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Prasad S, Mathew PS, Piper BJ, Kaur K, Tian M. The Neurobiology of Methamphetamine Addiction and the Potential to Reduce Misuse Through Conjugate Vaccines Targeting Toll-Like Receptor 4. Cureus 2023; 15:e40259. [PMID: 37440809 PMCID: PMC10335775 DOI: 10.7759/cureus.40259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2023] [Indexed: 07/15/2023] Open
Abstract
The methamphetamine epidemic continues to worsen each year and has contributed to more overdose deaths than opioids. Methamphetamine was listed in the top ten lethal drugs in 2021 in the United States. The drug has been shown to cause health problems such as addiction and neurological and behavioral changes. One possible solution to address this crisis is through vaccinations. Vaccinations consist of injecting a controlled substance with the goal of creating compound-specific antibodies. Although still early in development, vaccinations have been found to improve withdrawal symptoms and decrease drug-seeking behavior with minimal health side effects in rodent studies. This paper provides an overview of the clinical presentation and neurobiology of methamphetamine addiction and drug-seeking behaviors. The responses and adverse effects of conjugate vaccines IXTv-100 with adjuvant glucopyranosyl lipid A administered in oil-water stable emulsion and tetanus-toxoid conjugated to succinyl-methamphetamine adsorbed on aluminum hydroxide combined with adjuvant E6020 are examined.
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Affiliation(s)
- Savita Prasad
- Medical Education, Geisinger Commonwealth School of Medicine, Scranton, USA
| | - Phoebe S Mathew
- Medical Education, Geisinger Commonwealth School of Medicine, Scranton, USA
| | - Brian J Piper
- Medical Education, Geisinger Commonwealth School of Medicine, Scranton, USA
| | - Karndeep Kaur
- Medical Education, Geisinger Commonwealth School of Medicine, Scranton, USA
| | - Maria Tian
- Medical Education, Geisinger Commonwealth School of Medicine, Scranton, USA
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2
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Development of Methamphetamine Conjugated Vaccine through Hapten Design: In Vitro and In Vivo Characterization. Vaccines (Basel) 2023; 11:vaccines11020340. [PMID: 36851217 PMCID: PMC10004339 DOI: 10.3390/vaccines11020340] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Methamphetamine (METH) substance-use disorder is an ever-growing global health issue with no effective treatment. Anti-METH vaccines are under investigation as an alternative to existing psychological interventions. This platform has made significant progress over past decades mainly in preclinical stages, and efforts to develop an anti-METH vaccine with a high antibody response are of utmost importance. METHODOLOGY A novel conjugated anti-METH vaccine was developed using METH HCl as the starting material for the design of hapten, a peptide linker consisting of five lysines and five glycines, and finally immunogenic carrier mannan, which is novel to this platform. All the chemical reaction steps were confirmed by several analytical techniques, and the immunogenicity of the developed vaccine was investigated in a mouse model. RESULTS Thin-layer chromatography and gas chromatography confirmed the reaction between METH and peptide linker. UV, NMR and color tests were used to confirm the presence of the aldehyde groups in oxidized mannan (OM). The final conjugated vaccine was confirmed by UV and LC-MS. The stability of mannan, the METH hapten, and the final vaccine was evaluated by UV and LC-MS and demonstrated satisfactory stability over 3 months in various storage conditions. Animal studies supported the immunogenicity of the novel vaccine. CONCLUSIONS We successfully developed and characterized a novel METH vaccine in vitro and in vivo. The present study findings are encouraging and will form the basis of further exploration to assess its effectiveness to prevent METH addiction in preclinical models.
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Kamal Hossain M, Davidson M, Feehan J, Deraos G, Nurgali K, Matsoukas J, Apostolopoulos V. Development and characterization of a novel conjugated methamphetamine vaccine. Vaccine 2022; 40:5882-5891. [PMID: 36041942 DOI: 10.1016/j.vaccine.2022.08.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/09/2022] [Accepted: 08/18/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Methamphetamine (METH) addiction is a major public health concern globally with limited management options. The development of a METH vaccine through hapten design has received significant attention as a promising platform for the potential treatment of METH addiction and overdose, however there is yet to be a successful candidate in human trials. RESEARCH DESIGN AND METHODS In this study, we developed a novel conjugated METH vaccine using oxidized mannan (a polymannose) as an immunogenic carrier. A METH hapten was synthesized by using amphetamine and conjugated to mannan with a (Lysine-Glycine-Lysine-Glycine-lysine-Glycine-Lysine-Glycine-Lysine-Glycine) (KG)5 peptide linker. RESULTS The reaction between amphetamine and (KG)5, oxidation of mannan, and conjugation of amphetamine-(KG)5 with oxidized mannan were confirmed by color tests, Fourier-transform infrared spectroscopy, gas and liquid chromatography mass spectrometry, thin-layer chromatography, and ultraviolet spectrophotometer. Additionally, the ability of the vaccine to generate antibodies was confirmed in C57BL/6 mice. CONCLUSIONS The successful development and characterization of the METH-mannan conjugate vaccine, provides a potential therapeutic intervention to curb METH substance use disorders. Each step of vaccine development was characterized to aid in future research on these vaccines, and the immunogenicity shown in the animal models supports future evaluation of the approach. Future studies of the conjugated METH vaccine should evaluate the efficacy in animal models of acute and chronic METH to pave the way for human studies.
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Affiliation(s)
- Md Kamal Hossain
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Majid Davidson
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Jack Feehan
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia.
| | | | - Kulmira Nurgali
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - John Matsoukas
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia; Newdrug, Patras Science Park, 26500 Patras, Greece; Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Alberta, AB T2N 4N1, Canada
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4
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Weitzman ER, Kossowsky J, Blakemore LM, Cox R, Dowling DJ, Levy O, Needles EW, Levy S. Acceptability of a Fentanyl Vaccine to Prevent Opioid Overdose and Need for Personalized Decision-Making. Clin Infect Dis 2022; 75:S98-S109. [PMID: 35579508 PMCID: PMC9376272 DOI: 10.1093/cid/ciac344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The opioid epidemic worsened during the coronavirus disease 2019 (COVID-19) pandemic. Synthetic opioids (primarily fentanyl) comprise the most common drugs involved in overdose (OD) death. A vaccine that blocks fentanyl from reaching the brain to prevent OD is under development, and insight is needed into its acceptability. METHODS Using a semi-structured interview guide, persons with opioid use disorder (OUD), family, professionals, and the public were interviewed about attitudes and concerns regarding a fentanyl vaccine. Reactions to fictional clinical vignettes of persons at risk of OUD because of pain and/or substance use histories were collected, analyzed, and quantified for favorability. Interviews were transcribed, coded, and analyzed thematically. RESULTS Among N = 64 participants, (70.3% female, average age 32.4 years), attitudes were favorable toward a fentanyl vaccine, with preference for lifelong durability (76% of n = 55 asked). Perceived benefits centered on the potential for a life-saving intervention, suffering averted, healthcare dollars saved, and the utility of a passive harm reduction strategy. Concerns centered on uncertainty regarding vaccine safety, questions about efficacy, worry about implications for future pain management, stigma, and need for supportive counseling and guidance to personalize decision making. Reactions to vignettes revealed complex attitudes toward fentanyl vaccination when considering recipient age, health history, and future risks for addiction and pain. CONCLUSIONS Positive responses to a fentanyl vaccine were found along with appreciation for the complexity of a vaccine strategy to prevent OD in the setting of pain and uncertain durability. Further research is needed to elucidate operational, ethical, and communications strategies to advance the model.
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Affiliation(s)
- Elissa R Weitzman
- Correspondence: E. R. Weitzman, 1 Autumn Street, Boston, MA 02215 ()
| | - Joe Kossowsky
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Laura M Blakemore
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Rachele Cox
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - David J Dowling
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Precision Vaccines Program, Boston Children’s Hospital, Boston, Massachusetts, USA
- Division of Infectious Diseases, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Ofer Levy
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Precision Vaccines Program, Boston Children’s Hospital, Boston, Massachusetts, USA
- Division of Infectious Diseases, Boston Children’s Hospital, Boston, Massachusetts, USA
- Broad Institute of MIT & Harvard, Cambridge, Massachusetts, USA
| | - Emma W Needles
- Adolescent Substance Use and Addiction Program, Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Sharon Levy
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Adolescent Substance Use and Addiction Program, Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
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5
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Vaccines against Drug Abuse—Are We There Yet? Vaccines (Basel) 2022; 10:vaccines10060860. [PMID: 35746468 PMCID: PMC9230984 DOI: 10.3390/vaccines10060860] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 11/21/2022] Open
Abstract
Background: Drug abuse is a worldwide problem that is detrimental to public health. The potential for drug abuse extends to both legal and illicit drugs. Drawbacks associated with current treatments include limited effectiveness, potential side effects and, in some instances, the absence of or concerns with approved therapy options. A significant amount of clinical research has been conducted investigating immunotherapy as a treatment option against drug abuse. Vaccines against drug abuse have been the main area of research, and are the focus of this review. Methods: An extensive search using “EBSCOhost (Multiple database collection)” with all 28 databases enabled (including “Academic Search Ultimate”, “CINAHL Plus with Full Text”, and MEDLINE), interrogation of the ClinicalTrials.gov website, and searches of individual clinical trial registration numbers, was performed in February and March of 2022. This search extended to references within the obtained articles. Results: A total of 23 registered clinical trials for treating drug abuse were identified: 15 for treatment of nicotine abuse (all vaccine-based trials), 6 against cocaine abuse (4 were vaccine-based trials and 2 were metabolic-enzyme-based trials), 1 against methamphetamine abuse (a monoclonal-antibody-based trial), and 1 multivalent opioid treatment (vaccine-based trial). As indicated on the ClinicalTrials.gov website (Home—ClinicalTrials.gov), the status of all but two of these trials was “Completed”. Phase 3 clinical trials were completed for vaccine treatments against nicotine and cocaine abuse only. Conclusion: Evidence in the form of efficacy data indicates that vaccines are not an option for treating nicotine or cocaine abuse. Efficacy data are yet to be obtained through completion of clinical trials for vaccines against opioid abuse. These findings align with the absence of regulatory approval for any of these treatments. This review further highlights the need for novel treatment strategies in instances where patients do not respond to current treatments, and while the search for efficacious vaccine-based treatments continues.
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de Almeida Augusto PS, Pereira RLG, Caligiorne SM, Sabato B, Assis BRD, do Espírito Santo LP, Dos Reis KD, Castro Goulart GA, de Fátima Â, de Castro Lourenço das Neves M, Garcia FD. The GNE-KLH anti-cocaine vaccine protects dams and offspring from cocaine-induced effects during the prenatal and lactating periods. Mol Psychiatry 2021; 26:7784-7791. [PMID: 34381172 DOI: 10.1038/s41380-021-01210-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/03/2021] [Accepted: 06/23/2021] [Indexed: 02/07/2023]
Abstract
Protecting children from prenatal cocaine exposure is a significant challenge for physicians and childbearing women with cocaine use disorder. Cocaine use is highly prevalent among reproductive-aged women and prenatal cocaine exposure produces obstetric, foetal neurodevelopmental and long-term behavioural impairments. Cocaine crosses the maternal and foetal blood-brain barrier and the placenta by diffusion. The best approach to prevent prenatal cocaine exposure is to stop cocaine use. However, only 25% of cocaine users can discontinue their use during pregnancy. Anti-cocaine vaccination decreases cocaine passage through the blood-brain barrier. This study describes an innovative approach for preventing prenatal cocaine exposure using the GNE-KLH anti-cocaine vaccine, a novel use for the named anti-drug vaccines. Here, we show that anti-cocaine vaccination with GNE-KLH produced and maintained anti-cocaine IgG antibody titres and avidity during pregnancy. These antibodies protected the pregnant rats and their pups against prenatal cocaine damage during pregnancy until weaning. The present work is the first preclinical evidence of the efficacy of an innovative mechanism to prevent prenatal cocaine exposure damage, a worldwide public health care issue. In the future, this mechanism may be useful in pregnant women with cocaine use disorder. Further studies to understand the mechanisms of how anti-cocaine antibodies exert their protective effects in pregnancy are warranted.
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Affiliation(s)
- Paulo Sérgio de Almeida Augusto
- Centre of Research on Health Vulnerability (Núcleo de Pesquisa em Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, sala 240, Belo Horizonte, MG, Brazil.,Pós-graduação em Medicina Molecular, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, Belo Horizonte, MG, Brazil
| | - Raissa Lima Gonçalves Pereira
- Centre of Research on Health Vulnerability (Núcleo de Pesquisa em Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, sala 240, Belo Horizonte, MG, Brazil.,Pós-graduação em Medicina Molecular, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, Belo Horizonte, MG, Brazil
| | - Sordaini Maria Caligiorne
- Centre of Research on Health Vulnerability (Núcleo de Pesquisa em Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, sala 240, Belo Horizonte, MG, Brazil
| | - Brian Sabato
- Centre of Research on Health Vulnerability (Núcleo de Pesquisa em Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, sala 240, Belo Horizonte, MG, Brazil.,Pós-graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG). Avenida Antônio Carlos, 6627, Belo Horizonte, MG, Brazil
| | - Bruna Rodrigues Dias Assis
- Centre of Research on Health Vulnerability (Núcleo de Pesquisa em Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, sala 240, Belo Horizonte, MG, Brazil.,Department of Pharmaceutics, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG). Avenida Antônio Carlos, 6627, Belo Horizonte, MG, Brazil
| | - Larissa Pires do Espírito Santo
- Centre of Research on Health Vulnerability (Núcleo de Pesquisa em Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, sala 240, Belo Horizonte, MG, Brazil.,Pós-graduação em Medicina Molecular, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, Belo Horizonte, MG, Brazil
| | - Karine Dias Dos Reis
- Centre of Research on Health Vulnerability (Núcleo de Pesquisa em Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, sala 240, Belo Horizonte, MG, Brazil
| | - Gisele Assis Castro Goulart
- Department of Pharmaceutics, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG). Avenida Antônio Carlos, 6627, Belo Horizonte, MG, Brazil
| | - Ângelo de Fátima
- Grupo de Estudos em Química Orgânica e Biológica (GEQOB), Departament of Chemistry, Universidade Federal de Minas Gerias (UFMG). Avenida Antônio Carlos, 6627, Belo Horizonte, MG, Brazil
| | - Maila de Castro Lourenço das Neves
- Centre of Research on Health Vulnerability (Núcleo de Pesquisa em Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, sala 240, Belo Horizonte, MG, Brazil.,Pós-graduação em Medicina Molecular, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, Belo Horizonte, MG, Brazil.,Pós-graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG). Avenida Antônio Carlos, 6627, Belo Horizonte, MG, Brazil
| | - Frederico Duarte Garcia
- Centre of Research on Health Vulnerability (Núcleo de Pesquisa em Vulnerabilidade e Saúde - NAVES), Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, sala 240, Belo Horizonte, MG, Brazil. .,Pós-graduação em Medicina Molecular, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena, 190, Belo Horizonte, MG, Brazil. .,Pós-graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG). Avenida Antônio Carlos, 6627, Belo Horizonte, MG, Brazil.
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Assessing Neutralized Nicotine Distribution Using Mice Vaccinated with the Mucosal Conjugate Nicotine Vaccine. Vaccines (Basel) 2021; 9:vaccines9020118. [PMID: 33546163 PMCID: PMC7913222 DOI: 10.3390/vaccines9020118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/23/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
Tobacco smoking continues to be a global epidemic and the leading preventable cause of cancer and cardiovascular disease. Nicotine vaccines have been investigated as an alternative to currently available smoking cessation strategies as a means to increase rates of success and long-term abstinence. Recently, we demonstrated that a mucosal nicotine vaccine was able to induce robust mucosal and systemic antibodies when delivered heterologously using intranasal and intramuscular routes. Herein, we investigated the neutralization ability of the anti-nicotine antibodies using both intranasal and intracardiac nicotine challenges. Combining the extraction of lyophilized organ samples with RP-HPLC methods, we were able to recover between 47% and 56% of the nicotine administered from the blood, brain, heart, and lungs up to 10 min after challenge, suggesting that the interaction of the antibodies with nicotine forms a stable complex independently of the route of vaccination or challenge. Although both challenge routes can be used for assessing systemic antibodies, only the intranasal administration of nicotine, which is more physiologically similar to the inhalation of nicotine, permitted the crucial interaction of nicotine with the mucosal antibodies generated using the heterologous vaccination route. Notably, these results were obtained 6 months after the final vaccination, demonstrating stable mucosal and systemic antibody responses.
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8
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Ozgen MH, Blume S. The continuing search for an addiction vaccine. Vaccine 2019; 37:5485-5490. [PMID: 31266675 DOI: 10.1016/j.vaccine.2019.06.074] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 04/27/2019] [Accepted: 06/24/2019] [Indexed: 01/04/2023]
Abstract
Inspired by advances in immunology, in the 1970s scientists began to study the possibilities of mobilizing the human immune system against intruders other than pathogenic viruses and bacteria. In 1972 the suggestion was first made that it might be possible to provoke immunity to narcotic dependence. Because molecules of narcotics such as heroin and cocaine are too small to stimulate an immune response, researchers sought ways of coupling them to immunogenic proteins. The substances they developed soon became known as addiction vaccines. However, despite fifty years of research, and despite the growing problem of addiction, no vaccine against heroin, cocaine, methamphetamine or nicotine addiction has yet been licensed for clinical use. This paper reviews the history of addiction vaccinology, seeks to explain the unique appeal of a vaccinological approach to addiction, and argues for broad discussion of how such vaccines should ultimately be used.
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Affiliation(s)
- M Heval Ozgen
- Parnassia Psychiatric Institute and Addiction Research Center (PARC), Interculturel Psychiatry (i-psy), Parnassia Academy, The Hague, the Netherlands.
| | - Stuart Blume
- Department of Anthropology, University of Amsterdam, Amsterdam, the Netherlands
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9
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Kvello AMS, Andersen JM, Øiestad EL, Steinsland S, Aase A, Mørland J, Bogen IL. A Monoclonal Antibody against 6-Acetylmorphine Protects Female Mice Offspring from Adverse Behavioral Effects Induced by Prenatal Heroin Exposure. J Pharmacol Exp Ther 2018; 368:106-115. [PMID: 30361238 DOI: 10.1124/jpet.118.251504] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/22/2018] [Indexed: 01/04/2023] Open
Abstract
Escalating opioid use among fertile women has increased the number of children being exposed to opioids during fetal life. Furthermore, accumulating evidence links prenatal opioid exposure, including opioid maintenance treatment, to long-term negative effects on cognition and behavior, and presses the need to explore novel treatment strategies for pregnant opioid users. The present study examined the potential of a monoclonal antibody (mAb) targeting heroin's first metabolite, 6-acetylmorphine (6-AM), in providing fetal protection against harmful effects of prenatal heroin exposure in mice. First, we examined anti-6-AM mAb's ability to block materno-fetal transfer of active metabolites after maternal heroin administration. Next, we studied whether maternal mAb pretreatment could prevent adverse effects in neonatal and adolescent offspring exposed to intrauterine heroin (3 × 1.05 mg/kg). Anti-6-AM mAb pretreatment of pregnant dams profoundly reduced the distribution of active heroin metabolites to the fetal brain. Furthermore, maternal mAb administration prevented hyperactivity and drug sensitization in adolescent female offspring prenatally exposed to heroin. Our findings demonstrate that passive immunization with a 6-AM-specific antibody during pregnancy provides fetal neuroprotection against heroin metabolites, and thereby prevents persistent adverse behavioral effects in the offspring. An immunotherapeutic approach to protect the fetus against long-term effects of prenatal drug exposure has not been reported previously, and should be further explored as prophylactic treatment of pregnant heroin users susceptible to relapse.
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Affiliation(s)
- Anne Marte Sjursen Kvello
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway (A.M.S.K., J.M.A., E.L.Ø., S.S., I.L.B.); School of Pharmacy, Faculty of Mathematics and Natural Sciences (A.M.S.K., J.M.A., E.L.Ø.), Institute of Basic Medical Sciences (I.L.B.) and Institute of Clinical Medicine (J.M.), Faculty of Medicine, University of Oslo, Oslo, Norway; and Department of Infectious Disease Immunology (A.A.) and Department of Health Data and Digitalization (J.M.), Norwegian Institute of Public Health, Oslo, Norway
| | - Jannike Mørch Andersen
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway (A.M.S.K., J.M.A., E.L.Ø., S.S., I.L.B.); School of Pharmacy, Faculty of Mathematics and Natural Sciences (A.M.S.K., J.M.A., E.L.Ø.), Institute of Basic Medical Sciences (I.L.B.) and Institute of Clinical Medicine (J.M.), Faculty of Medicine, University of Oslo, Oslo, Norway; and Department of Infectious Disease Immunology (A.A.) and Department of Health Data and Digitalization (J.M.), Norwegian Institute of Public Health, Oslo, Norway
| | - Elisabeth Leere Øiestad
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway (A.M.S.K., J.M.A., E.L.Ø., S.S., I.L.B.); School of Pharmacy, Faculty of Mathematics and Natural Sciences (A.M.S.K., J.M.A., E.L.Ø.), Institute of Basic Medical Sciences (I.L.B.) and Institute of Clinical Medicine (J.M.), Faculty of Medicine, University of Oslo, Oslo, Norway; and Department of Infectious Disease Immunology (A.A.) and Department of Health Data and Digitalization (J.M.), Norwegian Institute of Public Health, Oslo, Norway
| | - Synne Steinsland
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway (A.M.S.K., J.M.A., E.L.Ø., S.S., I.L.B.); School of Pharmacy, Faculty of Mathematics and Natural Sciences (A.M.S.K., J.M.A., E.L.Ø.), Institute of Basic Medical Sciences (I.L.B.) and Institute of Clinical Medicine (J.M.), Faculty of Medicine, University of Oslo, Oslo, Norway; and Department of Infectious Disease Immunology (A.A.) and Department of Health Data and Digitalization (J.M.), Norwegian Institute of Public Health, Oslo, Norway
| | - Audun Aase
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway (A.M.S.K., J.M.A., E.L.Ø., S.S., I.L.B.); School of Pharmacy, Faculty of Mathematics and Natural Sciences (A.M.S.K., J.M.A., E.L.Ø.), Institute of Basic Medical Sciences (I.L.B.) and Institute of Clinical Medicine (J.M.), Faculty of Medicine, University of Oslo, Oslo, Norway; and Department of Infectious Disease Immunology (A.A.) and Department of Health Data and Digitalization (J.M.), Norwegian Institute of Public Health, Oslo, Norway
| | - Jørg Mørland
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway (A.M.S.K., J.M.A., E.L.Ø., S.S., I.L.B.); School of Pharmacy, Faculty of Mathematics and Natural Sciences (A.M.S.K., J.M.A., E.L.Ø.), Institute of Basic Medical Sciences (I.L.B.) and Institute of Clinical Medicine (J.M.), Faculty of Medicine, University of Oslo, Oslo, Norway; and Department of Infectious Disease Immunology (A.A.) and Department of Health Data and Digitalization (J.M.), Norwegian Institute of Public Health, Oslo, Norway
| | - Inger Lise Bogen
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway (A.M.S.K., J.M.A., E.L.Ø., S.S., I.L.B.); School of Pharmacy, Faculty of Mathematics and Natural Sciences (A.M.S.K., J.M.A., E.L.Ø.), Institute of Basic Medical Sciences (I.L.B.) and Institute of Clinical Medicine (J.M.), Faculty of Medicine, University of Oslo, Oslo, Norway; and Department of Infectious Disease Immunology (A.A.) and Department of Health Data and Digitalization (J.M.), Norwegian Institute of Public Health, Oslo, Norway
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10
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Moulahoum H, Zihnioglu F, Timur S, Coskunol H. Novel technologies in detection, treatment and prevention of substance use disorders. J Food Drug Anal 2018; 27:22-31. [PMID: 30648574 PMCID: PMC9298618 DOI: 10.1016/j.jfda.2018.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 08/18/2018] [Accepted: 09/10/2018] [Indexed: 11/03/2022] Open
Abstract
Substance use disorders are a widely recognized problem, which affects various levels of communities and influenced the world socioeconomically. Its source is deeply embedded in the global population. In order to fight against such an adversary, governments have spared no efforts in implementing substance abuse treatment centers and funding research to develop treatments and prevention procedures. In this review, we will discuss the use of immunological-based treatments and detection kit technologies. We will be detailing the steps followed to produce performant antibodies (antigens, carriers, and adjuvants) focusing on cocaine and methamphetamine as examples. Furthermore, part of this review is dedicated to substance use detection. Owing to novel technologies such as bio-functional polymeric surfaces and biosensors manufacturing, detection has become a more convenient method with the fast and on-site developed devices. Commercially available devices are able to test substance use disorders in urine, saliva, hair, and sweat. This improvement has had a tremendous impact on the prevention of driving under influence and other illicit behaviors. Lastly, substance abuse became a major issue involving the cooperation of experts on all levels to devise better treatment programs and prevent abuse-based accidents, injury and death.
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Affiliation(s)
- Hichem Moulahoum
- Biochemistry Department, Faculty of Science, Ege University, Bornova, Izmir 35100, Turkey.
| | - Figen Zihnioglu
- Biochemistry Department, Faculty of Science, Ege University, Bornova, Izmir 35100, Turkey
| | - Suna Timur
- Biochemistry Department, Faculty of Science, Ege University, Bornova, Izmir 35100, Turkey; Central Research Testing and Analysis Laboratory Research and Application Center, Ege University, Bornova, Izmir 35100, Turkey
| | - Hakan Coskunol
- Addiction Treatment Center, Faculty of Medicine, Ege University, Bornova, Izmir 35100, Turkey.
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11
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Kimishima A, Olson ME, Janda KD. Investigations into the efficacy of multi-component cocaine vaccines. Bioorg Med Chem Lett 2018; 28:2779-2783. [PMID: 29317163 DOI: 10.1016/j.bmcl.2017.12.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 12/15/2022]
Abstract
Although cocaine addiction remains a serious health and societal problem in the United States, no FDA-approved treatment has been developed. Vaccines offer an exciting strategy for the treatment of cocaine addiction; however, vaccine formulations need to be optimized to improve efficacy. Herein, we examine the effectiveness of a tricomponent cocaine vaccine, defined as having its hapten (GNE) and adjuvant (cytosine-guanine oligodeoxynucleotide 1826, CpG ODN 1826) covalently linked via the immunogenic protein ovalbumin (OVA). The tricomponent vaccine (GNE-OVA-CpG 1826) and a vaccine of analogous, individual components (GNE-OVA+CpG ODN 1826) were found to similarly induce highly specific anticocaine antibody production in mice and block cocaine's stimulant effects in hyperlocomotor testing.
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Affiliation(s)
- Atsushi Kimishima
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology and the Worm Institute of Research and Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States
| | - Margaret E Olson
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology and the Worm Institute of Research and Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States
| | - Kim D Janda
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology and the Worm Institute of Research and Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States.
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12
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Carfora A, Cassandro P, Feola A, La Sala F, Petrella R, Borriello R. Ethical Implications in Vaccine Pharmacotherapy for Treatment and Prevention of Drug of Abuse Dependence. JOURNAL OF BIOETHICAL INQUIRY 2018; 15:45-55. [PMID: 29350320 DOI: 10.1007/s11673-017-9834-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 10/10/2017] [Indexed: 06/07/2023]
Abstract
Different immunotherapeutic approaches are in the pipeline for the treatment of drug dependence. "Drug vaccines" aim to induce the immune system to produce antibodies that bind to drugs and prevent them from inducing rewarding effects in the brain. Drugs of abuse currently being tested using these new approaches are opioids, nicotine, cocaine, and methamphetamine. In human clinical trials, "cocaine and nicotine vaccines" have been shown to induce sufficient antibody levels while producing few side effects. Studies in humans, determining how these vaccines interact in combination with their target drug, are underway. However, although vaccines can become a reasonable treatment option for drugs of abuse, there are several disadvantages that must be considered. These include i) great individual variability in the formation of antibodies, ii) the lack of protection against a structurally dissimilar drug that produces the same effects as the drug of choice, and iii) the lack of an effect on the drug desire that may predispose an addict to relapse. In addition, a comprehensive overview of several crucial ethical issues has not yet been widely discussed in order to have not only a biological approach to immunotherapy of addiction. Overall, immunotherapy offers a range of possible treatment options: the pharmacological treatment of addiction, the treatment of overdoses, the prevention of toxicity to the brain or the heart, and the protection of the fetus during pregnancy. So far, the results obtained from a small-scale experiment using vaccines against cocaine and nicotine suggest that a number of important technical challenges still need to be overcome before such vaccines can be approved for clinical use.
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Affiliation(s)
- Anna Carfora
- Forensic Toxicology Unit, Section of Legal Medicine, Università degli Studi della Campania "L. Vanvitelli", Via L. Armanni, 5, 80138, Naples, Italy.
| | - Paola Cassandro
- Forensic Toxicology Unit, Section of Legal Medicine, Università degli Studi della Campania "L. Vanvitelli", Via L. Armanni, 5, 80138, Naples, Italy
| | - Alessandro Feola
- Department of Biomedicine and Prevention, Università degli Studi di Roma "Tor Vergata", Via Montpellier, 1, 00133, Rome, Italy
| | - Francesco La Sala
- Forensic Toxicology Unit, Section of Legal Medicine, Università degli Studi della Campania "L. Vanvitelli", Via L. Armanni, 5, 80138, Naples, Italy
| | - Raffaella Petrella
- Forensic Toxicology Unit, Section of Legal Medicine, Università degli Studi della Campania "L. Vanvitelli", Via L. Armanni, 5, 80138, Naples, Italy
| | - Renata Borriello
- Forensic Toxicology Unit, Section of Legal Medicine, Università degli Studi della Campania "L. Vanvitelli", Via L. Armanni, 5, 80138, Naples, Italy
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13
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de Zafra CLZ, Markgraf CG, Compton DR, Hudzik TJ. Abuse liability assessment for biologic drugs - All molecules are not created equal. Regul Toxicol Pharmacol 2017; 92:165-172. [PMID: 29199066 DOI: 10.1016/j.yrtph.2017.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/27/2017] [Accepted: 11/29/2017] [Indexed: 12/21/2022]
Abstract
The development of novel drug candidates involves the thorough evaluation of potential efficacy and safety. To facilitate the safety assessment in light of global increases in prescription drug misuse/abuse, health authorities have developed guidance documents which provide a framework for evaluating the abuse liability of candidate therapeutics. The guidances do not distinguish between small molecules and biologics/biotherapeutics; however, there are key differences between these classes of therapeutics which are important drivers of concern for abuse. An analysis of these properties, including ability to distribute to the central nervous system, pharmacokinetic properties (e.g., half-life and metabolism), potential for off-target binding, and the physiochemical characteristics of biologic drug products suggests that the potential for abuse of a biologic is limited. Many marketed antibodies and recombinant proteins have been associated with adverse effects such as headache and dizziness. However, biologics have not historically engendered the rapid-onset psychoactive effects typically present for drugs of abuse, thus further underscoring their low risk for abuse potential. The factors to be taken into consideration before conducting nonclinical abuse liability studies with biologics are described herein; importantly, the aggregate assessment of these factors leads to the conclusion that abuse liability studies are unlikely to be necessary for this class of therapeutics.
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Affiliation(s)
| | - Carrie G Markgraf
- Preclinical Safety, Discovery Sciences Support, Merck & Co., Ltd., Kenilworth, NJ, USA
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14
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Augmenting the efficacy of anti-cocaine catalytic antibodies through chimeric hapten design and combinatorial vaccination. Bioorg Med Chem Lett 2017; 27:3666-3668. [PMID: 28709828 DOI: 10.1016/j.bmcl.2017.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 07/04/2017] [Indexed: 01/25/2023]
Abstract
Given the need for further improvements in anti-cocaine vaccination strategies, a chimeric hapten (GNET) was developed that combines chemically-stable structural features from steady-state haptens with the hydrolytic functionality present in transition-state mimetic haptens. Additionally, as a further investigation into the generation of an improved bifunctional antibody pool, sequential vaccination with steady-state and transition-state mimetic haptens was undertaken. While GNET induced the formation of catalytically-active antibodies, it did not improve overall behavioral efficacy. In contrast, the resulting pool of antibodies from GNE/GNT co-administration demonstrated intermediate efficacy as compared to antibodies developed from either hapten alone. Overall, improved antibody catalytic efficiency appears necessary to achieve the synergistic benefits of combining cocaine hydrolysis with peripheral sequestration.
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15
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Effective active vaccination against methamphetamine in female rats. Drug Alcohol Depend 2017; 175:179-186. [PMID: 28437722 PMCID: PMC5484075 DOI: 10.1016/j.drugalcdep.2017.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 02/28/2017] [Accepted: 03/18/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Immunotherapies directed against methamphetamine (MA) abuse have shown success in rodent models, however only a limited number of studies have investigated active vaccination in female mice and none in female rats. It is critical to determine if potential immunotherapeutic strategies generalize across sex, particularly for drugs that may produce significant sex-differences on behavioral or physiological endpoints. METHODS Female Wistar rats were initially vaccinated with keyhole-limpet hemocyanin (KLH) or an anti-methamphetamine-KLH conjugate (MH6-KLH) three times over five weeks and implanted with radiotelemetry devices to assess locomotor activity and body temperature responses to MA. Rats were first exposed to MA via vapor inhalation (100mg/mL in propylene glycol) and then by injection (0.25-1.0mg/kg, i.p.) and vapor after a final vaccine boost. RESULTS The MH6-KLH vaccine generated an increase in antibody titers across the initial 6-week, 3 immunization protocol and a restoration of titer after a week 14 booster. Locomotor stimulation induced by 0.25mg/kg MA, i.p, in the KLH group was prevented in the MH6-KLH group. MH6-KLH animals also exhibited an attenuated locomotor stimulation produced by 0.5mg/kg MA, i.p. No group differences in locomotion induced by vapor inhalation of MA were observed and body temperature was not differentially affected by MA across the groups, most likely because vapor inhalation of MA that produced similar locomotor stimulation resulted in ∼10-fold higher plasma MA levels. CONCLUSIONS This study confirms the efficacy of the MH6-KLH vaccine in attenuating the effects of MA in female rats.
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Brashier DBS, Sharma AK, Akhoon N. Are therapeutic vaccines an answer to the global problem of drug and alcohol abuse? Indian J Pharmacol 2016; 48:487-489. [PMID: 27721531 PMCID: PMC5051239 DOI: 10.4103/0253-7613.190717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Drug Abuse has become a major challenging problem for the society. It effects people of all countries economical strata's and all ages. According. Monetary loss all over the world regarding drug abuse is in million dollars, it not only has an impact on human productivity and healthcare cost but also on cost of crimes conducted by these drugs and alcohol abuse. Therapeutic vaccine has come as new approach to deal with this problem, after failures in search for a pharmaceutical agent to deal with drug of abuse and alcohol. Research in field of nicotine abuse has gone a way ahead with number of vaccines being tried clinically followed by cocaine, opioids, methamphetamine, phencyclidine and alcohol. All of them have a common mechanism of action by antibody production whereas alcohol acts by genetic intervention. None have being approved yet due to poor results in phase II trials, possibly due to not able to trigger an adequate immunological response. But still quest is on for cracking the ice by developing first successful vaccine against drug of abuse, that would follow for other drugs too. It would be great step in field of therapeutic vaccines for drug abuse after similar successful vaccines being approved for other diseases like cancer.
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Affiliation(s)
- Dick B S Brashier
- Department of Pharmacology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ashok Kumar Sharma
- Department of Pharmacology, Armed Forces Medical College, Pune, Maharashtra, India
| | - Neha Akhoon
- Department of Pharmacology, Armed Forces Medical College, Pune, Maharashtra, India
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17
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Del Felice A, Bellamoli E, Formaggio E, Manganotti P, Masiero S, Cuoghi G, Rimondo C, Genetti B, Sperotto M, Corso F, Brunetto G, Bricolo F, Gomma M, Serpelloni G. Neurophysiological, psychological and behavioural correlates of rTMS treatment in alcohol dependence. Drug Alcohol Depend 2016; 158:147-53. [PMID: 26679060 DOI: 10.1016/j.drugalcdep.2015.11.018] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 11/12/2015] [Accepted: 11/12/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Addiction is associated with dorso-lateral prefrontal cortex (DLPFC) dysfunction and altered brain-oscillations. High frequency repetitive transcranial magnetic stimulation (HFrTMS) over DLPFC reportedly reduces drug craving. Its effects on neuropsychological, behavioural and neurophysiological are unclear. METHODS We assessed psychological, behavioural and neurophysiological effects of 4 sessions of 10-min adjunctive HFrTMS over the left DLPFC during two weeks during a residential programme for alcohol detoxification. Participants were randomized to active HFrTMS (10 Hz, 100% motor threshold) or sham. Immediately before the first and after the last session, 32-channels EEG was recorded and alcohol craving Visual Analogue Scale, Symptom Check List-90-R, Numeric Stroop task and Go/No-go task administered. Tests were repeated at 1-month follow-up. RESULTS 17 subjects (mean age 44.7 years, 4 F) were assessed. Active rTMS subjects performed better at Stroop test at end of treatment (p=0.036) and follow up (p=0.004) and at Go-NoGo at end of treatment (p=0.05) and follow up (p=0.015). Depressive symptoms decreased at end of active treatment (p=0.036). Active-TMS showed an overall decrease of fast EEG frequencies after treatment compared to sham (p=0.026). No significant modifications over time or group emerged for craving and number of drinks at follow up. CONCLUSION 4 HFrTMS sessions over two weeks on the left DLPFC can improve inhibitory control task and selective attention and reduce depressive symptoms. An overall reduction of faster EEG frequencies was observed. Nonetheless, this schedule is ineffective in reducing craving and alcohol intake.
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Affiliation(s)
- Alessandra Del Felice
- Department of Neuroscience-DSN, University of Padova, Via Giustiniani 2, Padua, Italy.
| | - Elisa Bellamoli
- Department of Neurological and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Emanuela Formaggio
- Department of Neurophysiology, Foundation IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Paolo Manganotti
- Neurology Clinic, University Hospital, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Stefano Masiero
- Department of Neuroscience-DSN, University of Padova, Via Giustiniani 2, Padua, Italy
| | - Giuseppe Cuoghi
- Institute of Constructivist Psychology, Via Martiri della Libertà 13, 35137 Padua, Italy
| | - Claudia Rimondo
- National Coordination Centre for NIDA Collaborations, Via Germania 20, 37136 Verona, Italy
| | - Bruno Genetti
- Explora-Centro di Ricerca e Analisi Statistica, Via Cà Pisani 7, Padua, Vigodarzere, Italy
| | - Milena Sperotto
- Explora-Centro di Ricerca e Analisi Statistica, Via Cà Pisani 7, Padua, Vigodarzere, Italy
| | - Flavia Corso
- Addiction Department, ULSS 20, Via Germania 20, 37136 Verona, Italy
| | | | | | - Maurizio Gomma
- Addiction Department, ULSS 20, Via Germania 20, 37136 Verona, Italy
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