Safety and immunogenicity of a live oral recombinant cholera vaccine VA1.4: a randomized, placebo controlled trial in healthy adults in a cholera endemic area in Kolkata, India.

BACKGROUND: A live oral cholera vaccine VA 1.4 developed from a non-toxigenic Vibrio cholerae O1 El Tor strain using ctxB gene insertion was further developed into a clinical product following cGMP and was evaluated in a double-blind randomized placebo controlled parallel group two arm trial with al...

Full description

Bibliographic Details
Main Authors: Suman Kanungo, Bandana Sen, Thandavarayan Ramamurthy, Dipika Sur, Byomkesh Manna, Gururaja P Pazhani, Goutam Chowdhury, Puja Jhunjhunwala, Ranjan K Nandy, Hemanta Koley, Mihir Kumar Bhattacharya, Sanjay Gupta, Gaurav Goel, Bindu Dey, Thungapathra M, G Balakrish Nair, Amit Ghosh, Dilip Mahalanabis
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4077646?pdf=render
_version_ 1819260988745056256
author Suman Kanungo
Bandana Sen
Thandavarayan Ramamurthy
Dipika Sur
Byomkesh Manna
Gururaja P Pazhani
Goutam Chowdhury
Puja Jhunjhunwala
Ranjan K Nandy
Hemanta Koley
Mihir Kumar Bhattacharya
Sanjay Gupta
Gaurav Goel
Bindu Dey
Thungapathra M
G Balakrish Nair
Amit Ghosh
Dilip Mahalanabis
author_facet Suman Kanungo
Bandana Sen
Thandavarayan Ramamurthy
Dipika Sur
Byomkesh Manna
Gururaja P Pazhani
Goutam Chowdhury
Puja Jhunjhunwala
Ranjan K Nandy
Hemanta Koley
Mihir Kumar Bhattacharya
Sanjay Gupta
Gaurav Goel
Bindu Dey
Thungapathra M
G Balakrish Nair
Amit Ghosh
Dilip Mahalanabis
author_sort Suman Kanungo
collection DOAJ
description BACKGROUND: A live oral cholera vaccine VA 1.4 developed from a non-toxigenic Vibrio cholerae O1 El Tor strain using ctxB gene insertion was further developed into a clinical product following cGMP and was evaluated in a double-blind randomized placebo controlled parallel group two arm trial with allocation ratio of 1∶1 for safety and immunogenicity in men and women aged 18-60 years from Kolkata, India. METHOD: A lyophilized dose of 1.9×109 CFU (n = 44) or a placebo (n = 43) reconstituted with a diluent was administered within 5 minutes of drinking 100 ml of a buffer solution made of sodium bicarbonate and ascorbic acid and a second dose on day 14. RESULT: The vaccine did not elicit any diarrhea related adverse events. Other adverse events were rare, mild and similar in two groups. One subject in the vaccine group excreted the vaccine strain on the second day after first dose. The proportion of participants who seroconverted (i.e. had 4-folds or higher rise in reciprocal titre) in the vaccine group were 65.9% (95% CI: 50.1%-79.5%) at both 7 days (i.e. after 1st dose) and 21 days (i.e. after 2nd dose). None of the placebo recipients seroconverted. Anti-cholera toxin antibody was detected in very few recipients of the vaccine. CONCLUSION: This study demonstrates that VA 1.4 at a single dose of 1.9×109 is safe and immunogenic in adults from a cholera endemic region. No additional benefit after two doses was seen. TRIAL REGISTRATION: Clinical Trials Registry-India, National Institute of Medical Statistics (Indian Council of Medical Research) CTRI/2012/04/002582.
first_indexed 2024-12-23T19:34:39Z
format Article
id doaj.art-872fc9c11e9943b38abe9d44f36de578
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-23T19:34:39Z
publishDate 2014-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-872fc9c11e9943b38abe9d44f36de5782022-12-21T17:33:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0197e9938110.1371/journal.pone.0099381Safety and immunogenicity of a live oral recombinant cholera vaccine VA1.4: a randomized, placebo controlled trial in healthy adults in a cholera endemic area in Kolkata, India.Suman KanungoBandana SenThandavarayan RamamurthyDipika SurByomkesh MannaGururaja P PazhaniGoutam ChowdhuryPuja JhunjhunwalaRanjan K NandyHemanta KoleyMihir Kumar BhattacharyaSanjay GuptaGaurav GoelBindu DeyThungapathra MG Balakrish NairAmit GhoshDilip MahalanabisBACKGROUND: A live oral cholera vaccine VA 1.4 developed from a non-toxigenic Vibrio cholerae O1 El Tor strain using ctxB gene insertion was further developed into a clinical product following cGMP and was evaluated in a double-blind randomized placebo controlled parallel group two arm trial with allocation ratio of 1∶1 for safety and immunogenicity in men and women aged 18-60 years from Kolkata, India. METHOD: A lyophilized dose of 1.9×109 CFU (n = 44) or a placebo (n = 43) reconstituted with a diluent was administered within 5 minutes of drinking 100 ml of a buffer solution made of sodium bicarbonate and ascorbic acid and a second dose on day 14. RESULT: The vaccine did not elicit any diarrhea related adverse events. Other adverse events were rare, mild and similar in two groups. One subject in the vaccine group excreted the vaccine strain on the second day after first dose. The proportion of participants who seroconverted (i.e. had 4-folds or higher rise in reciprocal titre) in the vaccine group were 65.9% (95% CI: 50.1%-79.5%) at both 7 days (i.e. after 1st dose) and 21 days (i.e. after 2nd dose). None of the placebo recipients seroconverted. Anti-cholera toxin antibody was detected in very few recipients of the vaccine. CONCLUSION: This study demonstrates that VA 1.4 at a single dose of 1.9×109 is safe and immunogenic in adults from a cholera endemic region. No additional benefit after two doses was seen. TRIAL REGISTRATION: Clinical Trials Registry-India, National Institute of Medical Statistics (Indian Council of Medical Research) CTRI/2012/04/002582.http://europepmc.org/articles/PMC4077646?pdf=render
spellingShingle Suman Kanungo
Bandana Sen
Thandavarayan Ramamurthy
Dipika Sur
Byomkesh Manna
Gururaja P Pazhani
Goutam Chowdhury
Puja Jhunjhunwala
Ranjan K Nandy
Hemanta Koley
Mihir Kumar Bhattacharya
Sanjay Gupta
Gaurav Goel
Bindu Dey
Thungapathra M
G Balakrish Nair
Amit Ghosh
Dilip Mahalanabis
Safety and immunogenicity of a live oral recombinant cholera vaccine VA1.4: a randomized, placebo controlled trial in healthy adults in a cholera endemic area in Kolkata, India.
PLoS ONE
title Safety and immunogenicity of a live oral recombinant cholera vaccine VA1.4: a randomized, placebo controlled trial in healthy adults in a cholera endemic area in Kolkata, India.
title_full Safety and immunogenicity of a live oral recombinant cholera vaccine VA1.4: a randomized, placebo controlled trial in healthy adults in a cholera endemic area in Kolkata, India.
title_fullStr Safety and immunogenicity of a live oral recombinant cholera vaccine VA1.4: a randomized, placebo controlled trial in healthy adults in a cholera endemic area in Kolkata, India.
title_full_unstemmed Safety and immunogenicity of a live oral recombinant cholera vaccine VA1.4: a randomized, placebo controlled trial in healthy adults in a cholera endemic area in Kolkata, India.
title_short Safety and immunogenicity of a live oral recombinant cholera vaccine VA1.4: a randomized, placebo controlled trial in healthy adults in a cholera endemic area in Kolkata, India.
title_sort safety and immunogenicity of a live oral recombinant cholera vaccine va1 4 a randomized placebo controlled trial in healthy adults in a cholera endemic area in kolkata india
url http://europepmc.org/articles/PMC4077646?pdf=render
work_keys_str_mv AT sumankanungo safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT bandanasen safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT thandavarayanramamurthy safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT dipikasur safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT byomkeshmanna safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT gururajappazhani safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT goutamchowdhury safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT pujajhunjhunwala safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT ranjanknandy safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT hemantakoley safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT mihirkumarbhattacharya safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT sanjaygupta safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT gauravgoel safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT bindudey safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT thungapathram safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT gbalakrishnair safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT amitghosh safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia
AT dilipmahalanabis safetyandimmunogenicityofaliveoralrecombinantcholeravaccineva14arandomizedplacebocontrolledtrialinhealthyadultsinacholeraendemicareainkolkataindia