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Enrolling by invitationNCT06266754Updated Feb 20, 2024

The Non-Specific Immunological Effects of Providing Oral Polio Vaccine to Seniors in Guinea-Bissau

A Phase 4 interventional study of Oral polio vaccine and Placebo in Vaccine Reaction, sponsored by Bandim Health Project. Enrolling by invitation at 1 site in Guinea-Bissau. Open to male participants aged 50 Years to 120 Years. Per ClinicalTrials.gov, last updated 2024-02-20.

Sponsored by Bandim Health Project · Phase 4, Interventional, and Prevention

Phase
Phase 4
Study type
Interventional
Enrollment
80
Allocation
Randomized
Ages
50 Years to 120 Years
Sex
Male
01

Study summary

OPV is the live attenuated vaccine against polio virus. OPV has been key in almost eradicating polio infection. Intriguingly, OPV has been associated with lower all-cause mortality and morbidity. These beneficial OPV effects were seen in contexts with no circulating polio virus and thus have nothing to do with the specific effects of OPV against polio infection. They have been coined "non-specific effects" (NSEs). Such NSEs have also been observed for other live attenuated vaccines such as BCG vaccine and measles vaccine. The underlying immunological mechanisms are unknown. Other live vaccines with beneficial NSEs have been shown to induce epigenetic changes leading to "trained immunity". They have also been associated with decreased inflammation. In the present study it will be investigates whether OPV can induce trained immunity, reduce inflammation, and induce epigenetic modifications of the innate immune cells in senior citizens in Guinea-Bissau.

Read the detailed description

The aim is to study the non-specific immunological effects of providing a single dose of OPV to seniors aged 50 and above in Guinea-Bissau:

Hypotheses

  1. OPV induces innate immune training (substudy A)
  2. OPV is associated with reduced systemic inflammation (substudy A)
  3. OPV induces epigenetic modifications of the innate immune cells (substudy B)

Setting: Bandim Health Project (BHP)'s Health and Demographic Surveillance System (HDSS) in Bissau.

Design: Individually randomized trial in BHP's study area. Participants will be randomized 1:1 to OPV or placebo. To limit the amount of blood drawn from one single participant, two substudies with similar design will be conducted, with two different outcomes.

The outcomes of the two substudies will be as follows:

Substudy A: Immunological impact of OPV. Study the stimulation of cytokine production by heterologous stimuli as a biomarker of trained immunity induction and circulating biomarkers as a mirror of systemic inflammation induced by OPV.

Substudy B: Transcriptional and epigenetic reprogramming of immune cells by OPV. Study the transcriptional and epigenetic rewiring of immune cells induced by OPV by single-cell ATAC-Sequencing and RNA-Sequencing.

02

Conditions studied

  • Vaccine Reaction

Keywords

  • Oral polio vaccine
  • Trained immunity
03

Who can participate

Ages eligible
50 Years to 120 Years
Sexes eligible
Male
Accepts healthy volunteers
No

Inclusion criteria

  • Male.
  • Living in a household which had a Bandim Health Project census visit conducted after 1 January 2017.
  • Age above 50.
  • Has a visible BCG scar.

Exclusion criteria

Exclusion Criteria:

  • Previous adverse events to OPV
  • Suspicion of active viral/bacterial/HIV infection.
04

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
80 participants (estimated)

Study arms

  • Experimental
    Oral polio vaccine

    Oral polio vaccine, 2 drops on a sugar lump

    Biological: Oral polio vaccine

  • Placebo comparator
    Placebo

    Saline, 2 drops on a sugar lump

    Other: Placebo

Interventions

  • BiologicalOral polio vaccine

    Standard oral polio vaccine

  • OtherPlacebo

    Saline 0.9%

05

What researchers measure

Primary outcomes

  1. Levels of in vitro proinflammatory cytokines such as IL1-beta, TNF-alfa and IFN-gamma after stimulation of peripheral blood mononuclear cells with non-OPV antigens and mitogens

    Study the ability of cells of producing cytokines in vitro after heterologous stimuli. This is a well-established biomarker of trained immunity (ref: https://pubmed.ncbi.nlm.nih.gov/38198850/).

    Time frame: 1 month after the intervention

  2. Levels of plasma markers of systemic inflammation such as TNF ligand superfamily member 12 (TWEAK) and sirtuin 2 (SIRT2)

    Study the effect on systemic inflammation induced by OPV. Previous studies have shown that BCG reduce up to a third of proinflammatory proteins as a marker of non-specific effects of that vaccine, we will study if this is the case also for OPV (ref:https://pubmed.ncbi.nlm.nih.gov/32692728/).

    Time frame: 1 month after the intervention

  3. Amount of pseudo-bulk ATACseq and RNAseq - indicating chromatin accessibility of interferon-stimulated genes associated with the interferon response pathway in PBMCs.

    Study the epigenetic rewiring of immune cells induced by OPV by single-cell ATAC-Sequencing and whole-genome methylation assays. This is a new method to assess if there has been changes to the accessibility of the genes (ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9022455/).

    Time frame: 1 month after the intervention

  4. Proportions of immune cell subsets

    Study the transcriptional effects of OPV on immune cell by studying the transcriptional rewiring of immune cells induced by OPV by single-cell RNA-Sequencing (ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9022455/).

    Time frame: 1 month after the intervention

06

Study locations

1 site
  • Bandim Health Project, Apartado 861
    Bissau, Guinea-Bissau
07

References and documents

Individual participant data

Plan to share: No — We collect sensitive data that cannot immediately be shared.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT06266754
Lead sponsor
Bandim Health Project
Collaborators
Radboud University Medical Center
Responsible party
Sponsor
First posted
Feb 20, 2024
Start date
Jan 29, 2024
Primary completion
Jul 31, 2024 (estimated)
Completion
Dec 31, 2024 (estimated)
Last update
Feb 20, 2024

Study contacts

Anne Marie R Madsen, MD, PhD
principal investigator · Bandim Health Project

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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