title: Randomized controlled study of the safety and immunogenicity of pneumococcal vaccine formulations containing PhtD and detoxified pneumolysin with alum or adjuvant system AS02V in elderly adults.
abstract: Six vaccine formulations containing AS02V or alum (aluminum phosphate [AlPO4]) adjuvant with pneumococcal proteins, pneumococcal histidine triad D (PhtD), and/or detoxified pneumolysin (dPly), either as a polysaccharide carrier in an 8-valent pneumococcal conjugate vaccine (8PCV) or as free (unconjugated) proteins, were evaluated in adults -65 to 85 years of age. In this phase I observer-blind study, 167 healthy subjects were randomized to receive two doses (days 0 and 60) of 10 or 30 μg PhtD-dPly plus AS02V or alum, 8PCV plus AS02V or alum, or one dose (day 0) of 23-valent polysaccharide pneumococcal vaccine (23PPV) as a control (placebo on day 60). The safety, reactogenicity, and antibody-specific responses to these vaccines were evaluated. No vaccine-related serious adverse events were reported. The incidences of solicited local and specific general (fatigue and myalgia) symptoms tended to be higher in the AS02V groups than in other groups. Anti-PhtD and anti-Ply antibody responses were observed in all groups except the control group. One month post-dose 2, the anti-PhtD and anti-Ply antibody geometric mean concentrations tended to be higher with AS02V than with alum, higher with a dose of 30 μg than with 10 μg for PhtD-dPly and higher with 30-μg PhtD-dPly formulations than with conjugated PhtD and dPly (8PCV) formulations. Functional antibody responses, measured by an opsonophagocytic activity assay, tended to be higher with 8PCV than with 23PPV. In conclusion, vaccine formulations containing free or conjugated PhtD and dPly had acceptable reactogenicity and safety profiles in elderly adults. Immune responses were enhanced with an AS02V-adjuvanted formulation containing free 30-μg PhtD-dPly compared to those with alum adjuvant and conjugated proteins. (This study has been registered at ClinicalTrials.gov under registration no. NCT00756067.).
authors.affiliation: Department of Infectious Diseases, Uppsala University Hospital, Akademiska Sjukhuset, Uppsala, Sweden.
authors.forename: Karlis
authors.initials: K
authors.lastname: Pauksens
authors.forename: Anna C
authors.initials: AC
authors.lastname: Nilsson
authors.forename: Magalie
authors.initials: M
authors.lastname: Caubet
authors.forename: Thierry G
authors.initials: TG
authors.lastname: Pascal
authors.forename: Pascale
authors.initials: P
authors.lastname: Van Belle
authors.forename: Jan T
authors.initials: JT
authors.lastname: Poolman
authors.forename: Pierre G
authors.initials: PG
authors.lastname: Vandepapelière
authors.forename: Vincent
authors.initials: V
authors.lastname: Verlant
authors.forename: Peter E
authors.initials: PE
authors.lastname: Vink
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects*; D000368:Aged; D000369:Aged, 80 and over; D000534:Alum Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology*; D001426:Bacterial Proteins / Q000276:immunology; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009895:Opsonin Proteins / Q000097:blood; D010587:Phagocytosis; D010919:Placebos / Q000008:administration & dosage; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology*; D012503:Saponins / Q000008:administration & dosage / Q000009:adverse effects*; D016037:Single-Blind Method; D013301:Streptolysins / Q000276:immunology*; D022223:Vaccines, Subunit / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology
chemical_list: D000276:Adjuvants, Immunologic; D000534:Alum Compounds; D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D009895:Opsonin Proteins; D010919:Placebos; D022242:Pneumococcal Vaccines; D012503:Saponins; D013301:Streptolysins; D022223:Vaccines, Subunit; C032290:plY protein, Streptococcus pneumoniae; C041524:aluminum sulfate