Sources of COmplement in Meningococcal and Pertussis Serum Bactericidal Antibody Assays

NCT ID: NCT04023929

Last Updated: 2021-01-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

45 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-10-28

Study Completion Date

2021-09-21

Brief Summary

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This study is designed to allow cord blood sample collection from the cords of babies born in three gestational age windows: ≥37 gestational weeks, 32-36+6 gestational weeks and less than 32 gestational weeks to investigate whether the result obtained using a standard hSBA assay is comparable to that achieved using complement from a gestation matched population for meningococcal B and pertussis.

Detailed Description

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Newborn infants, particularly those who are born preterm, are vulnerable to infection because of their immature immune systems. Invasive meningococcal disease (IMD) and pertussis both represent significant risks to the newborn infant.

Invasive meningococcal disease (IMD), caused by Neisseria meningitidis, is a devastating illness with a case fatality rate of 10-20% even with intensive treatment. Even infants who survive IMD experience significant disability in 10-20% of cases. Serogroups A, B, C, Y, W and X cause almost all cases of IMD, and in Europe, North America and parts of Latin America serogroup B is responsible for the majority of cases. In the UK there were 747 cases of IMD in 2016/17 and Men B was responsible for 396 (53%) of these. The major burden of disease is in infants under the age of 1 year. Pertussis is a highly infectious respiratory illness caused by Bordetella pertussis which can cause significant morbidity and mortality in young infants. There has been an increase in the incidence of pertussis in the UK, along with other high income countries in recent years which has disproportionately affected young infants.

Infants in the UK are vaccinated against meningococcal group B disease at 2, 4 and 12 months with Bexsero® and against pertussis at 2,3 and 4 months as part of the 6-in-1 vaccine Infanrix hexa®. Additionally, since 2012 pregnant women in the UK have been routinely offered pertussis vaccination during pregnancy to protect the infant in the first few months of life prior to them receiving their own vaccinations.

Serum bactericidal antibody (SBA) assays are important in the assessment of immunity following vaccination and are used in the production, release and licensure of some vaccines and the evaluation of the function of others. SBA assays for pertussis and meningococcal B typically use adult complement from a healthy adult donor pool. There is some concern that using adult complement may not allow an adequate assessment of neonatal immunity. The concentration of most complement components in the neonate is around 10-80% of that in the adult and circulating regulator levels are also reduced. Differences in complement function are more pronounced in preterm infants and the differences in the quality and activation of complement in neonates raises questions about whether an SBA assay using adult complement sources allows an accurate assessment of neonatal immunity.

In this study the investigators will create a pooled complement source for three different gestational ages, ≥37 gestational weeks, 32-36+6 gestational weeks and less than 32 gestational weeks, which will allow the investigators to compare the results of the pertussis and meningococcal SBA assays when using both standard adult complement and a gestational age appropriate complement source. To do this the investigators will collect cord blood samples from deliveries within the three gestational age groups.

Conditions

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Pertussis Meningococcal Disease Prematurity

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Term babies

Babies who are born at or after 37 gestational weeks.

Cord blood sampling

Intervention Type PROCEDURE

A cord blood sample will be obtained after the baby has been delivered and the cord has been clamped and cut.

Preterm babies

Babies who are born between 32 and 36+6 gestational weeks.

Cord blood sampling

Intervention Type PROCEDURE

A cord blood sample will be obtained after the baby has been delivered and the cord has been clamped and cut.

Very preterm babies

Babies who are born before 32 gestational weeks.

Cord blood sampling

Intervention Type PROCEDURE

A cord blood sample will be obtained after the baby has been delivered and the cord has been clamped and cut.

Interventions

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Cord blood sampling

A cord blood sample will be obtained after the baby has been delivered and the cord has been clamped and cut.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Pregnant and planning to deliver at St George's University Hospitals NHS Foundation Trust

Exclusion Criteria

* Aged less than 16 years
* Known complement deficiency
Minimum Eligible Age

16 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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St George's, University of London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anna Calvert, MBChB

Role: PRINCIPAL_INVESTIGATOR

St George's, Univeristy of London

Locations

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St George's, University of London

London, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Anna Calvert, MBChB

Role: CONTACT

02087253887

Kirsty Le Doare, PhD

Role: CONTACT

02087253887

Facility Contacts

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Anna Calvert, MBChB

Role: primary

02087253887

Vanessa Greening

Role: backup

02087253887

Other Identifiers

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2019.0116

Identifier Type: -

Identifier Source: org_study_id

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