A Phase 1 interventional study of Shigella sonnei 53G and Ciprofloxacin 500 mg in Shigellosis, sponsored by University of Oxford. Recruiting at 1 site in Kenya. Open to participants aged 18 Years to 45 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-03-13.
Sponsored by University of Oxford · Phase 1, Interventional, and Basic science
Diarrhoea caused by Shigella (shigellosis) is of major public health importance. However, there are no licensed Shigella vaccines in routine use, with several candidates still in various stages of clinical development. Shigella human infection studies (HIS) have played a key role in vaccine development. These models also allow for the evaluation of immunity and other non-immunological parameters that are important to understand resistance and/or susceptibility to disease. This is particularly useful in individuals from endemic areas with varying levels of prior exposure and immunity to Shigella. Thus, establishing a Shigella HIS would enable the testing of interventions such as vaccines in a population that would most benefit from a subsequent vaccine and has potential to accelerate vaccine development. Here, the goal is to successfully establish a Shigella sonnei human infection model in Kenyan adults. This will be achieved by conducting dose-finding and dose verification Shigella studies that safely and reproducibly induce ≥60% attack rates. In this study, investigators aim to use Shigella HIS in healthy adults to develop a model as a platform to test vaccines, to study immune responses identifying potential correlates of infection, and non-immunological factors mediating and influencing susceptibility to disease. To achieve this, the study will be carried out in two phases over a period of 12-14 months. Phase A will enroll (N=up to 40 volunteers) and Phase B will enroll an additional (N=30 volunteers). To be eligible to receive a dose of 53G, volunteers must pass the screening visit. Investigators will vary the dose of bacteria in individuals enrolled for challenge to identify the dose needed to cause ≥60% shigellosis (attack rate) (Phase A) followed by testing and demonstrate the reproducibility of the model (Phase B). Thus, the main outcomes of the study will be: (1) optimisation of bacterial dose for infection success (≥60% attack rate); and (2) safety.
This is a Phase 1 dose finding and dose verification study which will be used to determine the dose of S. sonnei 53G that induces the primary outcome in approximately ≥60% of Kenyan adult volunteers. This study will occur in two phases, Phase A (dose-finding) with up to 40 volunteers challenged with 53G and Phase B (dose verification) with N=30 volunteers planned to be administered 53G. Based on previously published data using this model, 1,500 colony-forming units (CFU) will be the dose administered to the first cohort. Dosing of subsequent cohorts will depend on results of the previous cohort. If a lower-than-expected attack rate (AR) occurs, the dose for the next cohort will be increased by 500 CFU. Conversely, if the AR is higher than expected the dose for the next cohort will be decreased by 500 CFU. Cohorts of volunteers will continue to be challenged until either; a dose that reproducibly causes infection in at least 60% of volunteers; safety precludes continuing (>90% AR at 500 CFU) or futility (an AR of 60% is unable to be achieved, even with a 3000 CFU dose). It may take more or less than 3 dose-finding groups to find the optimal dose for which the primary outcome (shigellosis) is achieved in approximately ≥60% of the volunteers and thus the total number of volunteers enrolled in both phases may be less or more than N=60. Once the optimal dose is established in Phase A, that dose will be carried forward for verification in Phase B. For Phase B, dose verification groups of 30 volunteers (2 cohorts of 15 volunteers per cohort) will be conducted to verify the AR with the chosen dose. The dose finding and verification stages will be done in a staggered fashion in case the dose needs to be adjusted, resulting in approximately 5 cohorts to be enrolled over time. Allocation into the groups will be on "first come first served basis" with no randomization occurring for enrolment in any of the cohorts.
61 studies on the registry are indexed under Dysentery, Bacillary; 6 are open to participants now.
This study's planned enrollment of 70 is close to the median of 76 across 54 interventional studies indexed under Dysentery, Bacillary.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.
Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
The human immunodeficiency virus, which weakens the immune system.
Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.
Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.
Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.
Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.
After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.
Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.
A drug or device being studied in a clinical trial.
It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.
Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraception
Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.
Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Immunosuppression
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
HIV
The human immunodeficiency virus, which weakens the immune system.
Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Hepatitis B tests
Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.
Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Hepatitis C tests
Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.
After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Clinically significant
Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Investigational drug or device
A drug or device being studied in a clinical trial.
It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Live vaccines
Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Dose finding group Group 1 will receive lyophilised S. sonnei 53G strain at a dose of 1500CFU. Group 1 will receive curative treatment of Ciprofloxacin.
Biological: Shigella sonnei 53G · Drug: Ciprofloxacin 500 mg
Dose finding group Group 2 will receive lyophilised S. sonnei 53G strain at a dose of 2000CFU. Group 2 will receive curative treatment of Ciprofloxacin.
Biological: Shigella sonnei 53G · Drug: Ciprofloxacin 500 mg
Dose finding group Group 3 will receive lyophilised S. sonnei 53G strain at a dose of 2500CFU. Group 3 will receive curative treatment of Ciprofloxacin.
Biological: Shigella sonnei 53G · Drug: Ciprofloxacin 500 mg
Dose finding group Group 4 will receive lyophilised S. sonnei 53G strain at a dose of 3000CFU. Group 4 will receive curative treatment of Ciprofloxacin.
Biological: Shigella sonnei 53G · Drug: Ciprofloxacin 500 mg
Dose verification group Group 5 will receive lyophilised S. sonnei 53G strain at a dose TBD. Group 5 will receive curative treatment of Ciprofloxacin.
Biological: Shigella sonnei 53G · Drug: Ciprofloxacin 500 mg
Dose verification group Group 6 will receive lyophilised S. sonnei 53G strain at a dose TBD. Group 6 will receive curative treatment of Ciprofloxacin.
Biological: Shigella sonnei 53G · Drug: Ciprofloxacin 500 mg
Lyophilized S. sonnei 53G strain (Lot 1794)
Ciprofloxacin (500 mg orally twice daily for three days),
Number of volunteers with solicited adverse events
Occurrence and severity of solicited adverse events (AEs) through 11 days post-challenge. Occurrence, severity, and relatedness of unsolicited AEs through 11 days post-challenge. Occurrence, severity, and relatedness of serious adverse events (SAEs) throughout the entire study. Occurrence of abnormal clinical laboratory values within 11 days post challenge. Percent of volunteers with nausea, vomiting, anorexia, abdominal pain/cramps rated as moderate to severe.
Time frame: Through 11 days post challenge
Number of volunteers with an attack rate of ≥60%
Confirmation of the dose with an acceptable safety profile as determined by that gives an attack rate of ≥60% of shigellosis in Kenyan adults.
Time frame: Through 11 days post challenge
Percent of volunteers with
Maximum 24-hour stool output
Time frame: Through 11 days post challenge
Percent of volunteers shedding
Peak shedding levels of the 53G challenge strain (CFUs/g of stool) post-challenge based on the results of quantitative cultures post-challenge
Time frame: Through 11 days post challenge
Kinetics of serum IgA and IgG antibody responses
S. sonnei O-Ag, LPS, IpaB, and IpaC;
Time frame: From baseline to 366 days
Plan to share: Yes — Within 2 years of the study completion date
Supporting information: Study protocol, Statistical analysis plan, Informed consent form, Clinical study report, Analytic code
Time frame: Within 2 years of the study completion date
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Studies of the drug tested here: Shigella sonnei