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大流行前A/H5N2流感减毒活候选疫苗在成年志愿者中的临床试验:一项安慰剂对照、随机双盲I期研究的结果

Clinical testing of pre-pandemic live attenuated A/H5N2 influenza candidate vaccine in adult volunteers: results from a placebo-controlled, randomized double-blind phase I study.

作者信息

Rudenko Larisa, Kiseleva Irina, Stukova Marina, Erofeeva Marianna, Naykhin Anatoly, Donina Svetlana, Larionova Natalie, Pisareva Maria, Krivitskaya Vera, Flores Jorge

机构信息

Department of Virology, Institute of Experimental Medicine, 197376 St Petersburg, Russia.

Department of Virology, Institute of Experimental Medicine, 197376 St Petersburg, Russia.

出版信息

Vaccine. 2015 Sep 22;33(39):5110-7. doi: 10.1016/j.vaccine.2015.08.019. Epub 2015 Aug 19.

Abstract

BACKGROUND

This study describes a double-blinded randomized placebo-controlled phase I clinical trial of A/H5N2 live attenuated influenza vaccine in healthy volunteers.

METHODS

Two doses of vaccine or placebo were administered intranasally to 30 and 10 subjects, respectively. Nasal swabs were examined for vaccine shedding and local antibody responses; serum samples were tested for binding, hemagglutinating and neutralizing antibodies and peripheral blood mononuclear cells were tested for cell-mediated immune responses.

RESULTS

The vaccine was well tolerated and not associated with increased rates of adverse events or the occurrence of serious adverse events. Influenza virus was detected in nasal swabs on the first day in the majority of volunteers (93%), while 17% of volunteers tested positive on the second, none on the third day or later following the first vaccination; lower frequency of shedding was observed after the second vaccination. The vaccine was immunogenic as assessed four weeks after the second dose, with 37.9% and 48.3% of subjects seroconverting by hemagglutination inhibition and neutralization assays, respectively. An immune response was observed in 96.6% subjects that received A/H5N2 LAIV in at least one of the assays conducted. None of the placebo recipients exhibited a response in any of the assays.

CONCLUSION

The A/H5N2 vaccine was safe, well tolerated, and immunogenic in healthy adults.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01719783.

摘要

背景

本研究描述了一项针对健康志愿者的A/H5N2减毒活流感疫苗双盲随机安慰剂对照I期临床试验。

方法

分别向30名和10名受试者鼻内给予两剂疫苗或安慰剂。检测鼻拭子中的疫苗排毒情况和局部抗体反应;检测血清样本中的结合抗体、血凝抗体和中和抗体,并检测外周血单核细胞的细胞介导免疫反应。

结果

该疫苗耐受性良好,与不良事件发生率增加或严重不良事件的发生无关。大多数志愿者(93%)在首次接种疫苗后的第一天鼻拭子中检测到流感病毒,而17%的志愿者在第二天检测呈阳性,首次接种后第三天及以后无人呈阳性;第二次接种后观察到较低的排毒频率。在第二次接种后四周评估时,该疫苗具有免疫原性,血凝抑制试验和中和试验中分别有37.9%和48.3%的受试者血清阳转。在至少一项检测中,96.6%接受A/H5N2减毒活流感疫苗的受试者观察到免疫反应。安慰剂组受试者在任何检测中均未出现反应。

结论

A/H5N2疫苗在健康成年人中安全、耐受性良好且具有免疫原性。

试验注册

ClinicalTrials.gov NCT01719783。

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