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2017-05-12Zeitschriftenartikel DOI: 10.1371/journal.pntd.0005527
A third generation vaccine for human visceral leishmaniasis and post kala azar dermal leishmaniasis: First-in-human trial of ChAd63-KH
dc.contributor.authorOsman, Mohamed
dc.contributor.authorMistry, Anoop
dc.contributor.authorKeding, Ada
dc.contributor.authorGabe, Rhian
dc.contributor.authorCook, Elizabeth
dc.contributor.authorForrester, Sarah
dc.contributor.authorWiggins, Rebecca
dc.contributor.authorMarco, Stefania Di
dc.contributor.authorColloca, Stefano
dc.contributor.authorSiani, Loredana
dc.contributor.authorCortese, Riccardo
dc.contributor.authorSmith, Deborah F.
dc.contributor.authorAebischer, Toni
dc.contributor.authorKaye, Paul M.
dc.date.accessioned2018-05-07T20:14:06Z
dc.date.available2018-05-07T20:14:06Z
dc.date.created2017-07-13
dc.date.issued2017-05-12none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/re7Wo1cnwTqmI/PDF/29FL5e9GFDkgQ.pdf
dc.identifier.urihttp://edoc.rki.de/176904/2709
dc.description.abstractBackground: Visceral leishmaniasis (VL or kala azar) is the most serious form of human leishmaniasis, responsible for over 20,000 deaths annually, and post kala azar dermal leishmaniasis (PKDL) is a stigmatizing skin condition that often occurs in patients after successful treatment for VL. Lack of effective or appropriately targeted cell mediated immunity, including CD8+ T cell responses, underlies the progression of VL and progression to PKDL, and can limit the therapeutic efficacy of anti-leishmanial drugs. Hence, in addition to the need for prophylactic vaccines against leishmaniasis, the development of therapeutic vaccines for use alone or in combined immuno-chemotherapy has been identified as an unmet clinical need. Here, we report the first clinical trial of a third-generation leishmaniasis vaccine, developed intentionally to induce Leishmania-specific CD8+ T cells. Methods: We conducted a first-in-human dose escalation Phase I trial in 20 healthy volunteers to assess the safety, tolerability and immunogenicity of a prime-only adenoviral vaccine for human VL and PKDL. ChAd63-KH is a replication defective simian adenovirus expressing a novel synthetic gene (KH) encoding two Leishmania proteins KMP-11 and HASPB. Uniquely, the latter was engineered to reflect repeat domain polymorphisms and arrangements identified from clinical isolates. We monitored innate immune responses by whole blood RNA-Seq and antigen specific CD8+ T cell responses by IFNγ ELISPOT and intracellular flow cytometry. Findings: ChAd63-KH was safe at intramuscular doses of 1x1010 and 7.5x1010 vp. Whole blood transcriptomic profiling indicated that ChAd63-KH induced innate immune responses characterized by an interferon signature and the presence of activated dendritic cells. Broad and quantitatively robust CD8+ T cell responses were induced by vaccination in 100% (20/20) of vaccinated subjects. Conclusion: The results of this study support the further development of ChAd63-KH as a novel third generation vaccine for VL and PKDL.eng
dc.language.isoeng
dc.publisherRobert Koch-Institut, Infektionskrankheiten / Erreger
dc.subject.ddc610 Medizin
dc.titleA third generation vaccine for human visceral leishmaniasis and post kala azar dermal leishmaniasis: First-in-human trial of ChAd63-KH
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-10053428
dc.identifier.doi10.1371/journal.pntd.0005527
dc.identifier.doihttp://dx.doi.org/10.25646/2634
local.edoc.container-titlePLoS Neglected Tropical Diseases
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttp://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005527
local.edoc.container-publisher-namePublic Library of Science
local.edoc.container-volume11
local.edoc.container-issue5
local.edoc.container-year2017

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