Lipopolysaccharide (LPS) or Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) Challenge Study on Healthy Subjects

• Cantharidin (Biological): 5 microliter (µL) of 0.2 percent Cantharidin solution (diluted in acetone) will be applied to all subjects on forearm by topical route.
• Lipopolysaccharide (Biological): 0.5 to 4 ng/kg body weight of LPS formulated as suspension in normal saline will be administered to randomized subjects via intravenous (IV) route in dose-escalation manner.
• Granulocyte-Macrophage Colony-Stimulating Factor (Biological): 5 to 15 µg/kg of GM-CSF will be administered to randomized subjects via subcutaneous (SC) route in the abdominal region in dose-escalation manner.
• Saline Solution (Drug): 0.9 percent sodium chloride will be administered via IV route to all subjects at a rate of 250 mL/hour for 4 hours prior to dosing with LPS and 8 hours after dosing with LPS.

Primary outcomes

• Part 1: Change From Baseline Primary Soluble Inflammatory Mediators in Blood: Tumor Necrosis Factor (TNF) Alpha and Interleukin (IL) 6 for LPS Arm [Baseline, Session 2: -5, 10, 25, 40 minutes, 1 hour 10 minutes, 1 hour 40 minutes, 2 hours 40 minutes,5 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were collected at indicated timepoints for the analysis of primary soluble inflammatory mediators like TNF-alpha and IL-6 in blood. Latest pre-challenge LPS assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Each session was for three days. NA indicates that data was not available as standard deviation could not be calculated for a single participant. All participants who were randomized to receive the treatment (LPS or GM-CSF challenge) and received one dose of challenge agent were included in Safety Population.
• Part 1: Change From Baseline in Primary Soluble Inflammatory Mediators : Urinary Tetranor Prostaglandin D Metabolite (PGDM) LPS Arm [Baseline, Session 2 Day 1]: The post-challenge urine samples were collected during session 2 after LPS challenge. In session 2, participants were encouraged to pass urine immediately before LPS challenge dose and urine voids were collected from after LPS until 12 hours post-LPS and the time of the urine collection were recorded as post-challenge 1 to 11. These samples were collected for measurement of tetranor-PGDM. Latest pre-challenge LPS assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. The data for normalized Tetranor PGDM was normalized by (Tetranor PGDM \[pg/mL\] divided by Creatinine \[milligram per deciliter\]) multiplied by 100. NA indicates that data was not available as standard deviation could not be calculated for a single participant.
• Part 2: Change From Baseline Primary Soluble Inflammatory Mediators in Blood: TNF Alpha and IL 6: LPS Arm [Baseline, Session 2: -5, 10, 25, 40 minutes, 1 hour 10 minutes, 1 hour 40 minutes, 5 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were planned to be collected at indicated timepoints for the analysis of primary soluble inflammatory mediators like TNF-alpha and IL-6 in blood. Latest pre-challenge LPS assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 2: Change From Baseline Primary Soluble Inflammatory Mediators : Urinary Tetranor PGDM: LPS Arm [Baseline, Session 2 Day 1]: Urine samples were planned to be collected for analysis. Latest pre-challenge LPS assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1: Change From Baseline in White Blood Cell Numbers in Blood: GM-CSF [Baseline, Session 2: 40 minutes, 2 hours 40 minutes, 5 hours 40 minutes, 9 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were collected at indicated time-points for analysis of white blood cells. Latest pre-challenge GM-CSF assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value.
• Part 2: Change From Baseline in White Blood Cell Numbers in Blood: GM-CSF [Baseline, Session 2: 40 minutes, 2 hours 40 minutes, 5 hours 40 minutes, 9 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were planned to be collected at indicated time-points for analysis of white blood cells. Baseline value is Session 2 Day 1. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.

Secondary outcomes

• Part 1: Change From Baseline Soluble Inflammatory Biomarkers in Skin Blister [Baseline; Session1: 48 hours on Day3; Session 2: 24 hours on Day 2 and 48 hours on Day 3]: Blister samples were collected at indicated time-points for the analysis of soluble inflammatory mediators like IL-1 beta (b), Interferon-gamma (INFg), IL-6, IL-2, IL-8, Monocyte chemotactic protein-1 (MCP-1) and TNF-alpha. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. NA indicates that data was not available as standard deviation could not be calculated for a single participant.
• Part 2: Change From Baseline Soluble Inflammatory Biomarkers in Skin Blister [Baseline; Session1: 48 hours Day3; Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were planned to be collected at indicated time-points for the analysis of soluble inflammatory mediators like IL-1 beta, INFg, IL-6, IL-2, IL-8, MCP-1 and TNF-alpha. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1: Absolute Values of Blister Volume [Baseline, Session 1: 48 hours Day 3. Session 2: 24 hours Day 2, 48 hours Day 3]: Blister samples were collected at indicated time-points for analysis of blister volumes. . Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline.
• Part 2: Absolute Values of Blister Volume [Baseline, Session 1: 48 hours Day 3. Session 2: 24 hours Day 2, 48 hours Day 3]: Blister samples were planned to be collected at indicated time-points for analysis of blister volumes. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1: Change From Baseline in Cell Numbers in Blister [Baseline, Session 1: 48 hours Day 3. Session 2: 24 hours Day 2, 48 hours Day 3]: Blister samples were collected at indicated time-points for analysis of white blood cell in blister. Latest pre-challenge LPS assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value.
• Part 2: Change From Baseline in Cell Numbers in Blister [Baseline, Session 1: 48 hours Day 3. Session 2: 24 hours Day 2, 48 hours Day 3]: Blood samples were planned to be collected at indicated time-points for analysis of white blood cell in blister. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1:Change From Baseline in Cell Activation Markers by Flow Cytometry on Monocytes in Blister [Baseline, Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were collected at indicated time-points for the measurement of activation markers by flow cytometry for monocytes in blister. Activation markers included Cluster of Differentiation (CD) 16, CD163, CD206, CD209, CD40, CD80, CD83, CD86 and Human Leukocyte Antigen - antigen D Related (HLA-DR). Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. NA indicates that data was not available as standard deviation could not be calculated for a single participant.
• Part 2:Change From Baseline in Cell Activation Markers by Flow Cytometry on Monocytes in Blister [Baseline, Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1:Change From Baseline of CD40+/CD80+ by Flow Cytometry on Monocytes in Blister [Baseline, Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were collected at indicated time-points for the measurement of activation markers by flow cytometry for monocytes in blister like CD40+/CD80+. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. NA indicates that data was not available as standard deviation could not be calculated for a single participant.
• Part 2:Change From Baseline of CD40+/CD80+ by Flow Cytometry on Monocytes in Blister [Baseline, Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1:Change From Baseline in Cell Activation Markers by Flow Cytometry on Dendritic Cells in Blister [Baseline; Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were collected at indicated time-points for the measurement of activation markers by flow cytometry for dendritic cells in blister. Activation markers included CD16, CD163, CD206, CD209, CD40, CD80, CD83, CD86 and HLA-DR. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. NA indicates that data was not available as standard deviation could not be calculated for a single participant.
• Part 2:Change From Baseline in Cell Activation Markers by Flow Cytometry on Dendritic Cells in Blister [Baseline, Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1:Change From Baseline of CD40+/CD80+ by Flow Cytometry on Dendritic Cells in Blister [Baseline, Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were collected at indicated time-points for the measurement of activation markers by flow cytometry for dendritic cells in blister like CD40+/CD80+. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. NA indicates that data was not available as standard deviation could not be calculated for a single participant.
• Part 2:Change From Baseline of CD40+/CD80+ by Flow Cytometry on Dendritic Cells in Blister [Baseline, Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1:Change From Baseline in Cell Activation Markers by Flow Cytometry on Macrophages in Blister [Baseline, Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were collected at indicated time-points for the measurement of activation markers by flow cytometry for macrophages in blister. Activation markers included CD16, CD163, CD206, CD209, CD40, CD80, CD83, CD86 and HLA-DR. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. NA indicates that data was not available as standard deviation could not be calculated for a single participant.
• Part 2:Change From Baseline in Cell Activation Markers by Flow Cytometry on Macrophages in Blister [Baseline, Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1:Change From Baseline of CD40+/CD80+ by Flow Cytometry on Macrophages in Blister [Baseline, Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were collected at indicated time-points for the measurement of activation markers by flow cytometry for dendritic cells in blister like CD40+/CD80+. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. NA indicates that data was not available as standard deviation could not be calculated for a single participant.
• Part 2:Change From Baseline of CD40+/CD80+ by Flow Cytometry on Macrophages in Blister [Baseline, Session1: 48 hours Day 3, Session 2: 24 hours Day 2 and 48 hours Day 3]: Blister samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1:Change From Baseline in Soluble Inflammatory Mediators in Blood [Baseline, Session 2: -5, 10, 25, 40 minutes, 1 hour 10 minutes, 1 hour 40 minutes, 2 hours 40 minutes, 5 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were collected at indicated timepoints for the analysis of primary soluble inflammatory mediators like IL-1 beta, INFg, IL-2, IL-8, and MCP-1 in blood. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. NA indicates that data was not available as standard deviation could not be calculated for a single participant.
• Part 2:Change From Baseline in Soluble Inflammatory Mediators in Blood [Baseline, Session 2: -5, 10, 25, 40 minutes, 1 hour 10 minutes, 1 hour 40 minutes, 2 hours 40 minutes, 5 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1: Change From Baseline in Soluble Inflammatory Mediators in Blood: TNF-alpha, IL-6 and GM-CSF: GM-CSF Arm [Baseline, Session 2: -5, 10, 25, 40 minutes, 1 hour 10 minutes, 1 hour 40 minutes, 2 hours 40 minutes, 5 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were collected at indicated time-points for the analysis of soluble inflammatory mediators like TNF-alpha, IL-6 and GM-CSF in blood. Latest pre-challenge GM-CSF assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value.
• Part 2: Change From Baseline in Soluble Inflammatory Mediators in Blood: TNF-alpha, IL-6 and GM-CSF for GM-CSF Arm [Baseline, Session 2: -5, 10, 25, 40 minutes, 1 hour 10 minutes, 1 hour 40 minutes, 2 hours 40 minutes, 5 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge GM-CSF assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1: Change From Baseline in Soluble Inflammatory Mediators in Blood: C-reactive Protein (CRP) [Baseline; Session 2: Post challenge Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were collected at indicated time-points for the analysis of soluble inflammatory mediators like CRP in blood. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value.
• Part 2: Change From Baseline in Soluble Inflammatory Mediators in Blood: CRP [Baseline; Session 2: Post challenge Day 1; Pre-fluid sample on Day 2 and Day 3]: Blood samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1: Change From Baseline in Cell Activation Markers by Flow Cytometry on Monocytes in Blood [Baseline; Session 2: 40 minutes, 2 hours 40 minutes, 5 hours 40 minutes, 9 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were collected at indicated time-points for the measurement of activation markers by flow cytometry for monocytes in blood. Activation markers included CD16, CD163, CD206, CD209, CD40, CD80, CD83, CD86 and HLA-DR. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value.
• Part 2: Change From Baseline in Cell Activation Markers by Flow Cytometry on Monocytes in Blood [Baseline, Session 2: 40 minutes, 2 hour 40 minutes, 5 hour 40 minutes,9hours 40 minutes on Day 1; Pre-fluid sample on Day 2 and Day 3]: Blood samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1: Change From Baseline in Cell Activation Markers by Flow Cytometry on Dendritic Cells in Blood [Baseline, Session 2: 40 minutes, 2 hours 40 minutes, 5 hours 40 minutes, 9 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were collected at indicated time-points for the measurement of activation markers by flow cytometry for dendritic cells in blood. Activation markers included CD16, CD163, CD206, CD209, CD40, CD80, CD83, CD86 and HLA-DR. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value.
• Part 2: Change From Baseline in Cell Activation Markers by Flow Cytometry on Dendritic Cells in Blood [Baseline, Session 2: 40 minutes, 2 hours 40 minutes, 5 hours 40 minutes, 9 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge (LPS or GM-CSF) assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.
• Part 1: Change From Baseline in Circulating Leukocyte Numbers in Blood: LPS Arm [Baseline; Session 2: 40 minutes, 2 hours 40 minutes, 5 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were collected at indicated time-points for analysis of leukocyte. Latest pre-challenge assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value.
• Part 2: Change From Baseline in Circulating Leukocyte Numbers in Blood: LPS Arm [Baseline; Session 2: 40 minutes, 2 hours 40 minutes, 5 hours 40 minutes on Day 1. Pre-fluid sample on Day 2 and Day 3]: Blood samples were planned to be collected at indicated time-points for the measurement of activation. Latest pre-challenge assessment with a non-missing value, including those from unscheduled visits was considered as Baseline. Change from Baseline was calculated as the value at specified visit minus the Baseline value. Part 2 of the study was not conducted as agreed criteria for Interim analysis was achieved.

Sex: Male, ages: 18 Years to 45 Years, accepts healthy volunteers

Inclusion Criteria:

* Subjects must be 18 to 45 years of age inclusive, at the time of signing the informed consent.
* Subjects who are overtly healthy as determined by medical evaluation including: medical history, physical examination, laboratory tests, and electrocardiogram (ECG).
* Body mass index (BMI) within the range 19.0-30.0 kilogram per meter square (kg/m\^2) (inclusive).
* All male subjects. All subjects must agree to use contraception during session 2 and refrain from donating sperm from session 2 to end of study (follow up 2 visits).
* Capable of giving signed informed consent.

Exclusion criteria:

* A positive pre-study Hepatitis B surface antigen or positive Hepatitis C antibody result within 3 months of screening.
* A positive test for human immuno deficiency virus (HIV) antibody.
* Persistent abnormal C-reactive protein/ white cell count (CRP/ WCC) levels at screening.
* Abnormal liver function tests at screening. For healthy subjects: Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase and bilirubin more than or equal to 1.5xupper limit of normal (ULN) (isolated bilirubin more than 1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin less than 35 percent) at screening.
* A positive pre-study drug/alcohol screen.
* Current, or chronic history of (h/o): liver disease or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones), anaphylaxis, and /or anaphylactoid (resembling anaphylaxis) reactions; Cardiac, respiratory or renal disease (childhood asthma can be included); Sensitivity or severe allergic responses to any of the challenge agents or cantharidin, or components thereof or a history of drug or other allergy that, in the opinion of the Investigator or GlaxoSmithKline (GSK) Medical Monitor, contraindicates their participation; Vasovagal syncope; Surgery or significant trauma in 3 months leading to study enrolment; Relevant skin conditions (for example recent h/o eczema or recurrent eczema, keloid, skin allergies, psoriasis, atopic dermatitis, and vitiligo) which in the opinion of the investigator could pose safety issues or cause interference with study procedures; Sepsis or known coagulation disorders; Peripheral edema, lymphangitis, lymph edema, pleural or pericardial effusion; Respiratory conditions including but not limited to asthma, Chronic obstructive pulmonary disease (COPD), and bronchiectasis and any current respiratory infection.
* Presence on either forearm of tattoos, naevi, hypertrophic scars, keloids, hyper or hypo-pigmentation. Subjects with very fair skin, very dark skin, excessive hair or any skin abnormalities that may, in the opinion of the Investigator, interfere with study assessments.
* Unable to refrain from the use of prescription drugs taken on an intermittent (as needed) basis or non-prescription drugs; these include non-steroidal anti-inflammatory drugs (NSAIDs), vitamins, herbal and dietary supplements (including St John's Wort) within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 half-lives (whichever is longer) prior to Day 1 of session 1 and continuing until the final follow up visit).
* The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 90 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer) or currently in a study of an investigational device.
* Previous exposure to LPS in a clinical research setting. Where participation in the study would result in donation of blood or blood products in excess of 500 milliliter (mL) within a 56-day period; Current smoker or former regular smoker within 6 months before the screening visit; Unwillingness or inability to follow the procedures outlined in the protocol.

Participant flow

Outcome results

• Part 1: Change From Baseline Primary Soluble Inflammatory Mediators in Blood: Tumor Necrosis Factor (TNF) Alpha and Interleukin (IL) 6 for LPS Arm (Primary), Mean, Picograms per milliliter: Part 1: LPS 0.5 ng/kg 2.4086 +/- 0.09467; Part 1: LPS 0.75 ng/kg 0.2798 +/- 0.12546; Part 1: LPS 1 ng/kg -0.0126 +/- 0.01785
• Part 1: Change From Baseline in Primary Soluble Inflammatory Mediators : Urinary Tetranor Prostaglandin D Metabolite (PGDM) LPS Arm (Primary), Mean, Picograms per milligram: Part 1: LPS 0.5 ng/kg 73.846 +/- 116.0073; Part 1: LPS 0.75 ng/kg -85.080 +/- 226.4168; Part 1: LPS 1 ng/kg 134.806 +/- 166.6716
• Part 2: Change From Baseline Primary Soluble Inflammatory Mediators in Blood: TNF Alpha and IL 6: LPS Arm (Primary)
• Part 2: Change From Baseline Primary Soluble Inflammatory Mediators : Urinary Tetranor PGDM: LPS Arm (Primary)
• Part 1: Change From Baseline in White Blood Cell Numbers in Blood: GM-CSF (Primary), Mean, Giga cells per liter: Part 1: GM-CSF 60 µg/m^2 0.3754 +/- 2.78811
• Part 1: Change From Baseline Soluble Inflammatory Biomarkers in Skin Blister (Secondary), Mean, Picograms per milliliter: Part 1: LPS 0.5 ng/kg -30.9691 +/- 3.58338; Part 1: LPS 0.75 ng/kg -41.5298 +/- 149.67553; Part 1: LPS 1 ng/kg 3.6243 +/- 35.28147; Part 1: GM-CSF 60 µg/m^2 35.4452 +/- 48.42938
• Part 2: Change From Baseline Soluble Inflammatory Biomarkers in Skin Blister (Secondary)
• Part 1: Absolute Values of Blister Volume (Secondary), Mean, Microliter: Part 1: LPS 0.5 ng/kg 361.325 +/- 145.9115; Part 1: LPS 0.75 ng/kg 156.638 +/- 112.1876; Part 1: LPS 1 ng/kg 185.550 +/- 22.4860; Part 1: GM-CSF 60 µg/m^2 230.425 +/- 146.2442
• Part 2: Absolute Values of Blister Volume (Secondary)
• Part 1: Change From Baseline in Cell Numbers in Blister (Secondary), Mean, Cells per milliliter: Part 1: LPS 0.5 ng/kg 841250.0 +/- 171473.39; Part 1: LPS 0.75 ng/kg -1405000.0 +/- 6808193.03; Part 1: LPS 1 ng/kg 667500.0 +/- 1375322.69
• Part 2: Change From Baseline in Cell Numbers in Blister (Secondary)
• Part 1:Change From Baseline in Cell Activation Markers by Flow Cytometry on Monocytes in Blister (Secondary), Mean, Mean fluorescence intensity: Part 1: LPS 0.5 ng/kg 255.500 +/- 343.6539; Part 1: LPS 0.75 ng/kg 304.409 +/- 387.9039; Part 1: LPS 1 ng/kg 314.000 +/- 129.4005; Part 1: GM-CSF 60 µg/m^2 94.943 +/- 140.1057
• Part 2:Change From Baseline in Cell Activation Markers by Flow Cytometry on Monocytes in Blister (Secondary)
• Part 1:Change From Baseline of CD40+/CD80+ by Flow Cytometry on Monocytes in Blister (Secondary), Mean, Ratio: Part 1: LPS 0.5 ng/kg 0.1475 +/- 0.22981; Part 1: LPS 0.75 ng/kg 0.2764 +/- 0.19587; Part 1: LPS 1 ng/kg 0.0610 +/- 0.13294; Part 1: GM-CSF 60 µg/m^2 -0.4060 +/- 0.82999
• Part 2:Change From Baseline of CD40+/CD80+ by Flow Cytometry on Monocytes in Blister (Secondary)
• Part 1:Change From Baseline in Cell Activation Markers by Flow Cytometry on Dendritic Cells in Blister (Secondary), Mean, Mean fluorescence intensity: Part 1: LPS 0.5 ng/kg -31.250 +/- 48.4368; Part 1: LPS 0.75 ng/kg 668.512 +/- 634.0204; Part 1: LPS 1 ng/kg 44.500 +/- 90.5097; Part 1: GM-CSF 60 µg/m^2 83.647 +/- 119.1684
• Part 2:Change From Baseline in Cell Activation Markers by Flow Cytometry on Dendritic Cells in Blister (Secondary)
• Part 1:Change From Baseline of CD40+/CD80+ by Flow Cytometry on Dendritic Cells in Blister (Secondary), Mean, Ratio: Part 1: LPS 0.5 ng/kg 42.7675 +/- 5.32805; Part 1: LPS 0.75 ng/kg 43.2094 +/- 6.81783; Part 1: LPS 1 ng/kg 47.8100 +/- 4.17193; Part 1: GM-CSF 60 µg/m^2 39.8453 +/- 6.60325
• Part 2:Change From Baseline of CD40+/CD80+ by Flow Cytometry on Dendritic Cells in Blister (Secondary)
• Part 1:Change From Baseline in Cell Activation Markers by Flow Cytometry on Macrophages in Blister (Secondary), Mean, Mean fluorescence intensity: Part 1: LPS 0.5 ng/kg -5027.00 +/- 5289.866; Part 1: LPS 0.75 ng/kg 4510.75 +/- 7162.125; Part 1: LPS 1 ng/kg -3449.75 +/- 1895.400; Part 1: GM-CSF 60 µg/m^2 -2607.25 +/- 6559.210
• 16 more outcome measures not shown.

Adverse events

Time frame: Adverse events (AEs) and serious adverse events (SAEs) were collected from the start of study treatment until 69 days in Part 1 of the study.

Other adverse events by term

• Study Protocol (PDF, 2017-08-07)
• Statistical Analysis Plan (PDF, 2018-05-14)

• GSK Clinical Trials, Study director, GlaxoSmithKline