Trial Outcomes & Findings for Cell Mediated Immunity Against RSV and Influenza in a Human Experimental Challenge (NCT NCT02755948)

NCT ID: NCT02755948

Last Updated: 2024-12-06

Results Overview

Total Symptom Score in infected versus uninfected participants by Jackson's criteria. Eight symptoms were evaluated in the symptom diary: nasal discharge, nasal congestion, sneezing, cough, sore throat, headache, feverishness and fatigue. Subjects were asked to score each symptom 0 (absent), 1 (mild), 2 (moderate), 3 (severe). A clinical cold was defined as 2 out of 3 of: a cumulative 14-day symptom score of ≥14; a subjective feeling of a cold; nasal discharge for ≥3 days. Symptoms were evaluated over a longer period than in Jackson's original description to account for an anticipated slower onset and longer duration of illness with RSV compared with rhinovirus. Maximum cumulative symptom score is therefore 336.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

75 participants

Primary outcome timeframe

14 days

Results posted on

2024-12-06

Participant Flow

Participant milestones

Participant milestones
Measure
RSV A Memphis 37
Participants will be inoculated with RSV Memphis 37 virus. RSV A Memphis 37: Good Manufacturing Practices-certified RSV Memphis 37 10(4) PFU in 1 mL 25% sucrose/DMEM delivered by intranasal drops
Influenza A/California/04/2009-like (H1N1)
Participants will be inoculated with Influenza A/California/04/2009-like (H1N1). Influenza A/California/04/2009-likw (H1N1): Good Manufacturing Practices-certified Influenza A/California/04/09 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Influenza A/Belgium/4217/2015 (H3N2)
Participants will be inoculated with Influenza A/Belgium/4217/2015 (H3N2). Influenza A/Belgium/4217/2015 (H3N2): Good Manufacturing Practices-certified Influenza A/Belgium/4217/2015 (H3N2) 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Overall Study
STARTED
41
24
10
Overall Study
COMPLETED
41
24
10
Overall Study
NOT COMPLETED
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Cell Mediated Immunity Against RSV and Influenza in a Human Experimental Challenge

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
RSV A Memphis 37
n=41 Participants
Participants will be inoculated with RSV Memphis 37 virus. RSV A Memphis 37: Good Manufacturing Practices-certified RSV Memphis 37 10(4) PFU in 1 mL 25% sucrose/DMEM delivered by intranasal drops
Influenza A/California/04/2009-like (H1N1)
n=24 Participants
Participants will be inoculated with Influenza A/California/04/2009-like (H1N1). Influenza A/California/04/2009-likw (H1N1): Good Manufacturing Practices-certified Influenza A/California/04/09 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Influenza A/Belgium/4217/2015 (H3N2)
n=10 Participants
Participants will be inoculated with Influenza A/Belgium/4217/2015 (H3N2). Influenza A/Belgium/4217/2015 (H3N2): Good Manufacturing Practices-certified Influenza A/Belgium/4217/2015 (H3N2) 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Total
n=75 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Age, Categorical
Between 18 and 65 years
41 Participants
n=5 Participants
24 Participants
n=7 Participants
10 Participants
n=5 Participants
75 Participants
n=4 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Age, Continuous
26.2 years
n=5 Participants
45.3 years
n=7 Participants
37.2 years
n=5 Participants
33.8 years
n=4 Participants
Sex: Female, Male
Female
12 Participants
n=5 Participants
6 Participants
n=7 Participants
5 Participants
n=5 Participants
23 Participants
n=4 Participants
Sex: Female, Male
Male
29 Participants
n=5 Participants
18 Participants
n=7 Participants
5 Participants
n=5 Participants
52 Participants
n=4 Participants
Race/Ethnicity, Customized
White British
0 Participants
n=5 Participants
11 Participants
n=7 Participants
8 Participants
n=5 Participants
19 Participants
n=4 Participants
Race/Ethnicity, Customized
Asian or Asian British (other)
0 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
1 Participants
n=4 Participants
Race/Ethnicity, Customized
White (other)
0 Participants
n=5 Participants
2 Participants
n=7 Participants
1 Participants
n=5 Participants
3 Participants
n=4 Participants
Race/Ethnicity, Customized
Asian or Asian British (Pakistan)
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race/Ethnicity, Customized
Mixed (White & Caribbean)
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race/Ethnicity, Customized
All other ethnic groups
0 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
2 Participants
n=4 Participants
Race/Ethnicity, Customized
White Irish
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race/Ethnicity, Customized
Black or Black British (Caribbean)
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race/Ethnicity, Customized
Asian or Asian British (Indian)
0 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
2 Participants
n=4 Participants
Race/Ethnicity, Customized
Black or Black British (African)
0 Participants
n=5 Participants
3 Participants
n=7 Participants
0 Participants
n=5 Participants
3 Participants
n=4 Participants
Race/Ethnicity, Customized
Unknown
41 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
41 Participants
n=4 Participants
Race/Ethnicity, Customized
Mixed White (White & Asian)
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Region of Enrollment
United Kingdom
41 participants
n=5 Participants
24 participants
n=7 Participants
10 participants
n=5 Participants
75 participants
n=4 Participants

PRIMARY outcome

Timeframe: 14 days

Population: Total number of participants challenged with the specified challenge virus. For the H1N1 arm, only 22 out of 24 participants were analysed because one participant lost their symptom diary and another was excluded from analysis as they had RSV co-infection

Total Symptom Score in infected versus uninfected participants by Jackson's criteria. Eight symptoms were evaluated in the symptom diary: nasal discharge, nasal congestion, sneezing, cough, sore throat, headache, feverishness and fatigue. Subjects were asked to score each symptom 0 (absent), 1 (mild), 2 (moderate), 3 (severe). A clinical cold was defined as 2 out of 3 of: a cumulative 14-day symptom score of ≥14; a subjective feeling of a cold; nasal discharge for ≥3 days. Symptoms were evaluated over a longer period than in Jackson's original description to account for an anticipated slower onset and longer duration of illness with RSV compared with rhinovirus. Maximum cumulative symptom score is therefore 336.

Outcome measures

Outcome measures
Measure
RSV A Memphis 37
n=41 Participants
Participants will be inoculated with RSV Memphis 37 virus. RSV A Memphis 37: Good Manufacturing Practices-certified RSV Memphis 37 10(4) PFU in 1 mL 25% sucrose/DMEM delivered by intranasal drops
Influenza A/California/04/2009-like (H1N1)
n=22 Participants
Participants will be inoculated with Influenza A/California/04/2009-like (H1N1). Influenza A/California/04/2009-likw (H1N1): Good Manufacturing Practices-certified Influenza A/California/04/09 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Influenza A/Belgium/4217/2015 (H3N2)
n=10 Participants
Participants will be inoculated with Influenza A/Belgium/4217/2015 (H3N2). Influenza A/Belgium/4217/2015 (H3N2): Good Manufacturing Practices-certified Influenza A/Belgium/4217/2015 (H3N2) 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Total Symptom Score
Infected
29.25 score on a scale
Interval 8.5 to 47.5
17.50 score on a scale
Interval 8.75 to 23.0
11.00 score on a scale
Interval 7.5 to 18.75
Total Symptom Score
Uninfected
13.00 score on a scale
Interval 4.75 to 22.0
0 score on a scale
Interval 0.0 to 1.25
1 score on a scale
Interval 0.0 to 4.0

SECONDARY outcome

Timeframe: 6 months

Population: For the H1N1 arm, one participant was excluded from analysis as they had RSV co-infection. For the RSV arm, only 32/41 participants were analysed because there were insufficient PBMCs from the remaining participants to run the analysis

Peak Ki-67+ CD38+ CD8+ T cells in the blood by flow cytometry.

Outcome measures

Outcome measures
Measure
RSV A Memphis 37
n=32 Participants
Participants will be inoculated with RSV Memphis 37 virus. RSV A Memphis 37: Good Manufacturing Practices-certified RSV Memphis 37 10(4) PFU in 1 mL 25% sucrose/DMEM delivered by intranasal drops
Influenza A/California/04/2009-like (H1N1)
n=23 Participants
Participants will be inoculated with Influenza A/California/04/2009-like (H1N1). Influenza A/California/04/2009-likw (H1N1): Good Manufacturing Practices-certified Influenza A/California/04/09 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Influenza A/Belgium/4217/2015 (H3N2)
n=7 Participants
Participants will be inoculated with Influenza A/Belgium/4217/2015 (H3N2). Influenza A/Belgium/4217/2015 (H3N2): Good Manufacturing Practices-certified Influenza A/Belgium/4217/2015 (H3N2) 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Frequency of T Cells in Blood by Flow Cytometry
Infected
0.79 % of CD8+ lymphocytes
Interval 0.42 to 1.1
3.81 % of CD8+ lymphocytes
Interval 2.46 to 5.56
4.13 % of CD8+ lymphocytes
Interval 2.55 to 16.21
Frequency of T Cells in Blood by Flow Cytometry
Uninfected
0.49 % of CD8+ lymphocytes
Interval 0.24 to 0.81
0.985 % of CD8+ lymphocytes
Interval 0.752 to 1.535
1.18 % of CD8+ lymphocytes
Interval 0.77 to 1.59

SECONDARY outcome

Timeframe: 6 months

Population: For the H1N1 arm, one participant was excluded from analysis as they had RSV co-infection. For the RSV arm, only 20/41 participants were analysed because there were insufficient airway cells from some participants to run the analysis. For the H3N2 arm, the analysis was not run on the 3 uninfected participants. Only 3 were analysed in the infected participants because 1 participant was excluded for co-infection and the other 3 participants had insufficient airway cells to run the analysis.

Peak Ki-67+ CD38+ CD8+ T cells in bronchoalveolar lavage (BAL) by flow cytometry

Outcome measures

Outcome measures
Measure
RSV A Memphis 37
n=20 Participants
Participants will be inoculated with RSV Memphis 37 virus. RSV A Memphis 37: Good Manufacturing Practices-certified RSV Memphis 37 10(4) PFU in 1 mL 25% sucrose/DMEM delivered by intranasal drops
Influenza A/California/04/2009-like (H1N1)
n=23 Participants
Participants will be inoculated with Influenza A/California/04/2009-like (H1N1). Influenza A/California/04/2009-likw (H1N1): Good Manufacturing Practices-certified Influenza A/California/04/09 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Influenza A/Belgium/4217/2015 (H3N2)
n=3 Participants
Participants will be inoculated with Influenza A/Belgium/4217/2015 (H3N2). Influenza A/Belgium/4217/2015 (H3N2): Good Manufacturing Practices-certified Influenza A/Belgium/4217/2015 (H3N2) 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Frequency of T Cells in Respiratory Tract by Flow Cytometry
Infected
2.21 % of CD8+ lymphocytes
Interval 0.96 to 3.8
81.15 % of CD8+ lymphocytes
Interval 0.0 to 90.48
4.36 % of CD8+ lymphocytes
Interval 1.35 to 5.49
Frequency of T Cells in Respiratory Tract by Flow Cytometry
Uninfected
0.65 % of CD8+ lymphocytes
Interval 0.27 to 1.11
0.412 % of CD8+ lymphocytes
Interval 0.187 to 0.598

SECONDARY outcome

Timeframe: 28 days

Population: For the H1N1 arm, one participant was excluded from analysis as they had RSV co-infection.

Nasal wash viral load by quantitative polymerase chain reaction (qPCR) (Area under curve)

Outcome measures

Outcome measures
Measure
RSV A Memphis 37
n=41 Participants
Participants will be inoculated with RSV Memphis 37 virus. RSV A Memphis 37: Good Manufacturing Practices-certified RSV Memphis 37 10(4) PFU in 1 mL 25% sucrose/DMEM delivered by intranasal drops
Influenza A/California/04/2009-like (H1N1)
n=23 Participants
Participants will be inoculated with Influenza A/California/04/2009-like (H1N1). Influenza A/California/04/2009-likw (H1N1): Good Manufacturing Practices-certified Influenza A/California/04/09 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Influenza A/Belgium/4217/2015 (H3N2)
n=10 Participants
Participants will be inoculated with Influenza A/Belgium/4217/2015 (H3N2). Influenza A/Belgium/4217/2015 (H3N2): Good Manufacturing Practices-certified Influenza A/Belgium/4217/2015 (H3N2) 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Viral Load
Infected
18.24 log10 copies*days/mL
Interval 11.51 to 24.34
5.85 log10 copies*days/mL
Interval 0.82 to 9.22
26.40 log10 copies*days/mL
Interval 5.52 to 33.13
Viral Load
Uninfected
0 log10 copies*days/mL
Interval 0.0 to 0.0
0 log10 copies*days/mL
Interval 0.0 to 0.0
0 log10 copies*days/mL
Interval 0.0 to 0.0

SECONDARY outcome

Timeframe: 6 months

Population: For the H1N1 arm, there were only enough remaining PBMCs from 14 participants. For the H3N2 arm, there were insufficient cells to run the analysis. For the RSV arm, only 18/41 participants were analysed because there were insufficient PBMCs from the remaining participants to run the analysis.

Peak T cells in blood by Enzyme-linked Immunospot (ELISpot). IFNy SFU/million PBMCs (Spot Forming Unit)

Outcome measures

Outcome measures
Measure
RSV A Memphis 37
n=18 Participants
Participants will be inoculated with RSV Memphis 37 virus. RSV A Memphis 37: Good Manufacturing Practices-certified RSV Memphis 37 10(4) PFU in 1 mL 25% sucrose/DMEM delivered by intranasal drops
Influenza A/California/04/2009-like (H1N1)
n=14 Participants
Participants will be inoculated with Influenza A/California/04/2009-like (H1N1). Influenza A/California/04/2009-likw (H1N1): Good Manufacturing Practices-certified Influenza A/California/04/09 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Influenza A/Belgium/4217/2015 (H3N2)
Participants will be inoculated with Influenza A/Belgium/4217/2015 (H3N2). Influenza A/Belgium/4217/2015 (H3N2): Good Manufacturing Practices-certified Influenza A/Belgium/4217/2015 (H3N2) 3.5x10\^6 TCID50 in 1 mL in DPBS delivered by intranasal drops
Frequency of T Cells in Blood by Enzyme-linked Immunospot (ELISpot)
Infected
778.30 IFNy SFU/million PBMCs
Interval 459.2 to 1228.0
161 IFNy SFU/million PBMCs
Interval 128.0 to 214.0
Frequency of T Cells in Blood by Enzyme-linked Immunospot (ELISpot)
Uninfected
159.20 IFNy SFU/million PBMCs
Interval 43.75 to 419.2
29 IFNy SFU/million PBMCs
Interval 21.0 to 43.0

Adverse Events

RSV A Memphis 37

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Influenza A/California/04/2009-like (H1N1)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Influenza A/Belgium/4217/2015 (H3N2)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Professor Christopher Chiu

Imperial College London

Phone: (0)20 8383 2301

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place