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Virus DiseasesMOSAICNCT04046978

Modelling the Interaction Between Synthetic Model Immunogens and the Induced B and T Cell Repertoires.

A study testing ConM SOSIP 50 ug and ConS UFO 50 ug, Mos3.1 100 ug and Mos3.2 100 ug in people with Virus Diseases, run by Imperial College London at 1 site in United Kingdom.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

MOSAIC is a single-blind experimental medicine study to determine the extent to which different prime-boost combinations of model immunogens based on HIV-1 envelope proteins influence the diversity of B and T cell responses. Read more about this study

Who is it for?
Ages 18 to 55 yearsHealthy volunteers can take part
Conditions the study is for
Virus Diseases
What is being tested?
ConM SOSIP 50 ug and ConS UFO 50 ug, Mos3.1 100 ug and Mos3.2 100 ug
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
1 siteUnited Kingdom
Study dates
11 Dec 2019to 31 Dec 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 55 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Healthy male and female volunteers aged between 18 and 55 years.
  • Available for ALL follow-up visits for the duration of the study.
  • Entered and clearance obtained from The Over volunteering Prevention System (TOPS) database (to avoid impact of any co-administered investigational products or treatments on our outcomes).
  • Women capable of becoming pregnant willing to take hormonal contraception or use an intrauterine device, or agree to complete abstinence (when in line with their preferred and usual lifestyle) for the duration of the study. Periodic abstinence (calendar, symptothermal and post-ovulation methods) and withdrawal are not acceptable methods of contraception.
  • Willing and able to give written informed consent.

Who cannot join

  • History of any medical, psychological or other condition, clinically significant laboratory result at screening, or use of any medications which, in the opinion of the investigators, would interfere with the study objectives or volunteers safety.
  • HIV-1 or HIV-2 antibody positive or indeterminate upon screening, or history of receipt of Env-based HIV immunogens (which would render the volunteers non-naive to the model immunogens).
  • Unable to read and/or speak English to a fluency level adequate for the full comprehension of study procedures and consent.

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • NIHR Imperial Clinical Research Facility

    London, Please Select..., W12 0HS

Other trials in United Kingdom

About this study

Official title: An Experimental Medicine Study Modelling the Interaction Between Rationally-designed Synthetic Model Viral Protein Immunogens and the Breadth of the Induced B and T Cell Repertoires.

MOSAIC is a single-blind experimental medicine study to determine the extent to which different prime-boost combinations of model immunogens based on HIV-1 envelope proteins influence the diversity of B and T cell responses.

Read the detailed description

One of the most effective arms of the human immune system is the ability of very low concentrations of antibody proteins to bind to viruses, bacteria and toxins and "neutralise" their activity or ability to infect. In contrast to cellular immunity, which may cause tissue destruction and pathology, antibody-mediated immunity can be very passive, while completely preventing infection. How antibodies bind their targets varies enormously, ranging from unhelpful "blocking" antibodies or narrowly focussed neutralising antibodies, to highly protective "broadly neutralising" antibodies (bNAbs) that can neutralise a wide range of strains of the same pathogen. Such bNAbs are especially sought after in virus infections such as HIV, influenza and others where the virus mutates to evade immune responses that are too narrow or focussed. Antibodies arise when an "immunogen" (an immunogen is anything that induces an immune response, typically a foreign protein) is taken up by the immune system and shown to white blood cells - T and B cells - by specialised immune cells. In some cases the T and B cells bind the immunogens to receptors on their surface, triggering an immune response in which T cells "help" B cells to manufacture specific antibodies. The events around how the protein is processed into manageable pieces, shown to the T and B cells, and the pattern of chemical signals produced by the immune cells is highly complex, but eventually determines how broad the antibody response will be (its breadth). For infections like HIV and influenza, decades of research and clinical vaccine trials have had limited or no success. To take HIV as an example, we have an almost complete lack of understanding of how immunogens interact with the naive human B cell receptor (BCR) repertoire and the pathways required to induce bNAbs during an infection or after an immunisation. Animal models have failed as the naïve, germline encoded, B cell antibody receptor repertoires of non-human species are sufficiently different from those of humans to render design and selection of vaccine based on non-human species problematic. Additionally, bNAbs isolated from HIV-1-infected individuals have structural features that occur rarely or not at all in other mammals, such as unusually long loop-binding regions (CDRH3 loops) required to penetrate past glycans on the surface of the envelope spike that shield key neutralising epitopes (Mascola JR 2013). There is therefore a critical need to better understand, in human experimental medicine models of immune challenge, how immunogens and B/T cells interact in the development of protective bNAb anti-viral responses.

Our approach to resolving this impasse is to challenge the human immune system with rationally-designed model immunogens to determine the structural and other characteristics required to drive human B cell antibody responses towards neutralisation breadth. We have selected HIV as an experimental model as there is a reasonable understanding about the specificity and function of anti-HIV bNAbs, as well as an urgent need to identify novel immunisation approaches following decades of failed or poorly successful trials. There is also a huge database of safety using HIV proteins as immunogens, and the technological expertise to design and manufacture HIV viral proteins. Assays for HIV neutralising activity are also well established in our laboratories. Although focussed on HIV, our findings will be applicable to other viral infections.

The model immunogens we propose to use in these experimental medicine studies are unlikely to be suitable as vaccines, and any clinical development would require iterative cycles of design refinement and development based on immunological insights gleaned from these experimental investigations. Therefore, the focus is on in-depth characterisation of the elicited immune response to rationally-designed model immunogens that may inform the design process of actual vaccines. This experimental medicine approach is only now possible due to unprecedented progress in our abilities to study the human immune system and to obtain complete information on immune responses to vaccination, since performing research on the human immune system is now almost as easy as it has been in mice. The main focus of this study will be to determine which of the design strategies is able to prime human germline (naive) B cells and drive antibody responses towards induction of neutralising antibody breadth.

Our range of model immunogens will be based on the envelope (Env) glycoprotein of HIV-1, which is the only target of neutralising antibodies, and therefore the only virally-encoded immunogen relevant for induction of such antibodies by immunisation. To ensure reproducibility of results and the highest level of volunteer safety, all immunogens will be manufactured under cGMP, using techniques applied to vaccine immunogens.

Env has extensive amino acid variation, structural and conformational instability, and immunodominance of hypervariable regions (Kwong PD, 2011; Sattentau QJ, 2013). We will design soluble immunogens that closely mimic the native viral trimer in situ, but that incorporate design strategies that may alter the intrinsic viral immune evasion mechanisms (Sanders RW, 2013). Env is made up of three identical complexes (trimers) each of which contains two molecules, gp120 and gp41 that can be modified to make a soluble molecule called gp140, upon which our immunogens are based. We have developed model consensus gp140 Env trimers (consensus of all global strains) designed to prime B cell responses to common epitopes represented in all HIV-1 subtypes. We have utilised two design strategies to stabilise these in a native-like conformation: ConM SOSIP and ConS UFO. The ConM SOSIP trimer includes novel mutations that include the incorporation of a disulphide linkage between the gp120 and gp41 ectodomain (making up gp140) which prevents their disassociation into monomer subunits.

The ConS UFO includes a short flexible amino-acid linker to tether the gp120 and gp41 subunits together as an alternative strategy to prevent dissociation of the Env trimer. We wish to test both designs to determine the effect on B cell repertoire.

A critical adjunct to our consensus-based model design is to use a cocktail of three mosaic gp140 Env trimers designed to overcome the immunodominance of hypervariable regions of Env and to determine whether they will focus antibody responses towards conserved neutralisation epitopes. While designed using computer algorithms, these mosaics represent authentic Env structures that are fully functional and native in their conformation. Our novel designs aim to eliminate unwanted immunodominant antibody responses and focus B cells towards highly conserved supersites of vulnerability on Env, with particular emphasis on quaternary bNAb epitopes (Julien, JP, 2013; Kong L, 2013; Lyumkis D, 2013). Like the ConM SOSIP and ConS UFO trimers described above, the mosaic trimers have disulphide linkage which prevents disassociation of gp120 and gp41 into monomer subunits.

In the MOSAIC study groups, we will explore the use of the three mosaic immunogens used sequentially (in a series of different orders), or as a cocktail, to focus B cell responses towards conserved areas of Env. To amplify these responses we intend to give a final boosting immunization with both consensus immunogens (ConM and ConS).

The extent to which these different strategies may induce neutralising breadth, and the identification of the mechanisms and drivers involved, can only be determined empirically through human immunogen challenge studies.

Conditions
Virus Diseases
Being tested
ConM SOSIP 50 ug and ConS UFO 50 ug, Mos3.1 100 ug, Mos3.2 100 ug, Mos3.3 100 ug, Mos3.1 33 ug, Mos3.2 33 ug and Mos3.3 33 ug
Keywords
Virus Diseases
Medical subject headings
Virus Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ConM SOSIP 50 ug and ConS UFO 50 ugOther

    Intramuscular injection of synthetic viral immunogens ConM SOSIP and ConS UFO

  • Mos3.1 100 ugOther

    Intramuscular injection of synthetic viral immunogen Mos3.1

  • Mos3.2 100 ugOther

    Intramuscular injection of synthetic viral immunogen Mos3.2

  • Mos3.3 100 ugOther

    Intramuscular injection of synthetic viral immunogen Mos3.3

  • Mos3.1 33 ug, Mos3.2 33 ug and Mos3.3 33 ugOther

    Intramuscular injection of synthetic viral immunogens Mos3.1, Mos3.2 and Mos3.3

Study groups in NCT04046978
Study groupRoleWhat they receive
Group FExperimentalMos3.1 100 ug at Month 0 Mos3.2 100 ug at Month 2 Mos3.3 100 ug at Month 4 ConM SOSIP 50 ug and ConS UFO 50 ug at Month 6
Receives: Other: ConM SOSIP 50 ug and ConS UFO 50 ug; Other: Mos3.1 100 ug; Other: Mos3.2 100 ug; Other: Mos3.3 100 ug
Group GExperimentalMos3.2 100 ug at Month 0 Mos3.1 100 ug at Month 2 Mos3.3 100 ug at Month 4 ConM SOSIP 50 ug and ConS UFO 50 ug at Month 6
Receives: Other: ConM SOSIP 50 ug and ConS UFO 50 ug; Other: Mos3.1 100 ug; Other: Mos3.2 100 ug; Other: Mos3.3 100 ug
Group HExperimentalMos3.3 100 ug at Month 0 Mos3.2 100 ug at Month 2 Mos3.1 100 ug at Month 4 ConM SOSIP 50 ug and ConS UFO 50 ug at Month 6
Receives: Other: ConM SOSIP 50 ug and ConS UFO 50 ug; Other: Mos3.1 100 ug; Other: Mos3.2 100 ug; Other: Mos3.3 100 ug
Group IExperimentalMos3.1 33 ug, Mos3.2 33 ug and Mos3.3 33 ug at Months 0, 2 and 4 ConM SOSIP 50 ug and ConS UFO 50 ug at Month 6
Receives: Other: ConM SOSIP 50 ug and ConS UFO 50 ug; Other: Mos3.1 33 ug, Mos3.2 33 ug and Mos3.3 33 ug

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Serum titres of neutralising antibodies

    Serum titres of neutralising antibodies to virus expressing ConM and ConS, and mosaic (Mos3.1, Mos3.2 and Mos3.3) envelopes

    Measured: 9 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Aug 2019
  2. Study start11 Dec 2019 (estimated)
  3. Primary completion31 Dec 2022 (estimated)
  4. Study completion31 Dec 2022 (estimated)

Why it stopped: MOSAIC was withdrawn and the study was incorporated into EAVI2020-01 (NCT03816137) as a substantial amendment.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04046978
Sponsor's protocol ID
MOSAIC
Other IDs
18HH4893
Acronym
MOSAIC
Status last verified
Aug 2023
First submitted
5 Aug 2019
Last updated
22 Aug 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing ConM SOSIP 50 ug and ConS UFO 50 ug, Mos3.1 100 ug and Mos3.2 100 ug in people with Virus Diseases, run by Imperial College London at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 22 Aug 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Serum titres of neutralising antibodies (time frame: 9 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Aug 2023.

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