A Phase I Clinical Study of a Live Attenuated Bordetella pertussis Vaccine - BPZE1; A Single Centre, Double-Blind, Placebo-Controlled, Dose-Escalating Study of BPZE1 Given Intranasally to Healthy Adult Male Volunteers

• Published in: PloS one Vol. 9; no. 1; p. e83449
• Main Authors: Thorstensson, Rigmor, Trollfors, Birger, Al-Tawil, Nabil, Jahnmatz, Maja, Bergström, Jakob, Ljungman, Margaretha, Törner, Anna, Wehlin, Lena, Van Broekhoven, Annie, Bosman, Fons, Debrie, Anne-Sophie, Mielcarek, Nathalie, Locht, Camille
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 08.01.2014; Public Library of Science (PLoS)
• Subjects: Administration, Intranasal; Adult; Adults; Antigens; Attenuation; Bacteria; Biology; Bordetella pertussis; Bordetella pertussis - immunology; Bordetella pertussis - isolation & purification; Clinical trials; Colonization; Colony Count, Microbial; Demography; Disease control; Dosage; Dose-Response Relationship, Immunologic; Double-Blind Method; Double-blind studies; Genetic modification; Genetically modified organisms; Healthy Volunteers; Humans; Immune response; Immunity - immunology; Immunoglobulin G - blood; Infants; Infections; Influenza; Male; Medical research; Medicine; Nasopharynx; Nasopharynx - microbiology; Nasopharynx - pathology; Optimization; Pertussis; Pertussis Vaccine - adverse effects; Pertussis Vaccine - immunology; Pertussis Vaccine - therapeutic use; Placebos; Respiratory tract; Toxins; Vaccination; Vaccines; Vaccines, Attenuated - adverse effects; Vaccines, Attenuated - immunology; Vaccines, Attenuated - therapeutic use; Whooping cough; Whooping Cough - blood; Whooping Cough - immunology; Whooping Cough - microbiology; Whooping Cough - prevention & control; Young Adult; France; Sweden
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0083449

Acellular pertussis vaccines do not control pertussis. A new approach to offer protection to infants is necessary. BPZE1, a genetically modified Bordetella pertussis strain, was developed as a live attenuated nasal pertussis vaccine by genetically eliminating or detoxifying 3 toxins. We performed a double-blind, placebo-controlled, dose-escalating study of BPZE1 given intranasally for the first time to human volunteers, the first trial of a live attenuated bacterial vaccine specifically designed for the respiratory tract. 12 subjects per dose group received 10³, 10⁵ or 10⁷ colony-forming units as droplets with half of the dose in each nostril. 12 controls received the diluent. Local and systemic safety and immune responses were assessed during 6 months, and nasopharyngeal colonization with BPZE1 was determined with repeated cultures during the first 4 weeks after vaccination. Colonization was seen in one subject in the low dose, one in the medium dose and five in the high dose group. Significant increases in immune responses against pertussis antigens were seen in all colonized subjects. There was one serious adverse event not related to the vaccine. Other adverse events were trivial and occurred with similar frequency in the placebo and vaccine groups. BPZE1 is safe in healthy adults and able to transiently colonize the nasopharynx. It induces immune responses in all colonized individuals. BPZE1 can thus undergo further clinical development, including dose optimization and trials in younger age groups. ClinicalTrials.gov NCT01188512.