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信使 RNA 基于的巨细胞病毒疫苗在健康成年人中的安全性和免疫原性:一项 1 期随机临床试验结果。

Safety and Immunogenicity of a Messenger RNA-Based Cytomegalovirus Vaccine in Healthy Adults: Results From a Phase 1 Randomized Clinical Trial.

机构信息

Johnson County Clin-Trials, Department of Clinical Safety & Risk Management, Lenexa, Kansas.

Optimal Research, LLC, Peoria, Illinois.

出版信息

J Infect Dis. 2024 Sep 23;230(3):e668-e678. doi: 10.1093/infdis/jiae114.

Abstract

BACKGROUND

This phase 1 trial evaluated the safety, reactogenicity, and immunogenicity of mRNA-1647, a messenger RNA (mRNA)-based cytomegalovirus (CMV) vaccine, in CMV-seronegative and -seropositive adults.

METHODS

Participants were randomly assigned to receive 30, 90, 180, or 300 µg of mRNA-1647 or placebo on a 0-, 2-, and 6-month schedule and followed for 12 months after the last dose.

RESULTS

A total of 154 (80 CMV-seronegative and 74 CMV-seropositive) participants were enrolled; 118 participants were randomized to mRNA-1647 and 36 to placebo. Mean (standard deviation) age was 32.5 (8.6) and 35.1 (8.9) years in the placebo and mRNA-1647 groups, respectively, in phase B (63% and 64% female) and 42.5 (6.2) and 33.3 (8.7) years, respectively, in phase C (2% and 16% female). No deaths, related serious adverse events, or adverse events of special interest were reported. Most adverse reactions were grade ≤2 severity. Increased neutralizing antibody, binding antibody, and antigen-specific cell-mediated responses were observed across mRNA-1647 treatment groups, regardless of CMV serostatus.

CONCLUSIONS

This phase 1, first-in-human trial demonstrated that mRNA-1647 has an acceptable safety profile in adults and elicits humoral and cellular immune responses. Clinical Trials Registration.  NCT03382405.

摘要

背景

这项 1 期临床试验评估了信使 RNA(mRNA)型巨细胞病毒(CMV)疫苗 mRNA-1647 在 CMV 阴性和阳性成人中的安全性、反应原性和免疫原性。

方法

参与者按 0、2 和 6 个月的时间表随机分配接受 30、90、180 或 300μg 的 mRNA-1647 或安慰剂,并在最后一次给药后随访 12 个月。

结果

共纳入 154 名(80 名 CMV 阴性和 74 名 CMV 阳性)参与者;118 名参与者被随机分配至 mRNA-1647 组,36 名参与者被分配至安慰剂组。在 B 期(63%和 64%为女性)中,安慰剂组和 mRNA-1647 组的参与者平均(标准差)年龄分别为 32.5(8.6)和 35.1(8.9)岁,在 C 期(2%和 16%为女性)中分别为 42.5(6.2)和 33.3(8.7)岁。没有死亡、相关严重不良事件或不良事件。大多数不良反应为 1 级或 2 级严重程度。无论 CMV 血清状态如何,mRNA-1647 治疗组均观察到中和抗体、结合抗体和抗原特异性细胞介导的反应增加。

结论

这项 1 期首次人体试验表明,mRNA-1647 在成人中具有可接受的安全性,并能引发体液和细胞免疫反应。临床试验注册。NCT03382405。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a9c/11420795/c2f073cc5921/jiae114_ga.jpg

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