 by the ball point pen technique.

Timeframe: Cohort 2: At 48hrs (Day3) and 744hrs (Day 31).

Part C: Erythema diameter measured in Cohort 2 by Laser Doppler Imaging (LDI) and ruler measurement.

Timeframe: Cohort 2: At pre-challenge (Day1) and 48hrs (Day 3) after first challenge. At pre-challenge (Day 29) and 48hrs (Day 31) after second challenge.

Part C: Characterisation and measurement of the T-cells in skin blisters in Cohort 2.

Timeframe: Cohort 2: At 48hrs (Day3) and 72hrs (Day 4) after first challenge. At 48hrs (Day 31) and 69hrs (Day 32) after second challenge.

Part A , B and C: Number of subjects with adverse events as a measure of safety and tolerability

Timeframe: Part A: Day 1 to Day 4, Part B: Cohort 1A: Day 1 to Day 46.Part B: Cohort 1B:Day 1 to Day 49.Part B Cohort 2: Day 1 to 35. Part C: Cohort 1:Day 1 to Day 19. Part C Cohort 2: Day 1 to 46.

Part A, B and C: changes in clinical laboratory measurements to access safety and tolerability

Timeframe: Part A and B: Screening and up to 14 days post last visit. Part C: Screening and up to 14 days post last blister draw.

Part A and B: Screening and up to 14 days post last visit. Part C: Screening and up to 14 days post last blister draw.

Timeframe: Part A and B: Screening and up to 14 days post last visit. Part C: Screening and up to 14 days post last blister draw.

Trends in and change from baseline in measure of 12-lead ECG to access safety and tolerability

Timeframe: Part A and B: Screening and up to 14 days post last visit. Part C: Screening and up to 14 days post last blister draw.

Immediate local hypersensitivity assessments

Timeframe: Part A and B: 15-30 minutes after each SC and ID challenge immunization in each Study part/Cohort. Part C: Screening and up to 14 days post last blister draw.

Part A and B: Trends in and change from baseline for heart rate measurement

Timeframe: Part A and B: Screening and up to 14 days post last visit. Part C: Screening and up to 14 days post last blister draw.

Interventions:
  • Other: KLH 0.1 mg
  • Other: KLH 5 mg
  • Other: PBS (0.1 mL)
  • Other: Tuberculin PPD
    • Enrollment:
    24
    Primary completion date:
    2013-26-11
    Observational study model:
    Not applicable
    Time perspective:
    Not applicable
    Clinical publications:
    Not applicable
    Medical condition
    Dermatitis
    Product
    GSK3039023, SKF71899
    Collaborators
    Not applicable
    Study date(s)
    February 2013 to November 2013
    Type
    Interventional
    Phase
    1

    Participation criteria

    Sex
    Female & Male
    Age
    18 - 55 years
    Accepts healthy volunteers
    Yes
    • Male or female between 18 and 55 years of age inclusive, at the time of signing the informed consent.
    • Healthy as determined by a responsible and experienced physician, based on a medical Evaluation.
    • Prior medical history of anaphylaxis, severe adverse reaction to vaccines, allergy to shellfish, asthma (excluding childhood asthma), allergic rhinitis or atopic dermatitis, severe adverse reaction to local anaesthetic, previous tuberculosis infection.
    • Current treatment with beta-blockers or angiotensin converting enzyme (ACE) inhibitors.
    Inclusion and exclusion criteria
    Inclusion criteria:
    • Male or female between 18 and 55 years of age inclusive, at the time of signing the informed consent.
    • Healthy as determined by a responsible and experienced physician, based on a medical Evaluation.
    • Body weight >= 50 kg and body mass index (BMI) within the range 19.5 to 29.9 kilogram/meter squared (inclusive).
    • Female subjects of non-child bearing potential. Females of child bearing potential are eligible to enter if they are not pregnant and willing to use protocol-specified methods of contraception to prevent pregnancy.
    • Male subjects with female partners of child-bearing potential must agree to use one of the contraception methods from the time of the first dose of challenge agent until follow-up.
    • Capable of giving written informed consent.
    • Alanine aminotransferase (ALT) alkaline phosphatase and bilirubin
    • Normal electrocardiogram (ECG) measurements. Average QT duration corrected for heart rate by Fridericia’s formula (QTcF) <450 millisecond (msec).
    • Part B and C cohort 2 only: Subjects with a history of Bacillus Calmette Guérin (BCG) vaccination as evidence by either a BCG scar and verbal confirmation of BCG vaccination or documented medical history of a BCG vaccination with or without a BCG scar
    Exclusion criteria:
    • Prior medical history of anaphylaxis, severe adverse reaction to vaccines, allergy to shellfish, asthma (excluding childhood asthma), allergic rhinitis or atopic dermatitis, severe adverse reaction to local anaesthetic, previous tuberculosis infection.
    • Current treatment with beta-blockers or angiotensin converting enzyme (ACE) inhibitors.
    • History of sensitivity to any of the study challenge agents or components thereof or a history of drug or other allergy that, in the opinion of the investigator or GlaxoSmithKline (GSK) Medical Monitor, contraindicates their participation.
    • Received live, attenuated or recombinant vaccine(s) within 2 months of the first KLH or PPD injection or will require vaccination prior to the follow-up visit.
    • Part B and C cohort 2 only: From a high risk area of the world for tuberculosis or have close family members with confirmed Mycobacterium tuberculosis (MTB).
    • Antibiotics or antiviral therapy after a serious illness within 30 days of study entry.
    • Immunodeficiency or autoimmunity, assessed by medical history.
    • Presence of tattoos, naevi or other skin abnormalities such as keloids (or history of keloids) that may, in the opinion of the investigator, interfere with study assessments.
    • Use of nicotine patches on the arm at screening that would interfere with the injection sites.
    • Subjects participating, within 7 days of screening, in recreational sun-bathing, or use of sun-bed, on the area of the skin from wrist to shoulder inclusive.
    • The subject has a phobia to needles or minor surgical procedures.
    • Current or chronic history of liver disease, or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones).
    • History of regular alcohol consumption within 6 months of the study.
    • Use of prescription drugs or non-prescription drugs, including NSAIDs, if in the opinion of the Investigator the medication will interfere with the study procedures or compromise subject safety. Subjects must not currently take any of the following: topical steroid cream on the arms, oral or systemic steroids or any other immune-modulators.
    • A positive pre-study Hepatitis B surface antigen or positive Hepatitis C antibody result within 3 months of screening
    • A positive pre-study drug/alcohol screen.
    • A positive test for human immunodeficiency virus (HIV) antibody.
    • Pregnant or lactating females.
    • Donation of more than 500 milliliter (mL) blood within a 56 day period.
    • Participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer)
    • Exposure to more than four new chemical entities within 12 months prior to the first dosing day.
    • Part A and part B Cohort 1: The subject has received KLH SC or ID in the past.

    Trial location(s)

    Location
    Status
    Contact us
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    Location
    GSK Investigational Site
    Cambridge, United Kingdom, CB2 2GG
    Status
    Study Complete
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    Study documents

    Protocol
    Available language(s): English
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    Scientific result summary
    Available language(s): English
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    If you wish to request for full study report, please contact - [email protected]

    Results overview

    Refer to study documents

    Recruitment status
    Study complete
    Actual primary completion date
    2013-26-11
    Actual study completion date
    2013-26-11

    Plain language summaries

    Plain language summaries of clinical trial results for Phase 2-4 clinical trials that were initiated on or after January 2022 will be posted by GSK within one year following study completion.

    Additional information about the trial

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    Results for study 117249 can be found on the GSK Clinical Study Register.
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