1
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Gallant JP, Hicks D, Shi K, Moeller NH, Hoppe B, Lake EW, Baehr C, Pravetoni M, Aihara H, LeBeau AM. Identification and biophysical characterization of a novel domain-swapped camelid antibody specific for fentanyl. J Biol Chem 2024:107502. [PMID: 38945452 DOI: 10.1016/j.jbc.2024.107502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/04/2024] [Accepted: 06/17/2024] [Indexed: 07/02/2024] Open
Abstract
Opioid use disorders (OUD) and overdoses are ever-evolving public health threats that continue to grow in incidence and prevalence in the United States and abroad. Current treatments consist of opioid receptor agonists and antagonists, which are safe and effective but still suffer from some limitations. Murine and humanized monoclonal antibodies (mAb) have emerged as an alternative and complementary strategy to reverse and prevent opioid-induced respiratory depression. To explore antibody applications beyond traditional heavy-light chain mAbs, we identified and biophysically characterized a novel single-domain antibody specific for fentanyl from a camelid variable-heavy-heavy (VHH) domain phage display library. Structural data suggested that VHH binding to fentanyl was facilitated by a unique domain-swapped dimerization mechanism, which accompanied a rearrangement of complementarity-determining region (CDR) loops leading to the formation of a fentanyl-binding pocket. Structure-guided mutagenesis further identified an amino acid substitution that improved the affinity and relaxed the requirement for dimerization of the VHH in fentanyl binding. Our studies demonstrate VHH engagement of an opioid and inform on how to further engineer a VHH for enhanced stability and efficacy, laying the groundwork for exploring the in vivo applications of VHH-based biologics against OUD and overdose.
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Affiliation(s)
- Joseph P Gallant
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Dustin Hicks
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Ke Shi
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Nicholas H Moeller
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Brooke Hoppe
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA USA
| | - Eric W Lake
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Carly Baehr
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
| | - Marco Pravetoni
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA USA; Center for Medication Development for Substance Use Disorders, Seattle, WA, USA; Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA.
| | - Hideki Aihara
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Aaron M LeBeau
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA; Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA; Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA.
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2
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Urban K, Gkeka A, Chandra M, Greiner D, Pollich S, Ruf S, Kelemen Y, Sundermann T, Pravetoni M, Baehr C, Stebbins CE, Papavasiliou FN, Verdi JP. The fentanyl-specific antibody FenAb024 can shield against carfentanil effects. Toxicol Lett 2024; 396:1-10. [PMID: 38588756 DOI: 10.1016/j.toxlet.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 04/10/2024]
Abstract
The surge in opioid-related deaths, driven predominantly by fentanyl and its synthetic derivatives, has become a critical public health concern, which is particularly evident in the United States. While the situation is less severe in Europe, the European Monitoring Centre for Drugs and Drug Addiction reports a rise in drug overdose deaths, with emerging concerns about the impact of fentanyl-related molecules. Synthetic opioids, initially designed for medical use, have infiltrated illicit markets due to their low production costs and high potency, with carfentanil posing additional threats, including potential chemical weaponization. Existing overdose mitigation heavily relies on naloxone, requiring timely intervention and caregiver presence, while therapeutic prevention strategies face many access challenges. To provide an additional treatment option, we propose the use of a fentanyl-specific monoclonal antibody (mAb), as a non-opioid method of prophylaxis against fentanyl and carfentanil. This mAb shows protection from opioid effects in a pre-clinical murine model. mAbs could emerge as a versatile countermeasure in civilian and biodefense settings, offering a novel approach to combat opioid-associated mortality.
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Affiliation(s)
| | | | | | | | | | - Sandra Ruf
- Panosome GmbH, Heidelberg 69123, Germany; Division of Immune Diversity, German Cancer Research Center, Heidelberg 69120, Germany
| | | | - Tom Sundermann
- Department of Forensic Toxicology, Institute for Forensic Medicine and Traffic Medicine, Heidelberg University Clinic, Heidelberg 69115, Germany
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455, USA; Department of Psychiatry and Behavioral Sciences, Department of Pharmacology, University of Washington School of Medicine, Center for Medication Development for Substance Use Disorders, Seattle, WA 98195, USA
| | - Carly Baehr
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - C Erec Stebbins
- Division of Structural Biology of Infection and Immunity, German Cancer Research Center, Heidelberg 69120, Germany
| | - F Nina Papavasiliou
- Division of Immune Diversity, German Cancer Research Center, Heidelberg 69120, Germany
| | - Joseph P Verdi
- Panosome GmbH, Heidelberg 69123, Germany; Division of Immune Diversity, German Cancer Research Center, Heidelberg 69120, Germany; Hepione Therapeutics, Inc., New York, NY 10014, USA.
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3
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Chen XY, Wang L, Ma X, Yang F, Wang X, Xu P, Xu LL, Di B. Development of fentanyl-specific monoclonal antibody (mAb) to antagonize the pharmacological effects of fentanyl. Toxicol Appl Pharmacol 2024; 486:116918. [PMID: 38570042 DOI: 10.1016/j.taap.2024.116918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/17/2024] [Accepted: 03/30/2024] [Indexed: 04/05/2024]
Abstract
Fentanyl, a critical component of opioid analgesics, poses a severe threat to public health, exacerbating the drug problem due to its potential fatality. Herein, we present two novel haptens designed with different attachment sites conjugated to keyhole limpet hemocyanin (KLH), aiming to develop an efficacious vaccine against fentanyl. KLH-Fent-1 demonstrated superior performance over KLH-Fent-2 in antibody titer, blood-brain distribution, and antinociceptive tests. Consequently, we immunized mice with KLH-Fent-1 to generate fentanyl-specific monoclonal antibodies (mAbs) using the hybridoma technique to compensate for the defects of active immunization in the treatment of opioid overdose and addiction. The mAb produced by hybridoma 9D5 exhibited the ability to recognize fentanyl and its analogs with a binding affinity of 10-10 M. Subsequently, we developed a human IgG1 chimeric mAb to improve the degree of humanization. Pre-treatment with murine and chimeric mAb significantly reduced the analgesic effect of fentanyl and altered its blood-brain biodistribution in vivo. Furthermore, in a mouse model of fentanyl-induced respiratory depression, the chimeric mAb effectively reversed respiratory depression promptly and maintained a certain level during the week. The development of high-affinity chimeric mAb gives support to combat the challenges of fentanyl misuse and its detrimental consequences. In conclusion, mAb passive immunization represents a viable strategy for addressing fentanyl addiction and overdose.
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Affiliation(s)
- Xiao-Yi Chen
- Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, China; Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing 210009, China
| | - Li Wang
- Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, China; Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing 210009, China
| | - Xiao Ma
- Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, China; Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing 210009, China
| | - Fan Yang
- Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, China; Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing 210009, China
| | - Xiao Wang
- Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, China; Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing 210009, China
| | - Peng Xu
- Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, China; Key Laboratory of Drug Monitoring and Control, Drug Intelligence and Forensic Center, Ministry of Public Security, Beijing 100193, China.
| | - Li-Li Xu
- Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, China; Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing 210009, China.
| | - Bin Di
- Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Nanjing 210009, China; Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, Nanjing 210009, China.
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4
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Shao W, Sorescu DC, Liu Z, Star A. Machine Learning Discrimination and Ultrasensitive Detection of Fentanyl Using Gold Nanoparticle-Decorated Carbon Nanotube-Based Field-Effect Transistor Sensors. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024:e2311835. [PMID: 38679787 DOI: 10.1002/smll.202311835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/12/2024] [Indexed: 05/01/2024]
Abstract
The opioid overdose crisis is a global health challenge. Fentanyl, an exceedingly potent synthetic opioid, has emerged as a leading contributor to the surge in opioid-related overdose deaths. The surge in overdose fatalities, particularly due to illicitly manufactured fentanyl and its contamination of street drugs, emphasizes the urgency for drug-testing technologies that can quickly and accurately identify fentanyl from other drugs and quantify trace amounts of fentanyl. In this paper, gold nanoparticle (AuNP)-decorated single-walled carbon nanotube (SWCNT)-based field-effect transistors (FETs) are utilized for machine learning-assisted identification of fentanyl from codeine, hydrocodone, and morphine. The unique sensing performance of fentanyl led to use machine learning approaches for accurate identification of fentanyl. Employing linear discriminant analysis (LDA) with a leave-one-out cross-validation approach, a validation accuracy of 91.2% is achieved. Meanwhile, density functional theory (DFT) calculations reveal the factors that contributed to the enhanced sensitivity of the Au-SWCNT FET sensor toward fentanyl as well as the underlying sensing mechanism. Finally, fentanyl antibodies are introduced to the Au-SWCNT FET sensor as specific receptors, expanding the linear range of the sensor in the lower concentration range, and enabling ultrasensitive detection of fentanyl with a limit of detection at 10.8 fg mL-1.
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Affiliation(s)
- Wenting Shao
- Department of Chemistry, University of Pittsburgh, Pittsburgh, Pennsylvania, 15260, USA
| | - Dan C Sorescu
- United States Department of Energy, National Energy Technology Laboratory, Pittsburgh, Pennsylvania, 15236, USA
- Department of Chemical & Petroleum Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, USA
| | - Zhengru Liu
- Department of Chemistry, University of Pittsburgh, Pittsburgh, Pennsylvania, 15260, USA
| | - Alexander Star
- Department of Chemistry, University of Pittsburgh, Pittsburgh, Pennsylvania, 15260, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, USA
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5
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Newman M, Lynch C, Connery H, Goldsmith W, Nurkiewicz T, Raylman R, Boyd J. Fentanyl overdose: Temporal effects and prognostic factors in SKH1 mice. Basic Clin Pharmacol Toxicol 2024; 134:460-471. [PMID: 38284460 PMCID: PMC10939806 DOI: 10.1111/bcpt.13984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/09/2024] [Accepted: 01/12/2024] [Indexed: 01/30/2024]
Abstract
Fentanyl exposure and overdose are growing concerns in public health and occupational safety. This study aimed to establish parameters of fentanyl lethality in SKH1 mice for future overdose research. Lethality was determined using the up-down procedure, with subjects monitored post-administration using pulse oximetry (5 min) and then whole-body plethysmography (40 min). Following the determination of subcutaneous dose-response, [18F]Fluorodeoxyglucose positron emission tomography (18 F-FDG PET) was performed after LD10 fentanyl at 40 min, 6 h, 24 h or 7 days post-dose. LD10 and LD50 were observed to be 110 and 135 mg/kg, respectively, and consistent with four-parameter logistic fit values of 111.2 and 134.6 mg/kg (r2 = 0.9996). Overdose (LD10 or greater) yielded three distinct cardiovascular groups: survival, non-survival with blood oxygen saturation (SpO2) minimum ≥37% and non-survival with SpO2 <37%. Breaths per minute, minute volume and inspiratory quotient were significantly different between surviving and non-surviving animals for up to 40 min post-injection. 18 F-FDG PET revealed decreased glucose uptake in the heart, lungs and brain for up to 24 h. These findings provide critical insights into fentanyl lethality in SKH1 mice, including non-invasive respiratory effects and organ-specific impacts that are invaluable for future translational studies investigating the temporal effects of fentanyl overdose.
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Affiliation(s)
- Mackenzie Newman
- Department of Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
- Department of Orthopaedics, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Cayla Lynch
- Department of Physiology, Pharmacology and Toxicology, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Heather Connery
- Department of Physiology, Pharmacology and Toxicology, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - William Goldsmith
- Department of Physiology, Pharmacology and Toxicology, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
- Center for Inhalation Toxicology (iTOX), West Virginia University School of Medicine, Morgantown, WV, USA
| | - Timothy Nurkiewicz
- Department of Physiology, Pharmacology and Toxicology, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
- Center for Inhalation Toxicology (iTOX), West Virginia University School of Medicine, Morgantown, WV, USA
| | - Raymond Raylman
- Department of Radiology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Jonathan Boyd
- Department of Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
- Department of Orthopaedics, West Virginia University School of Medicine, Morgantown, West Virginia, USA
- Department of Physiology, Pharmacology and Toxicology, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
- Center for Inhalation Toxicology (iTOX), West Virginia University School of Medicine, Morgantown, WV, USA
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
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6
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Pavlović RZ, Finnegan TJ, Metlushko A, Hansen AL, Waudby CA, Wang X, Hoefer N, McComb DW, Pavić A, Plackić N, Novaković J, Bradić J, Jeremić N, Jakovljević V, Šmit B, Matić S, Alvarez-Saavedra MA, Čapo I, Moore CE, Stupp SI, Badjić JD. Dynamic and Assembly Characteristics of Deep-Cavity Basket Acting as a Host for Inclusion Complexation of Mitoxantrone in Biotic and Abiotic Systems. Chemistry 2023; 29:e202303374. [PMID: 37851342 DOI: 10.1002/chem.202303374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 10/19/2023]
Abstract
We describe the preparation, dynamic, assembly characteristics of vase-shaped basket 13- along with its ability to form an inclusion complex with anticancer drug mitoxantrone in abiotic and biotic systems. This novel cavitand has a deep nonpolar pocket consisting of three naphthalimide sides fused to a bicyclic platform at the bottom while carrying polar glycines at the top. The results of 1 H Nuclear Magnetic Resonance (NMR), 1 H NMR Chemical Exchange Saturation Transfer (CEST), Calorimetry, Hybrid Replica Exchange Molecular Dynamics (REMD), and Microcrystal Electron Diffraction (MicroED) measurements are in line with 1 forming dimer [12 ]6- , to be in equilibrium with monomers 1(R) 3- (relaxed) and 1(S) 3- (squeezed). Through simultaneous line-shape analysis of 1 H NMR data, kinetic and thermodynamic parameters characterizing these equilibria were quantified. Basket 1(R) 3- includes anticancer drug mitoxantrone (MTO2+ ) in its pocket to give stable binary complex [MTO⊂1]- (Kd =2.1 μM) that can be precipitated in vitro with UV light or pH as stimuli. Both in vitro and in vivo studies showed that the basket is nontoxic, while at a higher proportion with respect to MTO it reduced its cytotoxicity in vitro. With well-characterized internal dynamics and dimerization, the ability to include mitoxantrone, and biocompatibility, the stage is set to develop sequestering agents from deep-cavity baskets.
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Affiliation(s)
- Radoslav Z Pavlović
- Department of Chemistry & Biochemistry, The Ohio State University, 1100 W. 18th Avenue, Columbus, OH, 43210, USA
- Department of Chemistry, Northwestern University, Evanston, IL, 60208, USA
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, USA
- Department of Medicine, Northwestern University, Chicago, IL, 60611, USA
- Department of Materials Science and Engineering, Northwestern University, Chicago, IL, 60208, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, 60208, USA)
| | - Tyler J Finnegan
- Department of Chemistry & Biochemistry, The Ohio State University, 1100 W. 18th Avenue, Columbus, OH, 43210, USA
| | - Anna Metlushko
- Department of Chemistry, Northwestern University, Evanston, IL, 60208, USA
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, USA
- Department of Medicine, Northwestern University, Chicago, IL, 60611, USA
- Department of Materials Science and Engineering, Northwestern University, Chicago, IL, 60208, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, 60208, USA)
| | - Alexandar L Hansen
- Campus Chemical Instrument Center, The Ohio State University, Columbus, OH, 43210, USA
| | | | - Xiuze Wang
- Department of Chemistry & Biochemistry, The Ohio State University, 1100 W. 18th Avenue, Columbus, OH, 43210, USA
| | - Nicole Hoefer
- Center for Electron Microscopy and Analysis, The Ohio State University, Columbus, OH, 43210, USA
- Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, 43210, USA
| | - David W McComb
- Center for Electron Microscopy and Analysis, The Ohio State University, Columbus, OH, 43210, USA
- Department of Materials Science and Engineering, The Ohio State University, Columbus, OH, 43210, USA
| | - Aleksandar Pavić
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, 11000, Belgrade, Serbia
| | - Nikola Plackić
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, 11000, Belgrade, Serbia
| | - Jovana Novaković
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center for Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders, Kragujevac, Serbia
| | - Jovana Bradić
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center for Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders, Kragujevac, Serbia
| | - Nevena Jeremić
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center for Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders, Kragujevac, Serbia
| | - Vladimir Jakovljević
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Center for Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders, Kragujevac, Serbia
| | - Biljana Šmit
- University of Kragujevac, Institute for Information Technologies, Department of Science, Kragujevac, Serbia)
| | - Sanja Matić
- University of Kragujevac, Institute for Information Technologies, Department of Science, Kragujevac, Serbia)
| | - Matias A Alvarez-Saavedra
- Department of Chemistry, Northwestern University, Evanston, IL, 60208, USA
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, USA
- Department of Medicine, Northwestern University, Chicago, IL, 60611, USA
- Department of Materials Science and Engineering, Northwestern University, Chicago, IL, 60208, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, 60208, USA)
| | - Ivan Čapo
- Department of Histology and Embryology, Medical Faculty of Novi Sad, Novi Sad, Serbia
| | - Curtis E Moore
- Department of Chemistry & Biochemistry, The Ohio State University, 1100 W. 18th Avenue, Columbus, OH, 43210, USA
| | - Samuel I Stupp
- Department of Chemistry, Northwestern University, Evanston, IL, 60208, USA
- Simpson Querrey Institute for BioNanotechnology, Northwestern University, Chicago, IL, 60611, USA
- Department of Medicine, Northwestern University, Chicago, IL, 60611, USA
- Department of Materials Science and Engineering, Northwestern University, Chicago, IL, 60208, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, 60208, USA)
| | - Jovica D Badjić
- Department of Chemistry & Biochemistry, The Ohio State University, 1100 W. 18th Avenue, Columbus, OH, 43210, USA
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7
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Bremer PT, Burke EL, Barrett AC, Desai RI. Investigation of monoclonal antibody CSX-1004 for fentanyl overdose. Nat Commun 2023; 14:7700. [PMID: 38052779 PMCID: PMC10698161 DOI: 10.1038/s41467-023-43126-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/01/2023] [Indexed: 12/07/2023] Open
Abstract
The opioid crisis in the United States is primarily driven by the highly potent synthetic opioid fentanyl leading to >70,000 overdose deaths annually; thus, new therapies for fentanyl overdose are urgently needed. Here, we present the first clinic-ready, fully human monoclonal antibody CSX-1004 with picomolar affinity for fentanyl and related analogs. In mice CSX-1004 reverses fentanyl antinociception and the intractable respiratory depression caused by the ultrapotent opioid carfentanil. Moreover, toxicokinetic evaluation in a repeat-dose rat study and human tissue cross-reactivity study reveals a favorable pharmacokinetic profile of CSX-1004 with no safety-related issues. Using a highly translational non-human primate (NHP) model of respiratory depression, we demonstrate CSX-1004-mediated protection from repeated fentanyl challenges for 3-4 weeks. Furthermore, treatment with CSX-1004 produces up to a 15-fold potency reduction of fentanyl in NHP respiration, antinociception and operant responding assays without affecting non-fentanyl opioids like oxycodone. Taken together, our data establish the feasibility of CSX-1004 as a promising candidate medication for preventing and reversing fentanyl-induced overdose.
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Affiliation(s)
| | - Emily L Burke
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Behavioral Biology Program, Integrative Neurochemistry Laboratory, McLean Hospital, Belmont, MA, USA
| | | | - Rajeev I Desai
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Behavioral Biology Program, Integrative Neurochemistry Laboratory, McLean Hospital, Belmont, MA, USA
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8
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Bogen IL, Boix F, Andersen JM, Steinsland S, Nerem E, Mørland J. Heroin metabolism in human blood and its impact for the design of an immunotherapeutic approach against heroin effects. Basic Clin Pharmacol Toxicol 2023; 133:418-427. [PMID: 37452619 DOI: 10.1111/bcpt.13926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Immunotherapeutic interventions that block drug effects by binding drug molecules to specific antibodies in the bloodstream have shown promising effects in animal studies. For heroin, which effects are mainly mediated by the metabolites 6-acetylmorphine (6-AM; also known as 6-monoacetylmorphine or 6-MAM) and morphine, the optimal antibody specificity has been discussed. In rodents, 6-AM specific antibodies have been recommended based on the rapid metabolism of heroin to 6-AM in the bloodstream. Since the metabolic rate of heroin in blood is unsettled in humans, we examined heroin metabolism with state-of-the-art analytical methodology (UHPLC-MS/MS) in freshly drawn human whole blood incubated with a wide range of heroin concentrations (1-500 μM). The half-life of heroin was highly concentration dependent, ranging from 1.2-1.7 min for concentrations at or above 25 μM, and gradually increasing to approximately 20 min for 1 μM heroin. At concentrations that can be attained in the bloodstream shortly after an i.v. injection, approximately 70% was transformed into 6-AM within 3 min, similar to previous observations in vivo. Our results indicate that blood enzymes play a more important role for the rapid metabolism of heroin in humans than previously assumed. This points to 6-AM as an important target for an efficient immunotherapeutic approach to block heroin effects in humans.
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Affiliation(s)
- Inger Lise Bogen
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Fernando Boix
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Jannike Mørch Andersen
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Synne Steinsland
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Elisabeth Nerem
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Jørg Mørland
- Division of Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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9
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Eubanks LM, Pholcharee T, Oyen D, Natori Y, Zhou B, Wilson IA, Janda KD. An Engineered Human-Antibody Fragment with Fentanyl Pan-Specificity That Reverses Carfentanil-Induced Respiratory Depression. ACS Chem Neurosci 2023; 14:2849-2856. [PMID: 37534714 PMCID: PMC10791143 DOI: 10.1021/acschemneuro.3c00455] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
The opioid overdose crisis primarily driven by potent synthetic opioids resulted in more than 500,000 deaths in the US over the last 20 years. Though naloxone, a short-acting medication, remains the primary treatment option for temporarily reversing opioid overdose effects, alternative countermeasures are needed. Monoclonal antibodies present a versatile therapeutic opportunity that can be tailored to synthetic opioids and help prevent post-treatment renarcotization. The ultrapotent analog carfentanil is especially concerning due to its unique pharmacological properties. With this in mind, we generated a fully human antibody through a drug-specific B cell sorting strategy with a combination of carfentanil and fentanyl probes. The resulting pan-specific antibody was further optimized through scFv phage display, producing C10-S66K. This monoclonal antibody displays high affinity to carfentanil, fentanyl, and other analogs and reversed carfentanil-induced respiratory depression. Additionally, X-ray crystal structures with carfentanil and fentanyl bound provided structural insight into key drug:antibody interactions.
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Affiliation(s)
- Lisa M. Eubanks
- Departments of Chemistry and Immunology, La Jolla, CA 92037,
United States
| | - Tossapol Pholcharee
- Department of Integrative Structural and Computational
Biology, La Jolla, CA 92037, United States
| | - David Oyen
- Department of Integrative Structural and Computational
Biology, La Jolla, CA 92037, United States
| | - Yoshihiro Natori
- Departments of Chemistry and Immunology, La Jolla, CA 92037,
United States
| | - Bin Zhou
- Departments of Chemistry and Immunology, La Jolla, CA 92037,
United States
| | - Ian A. Wilson
- Department of Integrative Structural and Computational
Biology, La Jolla, CA 92037, United States
- The Skaggs Institute for Chemical Biology, La Jolla, CA
92037, United States
| | - Kim D. Janda
- Departments of Chemistry and Immunology, La Jolla, CA 92037,
United States
- Worm Institute for Research and Medicine (WIRM), The
Scripps Research Institute, La Jolla, CA 92037, United States
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10
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Eubanks LM, Pholcharee T, Oyen D, Natori Y, Zhou B, Wilson IA, Janda KD. An Engineered Human-Antibody Fragment with Fentanyl Pan-Specificity that Reverses Carfentanil-Induced Respiratory Depression. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.04.547721. [PMID: 37461607 PMCID: PMC10349930 DOI: 10.1101/2023.07.04.547721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
The opioid overdose crisis primarily driven by potent synthetic opioids resulted in more than 500,000 deaths in the US over the last 20 years. Though naloxone, a short acting medication, remains the primary treatment option for temporarily reversing opioid overdose effects, alternative countermeasures are needed. Monoclonal antibodies present a versatile therapeutic opportunity that can be tailored for synthetic opioids and that can help prevent post-treatment renarcotization. The ultrapotent analog carfentanil, is especially concerning due to its unique pharmacological properties. With this in mind, we generated a fully human antibody through a drug-specific B cell sorting strategy with a combination of carfentanil and fentanyl probes. The resulting pan-specific antibody was further optimized through scFv phage display. This antibody, C10-S66K, displays high affinity to carfentanil, fentanyl, and other analogs, and reversed carfentanil-induced respiratory depression. Additionally, x-ray crystal structures with carfentanil and fentanyl bound provided structural insight into key drug:antibody interactions.
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Affiliation(s)
- Lisa M. Eubanks
- Departments of Chemistry and Immunology, The Scripps Research Institute, La Jolla, CA 92037, United States
| | - Tossapol Pholcharee
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, United States
| | - David Oyen
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, United States
| | - Yoshihiro Natori
- Departments of Chemistry and Immunology, The Scripps Research Institute, La Jolla, CA 92037, United States
| | - Bin Zhou
- Departments of Chemistry and Immunology, The Scripps Research Institute, La Jolla, CA 92037, United States
| | - Ian A. Wilson
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, United States
- The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, CA 92037, United States
| | - Kim D. Janda
- Departments of Chemistry and Immunology, The Scripps Research Institute, La Jolla, CA 92037, United States
- Worm Institute for Research and Medicine (WIRM), The Scripps Research Institute, La Jolla, CA 92037, United States
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11
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Lin M, Eubanks LM, Karadkhelkar NM, Blake S, Janda KD. Catalytic Antibody Blunts Carfentanil-Induced Respiratory Depression. ACS Pharmacol Transl Sci 2023; 6:802-811. [PMID: 37200811 PMCID: PMC10186356 DOI: 10.1021/acsptsci.3c00031] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Indexed: 05/20/2023]
Abstract
Carfentanil, the most potent of the fentanyl analogues, is at the forefront of synthetic opioid-related deaths, second to fentanyl. Moreover, the administration of the opioid receptor antagonist naloxone has proven inadequate for an increasing number of opioid-related conditions, often requiring higher/additional doses to be effective, as such interest in alternative strategies to combat more potent synthetic opioids has intensified. Increasing drug metabolism would be one strategy to detoxify carfentanil; however, carfentanil's major metabolic pathways involve N-dealkylation or monohydroxylation, which do not lend themselves readily to exogenous enzyme addition. Herein, we report, to our knowledge, the first demonstration that carfentanil's methyl ester when hydrolyzed to its acid was found to be 40,000 times less potent than carfentanil in activating the μ-opioid receptor. Physiological consequences of carfentanil and its acid were also examined through plethysmography, and carfentanil's acid was found to be incapable of inducing respiratory depression. Based upon this information, a hapten was chemically synthesized and immunized, allowing the generation of antibodies that were screened for carfentanil ester hydrolysis. From the screening campaign, three antibodies were found to accelerate the hydrolysis of carfentanil's methyl ester. From this series of catalytic antibodies, the most active underwent extensive kinetic analysis, allowing us to postulate its mechanism of hydrolysis against this synthetic opioid. In the context of potential clinical applications, the antibody, when passively administered, was able to reduce respiratory depression induced by carfentanil. The data presented supports further development of antibody catalysis as a biologic strategy to complement carfentanil overdose reversal.
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Affiliation(s)
- Mingliang Lin
- Departments of Chemistry
and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute
of Research and Medicine (WIRM), The Scripps
Research Institute, La Jolla, California 92037, United States
| | - Lisa M. Eubanks
- Departments of Chemistry
and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute
of Research and Medicine (WIRM), The Scripps
Research Institute, La Jolla, California 92037, United States
| | - Nishant M. Karadkhelkar
- Departments of Chemistry
and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute
of Research and Medicine (WIRM), The Scripps
Research Institute, La Jolla, California 92037, United States
| | - Steven Blake
- Departments of Chemistry
and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute
of Research and Medicine (WIRM), The Scripps
Research Institute, La Jolla, California 92037, United States
| | - Kim D. Janda
- Departments of Chemistry
and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute
of Research and Medicine (WIRM), The Scripps
Research Institute, La Jolla, California 92037, United States
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12
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Baehr C, Kassick AJ, Vigliaturo J, Luengas D, Khaimraj A, Pravetoni M, Averick SE, Raleigh MD. Anti-Strychnine Immunoconjugate Reduces the Effects of Strychnine-Induced Toxicity in Mice. ACS Chem Neurosci 2023; 14:1291-1298. [PMID: 36952479 DOI: 10.1021/acschemneuro.2c00797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
Strychnine poisoning induces seizures that result in loss of control of airway muscles, leading to asphyxiation and subsequent death. Current treatment options are limited, requiring hands-on medical care and isolation to low-stimulus environments. Anticonvulsants and muscle relaxants have shown limited success in cases of severe toxicity. Furthermore, nonfatal strychnine poisoning is likely to result in long-term muscular and cognitive damage. Due to its potency, accessibility, and lack of effective antidotes, strychnine poses a unique threat for mass casualty incidents. As a first step toward developing an anti-strychnine immunotherapy to reduce or prevent strychnine-induced seizures, a strychnine vaccine was synthesized using subunit keyhole limpet hemocyanin. Mice were vaccinated with the strychnine immunoconjugate and then given a 0.75 mg/kg IP challenge of strychnine and observed for seizures for 30 min. Vaccination reduced strychnine-induced events, and serum strychnine levels were increased while brain strychnine levels were decreased in vaccinated animals compared to the control. These data demonstrate that strychnine-specific antibodies can block the seizure-inducing effects of strychnine and could be used to develop a therapeutic for strychnine poisoning.
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Affiliation(s)
- Carly Baehr
- Department of Pharmacology, University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota 55455, United States
| | - Andrew J Kassick
- Neuroscience Disruptive Research Lab, Allegheny Health Network Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
- Neuroscience Institute, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
| | - Jennifer Vigliaturo
- Department of Pharmacology, University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota 55455, United States
| | - Diego Luengas
- Department of Pharmacology, University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota 55455, United States
| | - Aaron Khaimraj
- Department of Pharmacology, University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota 55455, United States
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota 55455, United States
- Center for Immunology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States
- Department of Psychiatry and Behavioral Sciences, and Department of Pharmacology, University of Washington School of Medicine, Seattle, Washington 98104, United States
| | - Saadyah E Averick
- Neuroscience Disruptive Research Lab, Allegheny Health Network Research Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
- Neuroscience Institute, Allegheny Health Network, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, United States
| | - Michael D Raleigh
- Department of Pharmacology, University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota 55455, United States
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13
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Bahrami F, Rossi RM, De Nys K, Defraeye T. An individualized digital twin of a patient for transdermal fentanyl therapy for chronic pain management. Drug Deliv Transl Res 2023:10.1007/s13346-023-01305-y. [PMID: 36897525 PMCID: PMC10382374 DOI: 10.1007/s13346-023-01305-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2023] [Indexed: 03/11/2023]
Abstract
Fentanyl transdermal therapy is a suitable treatment for moderate-to-severe cancer-related pain. The inter-individual variability of the patients leads to different therapy responses. This study aims to determine the effect of physiological features on the achieved pain relief. Therefore, a set of virtual patients was developed by using Markov chain Monte Carlo (MCMC) based on actual patient data. The members of this virtual population differ by age, weight, gender, and height. Tailored digital twins were developed using these correlated, individualized parameters to propose a personalized therapy for each patient. It was shown that patients of different ages, weights, and gender have significantly different fentanyl blood uptake, plasma fentanyl concentration, pain relief, and ventilation rate. In the digital twins, we included the virtual patients' response to the treatment, namely, pain relief. Therefore, the digital twin was able to adjust the therapy in silico to have more efficient pain relief. By implementing digital-twin-assisted therapy, the average pain intensity decreased by 16% compared to conventional therapy. The median time without pain increased by 23 h over 72 h. Therefore, the digital twin can be successfully used in individual control of transdermal therapy to reach higher pain relief and maintain steady pain relief. (Created with BioRender.com).
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Affiliation(s)
- Flora Bahrami
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland.,University of Bern, ARTORG Center for Biomedical Engineering Research, Mittelstrasse 43, CH-3012, Bern, Switzerland
| | - René Michel Rossi
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland
| | - Katelijne De Nys
- Kantonsspital St. Gallen, Palliativzentrum, Rorschacherstrasse 95, CH-9000, St. Gallen, Switzerland.,KU Leuven, Department of Pharmaceutical and Pharmacological Sciences, ON2 Herestraat 49 - Box 424, BE-3000, Leuven, Belgium
| | - Thijs Defraeye
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Biomimetic Membranes and Textiles, Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland.
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14
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Chamoun K, Chevillard L, Hajj A, Callebert J, Mégarbane B. Mechanisms of Neurorespiratory Toxicity Induced by Fentanyl Analogs—Lessons from Animal Studies. Pharmaceuticals (Basel) 2023; 16:ph16030382. [PMID: 36986482 PMCID: PMC10051837 DOI: 10.3390/ph16030382] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
In 2020, fentanyl and its analogs contributed to ~65% of drug-attributed fatalities in the USA, with a threatening increasing trend during the last ten years. These synthetic opioids used as potent analgesics in human and veterinary medicine have been diverted to recreational aims, illegally produced and sold. Like all opioids, central nervous system depression resulting from overdose or misuse of fentanyl analogs is characterized clinically by the onset of consciousness impairment, pinpoint miosis and bradypnea. However, contrasting with what observed with most opioids, thoracic rigidity may occur rapidly with fentanyl analogs, contributing to increasing the risk of death in the absence of immediate life support. Various mechanisms have been proposed to explain this particularity associated with fentanyl analogs, including the activation of noradrenergic and glutamatergic coerulospinal neurons and dopaminergic basal ganglia neurons. Due to the high affinities to the mu-opioid receptor, the need for more elevated naloxone doses than usually required in morphine overdose to reverse the neurorespiratory depression induced by fentanyl analogs has been questioned. This review on the neurorespiratory toxicity of fentanyl and analogs highlights the need for specific research focused on these agents to better understand the involved mechanisms of toxicity and develop dedicated strategies to limit the resulting fatalities.
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Affiliation(s)
- Karam Chamoun
- Inserm, UMR-S1144, Paris Cité University, 75006 Paris, France
- Faculty of Pharmacy, Saint-Joseph University, Beirut 1100, Lebanon
- Laboratory of Pharmacology, Clinical Pharmacy, and Medicine Quality Control, Saint-Joseph University, Beirut 1100, Lebanon
| | | | - Aline Hajj
- Faculty of Pharmacy, Saint-Joseph University, Beirut 1100, Lebanon
- Laboratory of Pharmacology, Clinical Pharmacy, and Medicine Quality Control, Saint-Joseph University, Beirut 1100, Lebanon
- Research Center, Quebec University Hospital, Laval University, Québec, QC G1V 0A6, Canada
| | - Jacques Callebert
- Inserm, UMR-S1144, Paris Cité University, 75006 Paris, France
- Laboratory of Biochemistry and Molecular Biology, AP-HP, Lariboisière Hospital, 75010 Paris, France
| | - Bruno Mégarbane
- Inserm, UMR-S1144, Paris Cité University, 75006 Paris, France
- Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Federation of Toxicology APHP, 75010 Paris, France
- Correspondence:
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15
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Martinez S, Harris H, Chao T, Luba R, Pravetoni M, Comer SD, Jones JD. The potential role of opioid vaccines and monoclonal antibodies in the opioid overdose crisis. Expert Opin Investig Drugs 2023; 32:181-185. [PMID: 36863002 PMCID: PMC10065938 DOI: 10.1080/13543784.2023.2187286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/01/2023] [Indexed: 03/04/2023]
Affiliation(s)
- Suky Martinez
- Division on Substance Use Disorders, Columbia University Irving Medical Center & New York State Psychiatric Institute, New York, NY, USA
| | - Hannah Harris
- Division on Substance Use Disorders, Columbia University Irving Medical Center & New York State Psychiatric Institute, New York, NY, USA
| | - Thomas Chao
- Behavioural Reward Affect + Impulsivity Neuroscience Lab, Faculty of Medicine, the University of British Columbia, Vancouver, Bc, Canada
| | - Rachel Luba
- Division on Substance Use Disorders, Columbia University Irving Medical Center & New York State Psychiatric Institute, New York, NY, USA
| | - Marco Pravetoni
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Sandra D Comer
- Division on Substance Use Disorders, Columbia University Irving Medical Center & New York State Psychiatric Institute, New York, NY, USA
| | - Jermaine D Jones
- Division on Substance Use Disorders, Columbia University Irving Medical Center & New York State Psychiatric Institute, New York, NY, USA
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16
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Triller G, Vlachou EP, Hashemi H, van Straaten M, Zeelen JP, Kelemen Y, Baehr C, Marker CL, Ruf S, Svirina A, Chandra M, Urban K, Gkeka A, Kruse S, Baumann A, Miller AK, Bartel M, Pravetoni M, Stebbins CE, Papavasiliou FN, Verdi JP. A trypanosome-derived immunotherapeutics platform elicits potent high-affinity antibodies, negating the effects of the synthetic opioid fentanyl. Cell Rep 2023; 42:112049. [PMID: 36719797 PMCID: PMC10387133 DOI: 10.1016/j.celrep.2023.112049] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 12/02/2022] [Accepted: 01/13/2023] [Indexed: 01/31/2023] Open
Abstract
Poorly immunogenic small molecules pose challenges for the production of clinically efficacious vaccines and antibodies. To address this, we generate an immunization platform derived from the immunogenic surface coat of the African trypanosome. Through sortase-based conjugation of the target molecules to the variant surface glycoprotein (VSG) of the trypanosome surface coat, we develop VSG-immunogen array by sortase tagging (VAST). VAST elicits antigen-specific memory B cells and antibodies in a murine model after deploying the poorly immunogenic molecule fentanyl as a proof of concept. We also develop a single-cell RNA sequencing (RNA-seq)-based computational method that synergizes with VAST to specifically identify memory B cell-encoded antibodies. All computationally selected antibodies bind to fentanyl with picomolar affinity. Moreover, these antibodies protect mice from fentanyl effects after passive immunization, demonstrating the ability of these two coupled technologies to elicit therapeutic antibodies to challenging immunogens.
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Affiliation(s)
- Gianna Triller
- Division of Immune Diversity, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Evi P Vlachou
- Division of Immune Diversity, German Cancer Research Center, 69120 Heidelberg, Germany; Panosome GmbH, 69123 Heidelberg, Germany
| | - Hamidreza Hashemi
- Division of Immune Diversity, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Monique van Straaten
- Division of Structural Biology of Infection and Immunity, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Johan P Zeelen
- Division of Structural Biology of Infection and Immunity, German Cancer Research Center, 69120 Heidelberg, Germany
| | | | - Carly Baehr
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | - Cheryl L Marker
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455, USA; Iuvo Bioscience, Rush, NY 14543, USA
| | - Sandra Ruf
- Division of Immune Diversity, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Anna Svirina
- Division of Immune Diversity, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Monica Chandra
- Panosome GmbH, 69123 Heidelberg, Germany; Division of Structural Biology of Infection and Immunity, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Katharina Urban
- Division of Immune Diversity, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Anastasia Gkeka
- Division of Immune Diversity, German Cancer Research Center, 69120 Heidelberg, Germany; Panosome GmbH, 69123 Heidelberg, Germany
| | | | - Andreas Baumann
- Cancer Drug Development Group, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Aubry K Miller
- Cancer Drug Development Group, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Marc Bartel
- Forensic Toxicology, Institute of Forensic and Traffic Medicine, Heidelberg University Hospital, 69115 Heidelberg, Germany
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455, USA; Department of Psychiatry and Behavioral Sciences, Department of Pharmacology, University of Washington School of Medicine, Center for Medication Development for Substance Use Disorders, Seattle, WA 98195, USA
| | - C Erec Stebbins
- Division of Structural Biology of Infection and Immunity, German Cancer Research Center, 69120 Heidelberg, Germany
| | - F Nina Papavasiliou
- Division of Immune Diversity, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Joseph P Verdi
- Division of Immune Diversity, German Cancer Research Center, 69120 Heidelberg, Germany; Hepione Therapeutics, Inc., New York, NY 10014, USA.
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17
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Rodarte JV, Baehr C, Hicks D, Liban TL, Weidle C, Rupert PB, Jahan R, Wall A, McGuire AT, Strong RK, Runyon S, Pravetoni M, Pancera M. Structures of drug-specific monoclonal antibodies bound to opioids and nicotine reveal a common mode of binding. Structure 2023; 31:20-32.e5. [PMID: 36513069 DOI: 10.1016/j.str.2022.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/03/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022]
Abstract
Opioid-related fatal overdoses have reached epidemic proportions. Because existing treatments for opioid use disorders offer limited long-term protection, accelerating the development of newer approaches is critical. Monoclonal antibodies (mAbs) are an emerging treatment strategy that targets and sequesters selected opioids in the bloodstream, reducing drug distribution across the blood-brain barrier, thus preventing or reversing opioid toxicity. We previously identified a series of murine mAbs with high affinity and selectivity for oxycodone, morphine, fentanyl, and nicotine. To determine their binding mechanism, we used X-ray crystallography to solve the structures of mAbs bound to their respective targets, to 2.2 Å resolution or higher. Structural analysis showed a critical convergent hydrogen bonding mode that is dependent on a glutamic acid residue in the mAbs' heavy chain and a tertiary amine of the ligand. Characterizing drug-mAb complexes represents a significant step toward rational antibody engineering and future manufacturing activities to support clinical evaluation.
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Affiliation(s)
- Justas V Rodarte
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Carly Baehr
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Dustin Hicks
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Tyler L Liban
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Connor Weidle
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Peter B Rupert
- Basic Science Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Rajwana Jahan
- Research Triangle Institute International, Research Triangle Park, Durham, NC, USA
| | - Abigail Wall
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Andrew T McGuire
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Roland K Strong
- Basic Science Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Scott Runyon
- Research Triangle Institute International, Research Triangle Park, Durham, NC, USA
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA; Department of Psychiatry and Behavioral Sciences, Department of Pharmacology, School of Medicine, University of Washington, Seattle, WA, USA; Center for Medication Development for Substance Use Disorders and Overdose, University of Washington, Seattle, WA, USA.
| | - Marie Pancera
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
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18
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Hicks D, Baehr C, Silva-Ortiz P, Khaimraj A, Luengas D, Hamid FA, Pravetoni M. Advancing humanized monoclonal antibody for counteracting fentanyl toxicity towards clinical development. Hum Vaccin Immunother 2022; 18:2122507. [PMID: 36194773 PMCID: PMC9746415 DOI: 10.1080/21645515.2022.2122507] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/19/2022] [Accepted: 09/04/2022] [Indexed: 12/15/2022] Open
Abstract
Innovative therapies to complement current treatments are needed to curb the growing incidence of fatal overdoses related to synthetic opioids. Murine and chimeric monoclonal antibodies (mAb) specific for fentanyl and its analogs have demonstrated pre-clinical efficacy in preventing and reversing drug-induced toxicity in rodent models. However, mAb-based therapeutics require extensive engineering as well as in vitro and in vivo characterization to advance to first-in-human clinical trials. Here, novel murine anti-fentanyl mAbs were selected for development based on affinity for fentanyl, and efficacy in counteracting the pharmacological effects of fentanyl in mice. Humanization and evaluation of mutations designed to eliminate predicted post-translational modifications resulted in two humanized mAbs that were effective at preventing fentanyl-induced pharmacological effects in rats. These humanized mAbs showed favorable biophysical properties with respect to aggregation and hydrophobicity by chromatography-based assays, and thermostability by dynamic scanning fluorimetry. These results collectively support that the humanized anti-fentanyl mAbs developed herein warrant further clinical development for treatment of fentanyl toxicity.
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Affiliation(s)
- Dustin Hicks
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Carly Baehr
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Pedro Silva-Ortiz
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Aaron Khaimraj
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Diego Luengas
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Fatima A. Hamid
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
- School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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19
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Abstract
The incidence of opioid use disorder (OUD) and overdose deaths is rising yearly within the United States. Many cases are associated with illicitly manufactured fentanyl use. In addition to offering patients medications for OUD (methadone, buprenorphine, and naltrexone), the approach to this epidemic should involve increasing provider awareness and education about substance use disorders, expanding urine toxicology screens to test for fentanyl, and using low-threshold treatment approaches.
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20
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Han Y, Cao L, Yuan K, Shi J, Yan W, Lu L. Unique Pharmacology, Brain Dysfunction, and Therapeutic Advancements for Fentanyl Misuse and Abuse. Neurosci Bull 2022; 38:1365-1382. [PMID: 35570233 PMCID: PMC9107910 DOI: 10.1007/s12264-022-00872-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/13/2022] [Indexed: 11/20/2022] Open
Abstract
Fentanyl is a fully synthetic opioid with analgesic and anesthetic properties. It has become a primary driver of the deadliest opioid crisis in the United States and elsewhere, consequently imposing devastating social, economic, and health burdens worldwide. However, the neural mechanisms that underlie the behavioral effects of fentanyl and its analogs are largely unknown, and approaches to prevent fentanyl abuse and fentanyl-related overdose deaths are scarce. This review presents the abuse potential and unique pharmacology of fentanyl and elucidates its potential mechanisms of action, including neural circuit dysfunction and neuroinflammation. We discuss recent progress in the development of pharmacological interventions, anti-fentanyl vaccines, anti-fentanyl/heroin conjugate vaccines, and monoclonal antibodies to attenuate fentanyl-seeking and prevent fentanyl-induced respiratory depression. However, translational studies and clinical trials are still lacking. Considering the present opioid crisis, the development of effective pharmacological and immunological strategies to prevent fentanyl abuse and overdose are urgently needed.
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21
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Crouse B, Wu MM, Gradinati V, Kassick AJ, Song D, Jahan R, Averick S, Runyon S, Comer SD, Pravetoni M. Efficacy and Selectivity of Monovalent and Bivalent Vaccination Strategies to Protect against Exposure to Carfentanil, Fentanyl, and Their Mixtures in Rats. ACS Pharmacol Transl Sci 2022; 5:331-343. [PMID: 35592436 PMCID: PMC9112413 DOI: 10.1021/acsptsci.1c00260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Indexed: 12/23/2022]
Abstract
Drug-related fatal overdoses have significantly increased in the past decade due to the widespread availability of illicit fentanyl and other potent synthetic opioids such as carfentanil. Deliberate or accidental consumption or exposure to carfentanil, fentanyl, and their mixture induces respiratory depression and bradycardia that can be difficult to reverse with the opioid receptor antagonist naloxone. Vaccines offer a promising strategy to reduce the incidence of fatalities associated with fentanyl-related substances, as well as treatment for opioid use disorder (OUD). This study reports monovalent and bivalent vaccination strategies that elicit polyclonal antibody responses effective in protecting against the pharmacological actions of carfentanil, fentanyl, or carfentanil/fentanyl mixtures. Rats were prophylactically immunized with individual conjugate vaccines containing either carfentanil- or fentanyl-based haptens, or their combination in bivalent vaccine formulations, and then challenged with carfentanil, fentanyl, or their mixture. First, these studies identified a lead vaccine protective against carfentanil-induced antinociception, respiratory depression, and bradycardia. Then, efficacy against both carfentanil and fentanyl was achieved through bivalent vaccination strategies that combined lead anti-carfentanil and anti-fentanyl vaccines via either heterologous prime/boost or co-administration immunization regimens. These preclinical data support the development of vaccines as a viable strategy to prevent toxicity from exposure to excessive doses of carfentanil, fentanyl, or their mixtures.
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Affiliation(s)
- Bethany Crouse
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States.,School of Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota 55108, United States
| | - Mariah M Wu
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States.,School of Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota 55108, United States
| | - Valeria Gradinati
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States
| | - Andrew J Kassick
- Neuroscience Institute, Allegheny Health Network, Allegheny General Hospita, Pittsburgh, Pennsylvania 15212, United States
| | - Daihyun Song
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States
| | - Rajwana Jahan
- RTI International, Durham, North Carolina 27709, United States
| | - Saadyah Averick
- Neuroscience Institute, Allegheny Health Network, Allegheny General Hospita, Pittsburgh, Pennsylvania 15212, United States
| | - Scott Runyon
- RTI International, Durham, North Carolina 27709, United States
| | - Sandra D Comer
- Division on Substance Use Disorders, New York State Psychiatric Institute, and Department of Psychiatry, Columbia University Irving Medical Center, New York, New York 10032, United States
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States.,Center for Immunology, University of Minnesota, Minneapolis, Minnesota 55455, United States.,Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington 98195, United States
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22
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Zhang X, Wang J, Liang J, Liu Z, Shen X, Liu Y, Li X, Xu Z, Lei Y, Lei H. A novel self-aggregated gold nanoparticles based on sensitive immunochromatographic assays for highly detection of opium poppy in herbal teas. Food Chem 2022; 390:133188. [PMID: 35567969 DOI: 10.1016/j.foodchem.2022.133188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/02/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022]
Abstract
Opium poppy abused in food has aroused public concerns due to its serious side effects. Effective monitoring is essential to fight the abuse crisis. Herein, we synthesized an easily prepared, affordable, accessible highly aggregated gold nanoparticles (AGNPs) performing in lateral flow immunoassay (LFIA) for detection opium poppy in herbal teas. Simultaneously, a LFIA based ontime-resolved fluorescent microspheres (TRFMs) was developed as contrastive method. In this study, morphine (MOR), codeine (COD) and thebaine (THE) were as the specific recognition markers of opium poppy. Results demonstrated the quantitative limits of detection were 0.0049/0.0053/0.084, 0.034/0.037/0.37 ng mL-1 for AGNPs/TRFMs-LFIA, respectively. The recoveries were 95%-107.5%/91%-106.7% with coefficient of variation was 1.6%-6.6%/1.8%-7.2%, indicating excellent accuracy and precision. Parallel experiments among AGNPs/TRFMs-LFIA and LC-MS/MS analysis showed good correlation. Overall, AGNPs-LFIA executed quantitative analysis within 15 min on the basis of simple treatment while providing a rapid and sensitive analysis strategy for illegal drugs abused.
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Affiliation(s)
- Xuan Zhang
- Guangdong Provincial Key Laboratory of Food Quality and Safety / National-Local Joint Engineering Research Center for Machining and Safety of Livestock and Poultry Products, South China Agricultural University, Guangzhou 510642, China
| | - Jin Wang
- Guangdong Provincial Key Laboratory of Food Quality and Safety / National-Local Joint Engineering Research Center for Machining and Safety of Livestock and Poultry Products, South China Agricultural University, Guangzhou 510642, China
| | - Jianhao Liang
- Guangdong Provincial Key Laboratory of Food Quality and Safety / National-Local Joint Engineering Research Center for Machining and Safety of Livestock and Poultry Products, South China Agricultural University, Guangzhou 510642, China
| | - Zhiwei Liu
- Guangdong Provincial Key Laboratory of Food Quality and Safety / National-Local Joint Engineering Research Center for Machining and Safety of Livestock and Poultry Products, South China Agricultural University, Guangzhou 510642, China
| | - Xing Shen
- Guangdong Provincial Key Laboratory of Food Quality and Safety / National-Local Joint Engineering Research Center for Machining and Safety of Livestock and Poultry Products, South China Agricultural University, Guangzhou 510642, China
| | - Yingju Liu
- Laboratory for Biobased Materials and Energy of Ministry of Education, College of Materials and Energy, South China Agricultural University, Guangzhou 510642, China
| | - Xiangmei Li
- Guangdong Provincial Key Laboratory of Food Quality and Safety / National-Local Joint Engineering Research Center for Machining and Safety of Livestock and Poultry Products, South China Agricultural University, Guangzhou 510642, China
| | - Zhenlin Xu
- Guangdong Provincial Key Laboratory of Food Quality and Safety / National-Local Joint Engineering Research Center for Machining and Safety of Livestock and Poultry Products, South China Agricultural University, Guangzhou 510642, China
| | - Yi Lei
- Guangdong Institute of Food Inspection, Guangzhou 510435, China
| | - Hongtao Lei
- Guangdong Provincial Key Laboratory of Food Quality and Safety / National-Local Joint Engineering Research Center for Machining and Safety of Livestock and Poultry Products, South China Agricultural University, Guangzhou 510642, China.
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23
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Baehr CA, Wu MM, Pandit SG, Arias-Umana J, AuCoin D, Pravetoni M. Pharmacological Profiling of Antifentanyl Monoclonal Antibodies in Combination with Naloxone in Pre- and Postexposure Models of Fentanyl Toxicity. J Pharmacol Exp Ther 2022; 381:129-136. [PMID: 35153198 PMCID: PMC9048265 DOI: 10.1124/jpet.121.001048] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/02/2022] [Indexed: 11/22/2022] Open
Abstract
The incidence of fatal drug overdoses in the United States is an alarming public health threat that has been exacerbated by the COVID-19 pandemic, resulting in over 100,000 deaths between April 2020 and April 2021. A significant portion of this is attributable to widespread access to fentanyl and other synthetic opioids, alone or in combination with heroin or psychostimulants, such as cocaine or methamphetamine. Monoclonal antibodies (mAb) offer prophylactic and therapeutic interventions against opioid overdose by binding opioids in serum, reducing distribution of drug to the brain and other organs. Here, we investigated the efficacy of a leading antifentanyl mAb, clone HY6-F9, in reversal and prevention of fentanyl-induced toxicity compared with the opioid receptor antagonist naloxone (NLX) in rats. In postexposure models, rats were challenged with fentanyl, followed by HY6-F9, NLX, or both. HY6-F9 reversed fentanyl-induced antinociception, respiratory depression, and bradycardia, and rats retained protection against additional challenges for at least 1 week. Although intravenous NLX reversed fentanyl-induced respiratory depression more rapidly than mAb alone, kinetics of reversal by intravenous mAb were similar to subcutaneous NLX. Coadministration of mAb and NLX provided greater protection than individual treatments against high doses of fentanyl. Prophylactic administration of mAb reduced the ED50 of NLX approximately twofold against 2.25 mg/kg of fentanyl. Finally, mAb sequestered fentanyl and its metabolite norfentanyl in serum and reduced brain concentrations of fentanyl. These results support the translation of mAb as medical interventions alone or in combination with NLX to prevent and reverse fentanyl-related overdose. SIGNIFICANCE STATEMENT: Fentanyl-related overdoses have increased dramatically in the US and worldwide. Currently, approved pharmacotherapies for treatment of opioid use disorder and reversal of overdose are not sufficient to curb the incidence of opioid-related deaths. Additionally, fentanyl and its potent analogs present a potential risk from use in deliberate poisoning or chemical attacks. This study demonstrates the use of monoclonal antibodies as a countermeasure to fentanyl-induced toxicity in pre- and postexposure scenarios, supporting their use in combination with the opioid antagonist naloxone.
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Affiliation(s)
- Carly A Baehr
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota (C.A.B., M.M.W., M.P.); Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, Minnesota (M.M.W.); Reno School of Medicine, University of Nevada, Reno, Nevada (S.G.P., J.A.-U., D.A.); University of Minnesota Center for Immunology, Minneapolis, Minnesota (M.P.); and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington (M.P.)
| | - Mariah M Wu
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota (C.A.B., M.M.W., M.P.); Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, Minnesota (M.M.W.); Reno School of Medicine, University of Nevada, Reno, Nevada (S.G.P., J.A.-U., D.A.); University of Minnesota Center for Immunology, Minneapolis, Minnesota (M.P.); and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington (M.P.)
| | - Sujata G Pandit
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota (C.A.B., M.M.W., M.P.); Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, Minnesota (M.M.W.); Reno School of Medicine, University of Nevada, Reno, Nevada (S.G.P., J.A.-U., D.A.); University of Minnesota Center for Immunology, Minneapolis, Minnesota (M.P.); and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington (M.P.)
| | - Jose Arias-Umana
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota (C.A.B., M.M.W., M.P.); Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, Minnesota (M.M.W.); Reno School of Medicine, University of Nevada, Reno, Nevada (S.G.P., J.A.-U., D.A.); University of Minnesota Center for Immunology, Minneapolis, Minnesota (M.P.); and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington (M.P.)
| | - David AuCoin
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota (C.A.B., M.M.W., M.P.); Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, Minnesota (M.M.W.); Reno School of Medicine, University of Nevada, Reno, Nevada (S.G.P., J.A.-U., D.A.); University of Minnesota Center for Immunology, Minneapolis, Minnesota (M.P.); and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington (M.P.)
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota (C.A.B., M.M.W., M.P.); Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, Minnesota (M.M.W.); Reno School of Medicine, University of Nevada, Reno, Nevada (S.G.P., J.A.-U., D.A.); University of Minnesota Center for Immunology, Minneapolis, Minnesota (M.P.); and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington (M.P.)
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24
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Inner Workings: Using vaccines to harness the immune system and fight drugs of abuse. Proc Natl Acad Sci U S A 2021; 118:2121094118. [PMID: 34937749 DOI: 10.1073/pnas.2121094118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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25
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Abstract
Opioids may produce life-threatening respiratory depression and death from their actions at the opioid receptors within the brainstem respiratory neuronal network. Since there is an increasing number of conditions where the administration of the opioid receptor antagonist naloxone is inadequate or undesired, there is an increased interest in the development of novel reversal and prevention strategies aimed at providing efficacy close to that of the opioid receptor antagonist naloxone but with fewer of its drawbacks such as its short duration of action and lesser ability to reverse high-affinity opioids, such as carfentanil, or drug combinations. To give an overview of this highly relevant topic, the authors systematically discuss predominantly experimental pharmacotherapies, published in the last 5 yr, aimed at reversal of opioid-induced respiratory depression as alternatives to naloxone. The respiratory stimulants are discussed based on their characteristics and mechanism of action: nonopioid controlled substances (e.g., amphetamine, cannabinoids, ketamine), hormones (thyrotropin releasing hormone, oxytocin), nicotinic acetylcholine receptor agonists, ampakines, serotonin receptor agonists, antioxidants, miscellaneous peptides, potassium channel blockers acting at the carotid bodies (doxapram, ENA001), sequestration techniques (scrubber molecules, immunopharmacotherapy), and opioids (partial agonists/antagonists). The authors argue that none of these often still experimental therapies are sufficiently tested with respect to efficacy and safety, and many of the agents presented have a lesser efficacy at deeper levels of respiratory depression, i.e., inability to overcome apnea, or have ample side effects. The authors suggest development of reversal strategies that combine respiratory stimulants with naloxone. Furthermore, they encourage collaborations between research groups to expedite development of viable reversal strategies of potent synthetic opioid-induced respiratory depression.
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26
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Zheng Z, Kyzer JL, Worob A, Wenthur CJ. Family of Structurally Related Bioconjugates Yields Antibodies with Differential Selectivity against Ketamine and 6-Hydroxynorketamine. ACS Chem Neurosci 2021; 12:4113-4122. [PMID: 34652905 PMCID: PMC9358770 DOI: 10.1021/acschemneuro.1c00498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The dissociative-hypnotic compound ketamine is being used in an increasingly wide range of therapeutic contexts, including anesthesia, adjunctive analgesia, treatment-resistant depression, but it also continues to be a notable substance of abuse. No specific antidotes exist for ketamine intoxication or overdose. Immunopharmacotherapy has demonstrated the ability to offer overdose protection through production of highly specific antibodies that prevent psychoactive drug penetration across the blood-brain barrier, although antiketamine antibodies have not yet been assessed or optimized for use in this approach. Moreover, generation of specific antibodies also provides an opportunity to address the role of 6-hydroxynorketamine metabolites in ketamine's rapid-acting antidepressant effect through selective restriction of metabolite access to the central nervous system. Hapten design is a critical element for tuning immune recognition of small molecules, as it affects the presentation of the target antigen and thus the quality and selectivity of the response. Here, we report the synthesis and optimization of carrier protein and conjugation conditions for an initial hapten, norketamine-N-COOH (NK-N-COOH), to optimize vaccination conditions and assess the functional consequences of such vaccination on ketamine-induced behavioral alterations occurring at dissociative-like (50 mg/kg) doses. Iterating from this initial approach, two additional haptens, ketamine-N-COOH (KET-N-COOH) and 6-hydroxynorketamine-N-COOH (HNK-N-COOH), were synthesized to target either ketamine or 6-hydroxynorketamine with greater selectivity. The ability of these haptens to generate antiketamine, antinorketamine, and anti-6-hydroxynorketamine immune responses in mice was then assessed using enzyme-linked immunosorbent assay (ELISA) and competitive surface plasmon resonance (SPR) methods. All three haptens provoked immune responses in vivo, although the KET-N-COOH and 6-HNK-N-COOH haptens yielded antibodies with 5- to 10-fold improvements in affinity for ketamine and/or 6-hydroxynorketamine, as compared to NK-N-COOH. Regarding selectivity, vaccines bearing a KET-N-COOH hapten yielded an antibody response with approximately equivalent Kd values against ketamine (86.4 ± 3.2 nM) and 6-hydroxynorketamine (74.1 ± 7.8 nM) and a 90-fold weaker Kd against norketamine. Contrastingly, 6-HNK-N-COOH generated the highest affinity and most selective antibody profile, with a 38.3 ± 4.7 nM IC50 against 6-hydroxynorketamine; Kd values for ketamine and norketamine were 33- to 105-fold weaker, at 1290 ± 281.5 and 3971 ± 2175 nM, respectively. Overall, these findings support the use of rational hapten design to generate antibodies capable of distinguishing between structurally related, yet mechanistically distinct, compounds arising from the same precursor molecule. As applied to the production of the first-reported anti-6-hydroxynorketamine antibodies to date, this approach demonstrates a promising path forward for identifying the individual and combinatorial roles of ketamine and its metabolites in supporting rewarding effects and/or rapid-acting antidepressant activity.
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Affiliation(s)
- Zhen Zheng
- School of Pharmacy, University of Wisconsin, Madison, Wisconsin 53705, United States
| | - Jillian L Kyzer
- School of Pharmacy, University of Wisconsin, Madison, Wisconsin 53705, United States
| | - Adam Worob
- School of Pharmacy, University of Wisconsin, Madison, Wisconsin 53705, United States
| | - Cody J Wenthur
- School of Pharmacy, University of Wisconsin, Madison, Wisconsin 53705, United States
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27
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Ban B, Barrientos RC, Oertel T, Komla E, Whalen C, Sopko M, You Y, Banerjee P, Sulima A, Jacobson AE, Rice KC, Matyas GR, Yusibov V. Novel chimeric monoclonal antibodies that block fentanyl effects and alter fentanyl biodistribution in mice. MAbs 2021; 13:1991552. [PMID: 34693882 PMCID: PMC8547829 DOI: 10.1080/19420862.2021.1991552] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The prevalence and societal impact of opioid use disorder (OUD) is an acknowledged public health crisis that is further aggravated by the current pandemic. One of the devastating consequences of OUD is opioid overdose deaths. While multiple medications are now available to treat OUD, given the prevalence and societal burden, additional well-tolerated and effective therapies are still needed. To this point, we have developed chimeric monoclonal antibodies (mAb) that will specifically complex with fentanyl and its analogs in the periphery, thereby preventing them from reaching the central nervous system. Additionally, mAb-based passive immunotherapy offers a high degree of specificity to drugs of abuse and does not interfere with an individual’s ability to use any of the medications used to treat OUD. We hypothesized that sequestering fentanyl and its analogs in the periphery will mitigate their negative effects on the brain and peripheral organs. This study is the first report of chimeric mAb against fentanyl and its analogs. We have discovered, engineered the chimeric versions, and identified the selectivity of these antibodies, through in vitro characterization and in vivo animal challenge studies. Two mAb candidates with very high (0.1–1.3 nM) binding affinities to fentanyl and its analogs were found to be effective in engaging fentanyl in the periphery and blocking its effects in challenged animals. Results presented in this work constitute a major contribution in the field of novel therapeutics targeting OUD.
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Affiliation(s)
- Bhupal Ban
- Pharmaceutical Center, Indiana Biosciences Research Institute, Indianapolis, Indiana, United States
| | - Rodell C Barrientos
- Laboratory of Adjuvant and Antigen Research, U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States.,U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States
| | - Therese Oertel
- Laboratory of Adjuvant and Antigen Research, U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States
| | - Essie Komla
- Laboratory of Adjuvant and Antigen Research, U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States.,U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States
| | - Connor Whalen
- Laboratory of Adjuvant and Antigen Research, U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States
| | - Megan Sopko
- Pharmaceutical Center, Indiana Biosciences Research Institute, Indianapolis, Indiana, United States
| | - Yingjian You
- Pharmaceutical Center, Indiana Biosciences Research Institute, Indianapolis, Indiana, United States
| | - Partha Banerjee
- Pharmaceutical Center, Indiana Biosciences Research Institute, Indianapolis, Indiana, United States
| | - Agnieszka Sulima
- Department of Health and Human Services, Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, United States
| | - Arthur E Jacobson
- Department of Health and Human Services, Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, United States
| | - Kenner C Rice
- Department of Health and Human Services, Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, United States
| | - Gary R Matyas
- Laboratory of Adjuvant and Antigen Research, U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States
| | - Vidadi Yusibov
- Pharmaceutical Center, Indiana Biosciences Research Institute, Indianapolis, Indiana, United States
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28
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Abstract
This paper is the forty-second consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2019 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonists and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (1), the roles of these opioid peptides and receptors in pain and analgesia in animals (2) and humans (3), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (4), opioid peptide and receptor involvement in tolerance and dependence (5), stress and social status (6), learning and memory (7), eating and drinking (8), drug abuse and alcohol (9), sexual activity and hormones, pregnancy, development and endocrinology (10), mental illness and mood (11), seizures and neurologic disorders (12), electrical-related activity and neurophysiology (13), general activity and locomotion (14), gastrointestinal, renal and hepatic functions (15), cardiovascular responses (16), respiration and thermoregulation (17), and immunological responses (18).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, 65-30 Kissena Blvd., Flushing, NY, 11367, United States.
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29
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Stone AE, Scheuermann SE, Haile CN, Cuny GD, Velasquez ML, Linhuber JP, Duddupudi AL, Vigliaturo JR, Pravetoni M, Kosten TA, Kosten TR, Norton EB. Fentanyl conjugate vaccine by injected or mucosal delivery with dmLT or LTA1 adjuvants implicates IgA in protection from drug challenge. NPJ Vaccines 2021; 6:69. [PMID: 33986280 PMCID: PMC8119695 DOI: 10.1038/s41541-021-00329-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/22/2021] [Indexed: 12/17/2022] Open
Abstract
Fentanyl is a major contributor to the devastating increase in overdose deaths from substance use disorders (SUD). A vaccine targeting fentanyl could be a powerful immunotherapeutic. Here, we evaluated adjuvant and delivery strategies for conjugate antigen vaccination with fentanyl-based haptens. We tested adjuvants derived from the heat-labile toxin of E. coli including dmLT and LTA1 by intramuscular, sublingual or intranasal delivery. Our results show anti-fentanyl serum antibodies and antibody secreting cells in the bone-marrow after vaccination with highest levels observed with an adjuvant (alum, dmLT, or LTA1). Vaccine adjuvanted with LTA1 or dmLT elicited the highest levels of anti-fentanyl antibodies, whereas alum achieved highest levels against the carrier protein. Vaccination with sublingual dmLT or intranasal LTA1 provided the most robust blockade of fentanyl-induced analgesia and CNS penetration correlating strongly to anti-FEN IgA. In conclusion, this study demonstrates dmLT or LTA1 adjuvant as well as mucosal delivery may be attractive strategies for improving the efficacy of vaccines against SUD.
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Affiliation(s)
- Addison E Stone
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Sarah E Scheuermann
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Colin N Haile
- Department of Psychology, University of Houston, Houston, TX, USA.,Texas Institute of Measurement Evaluation and Statistics, University of Houston, Houston, TX, USA
| | - Gregory D Cuny
- Department of Pharmacological & Pharmaceutical Sciences, University of Houston, Houston, TX, USA
| | - Marcela Lopez Velasquez
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Joshua P Linhuber
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Anantha L Duddupudi
- Department of Pharmacological & Pharmaceutical Sciences, University of Houston, Houston, TX, USA
| | - Jennifer R Vigliaturo
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA.,Center for Immunology, University of Minnesota, Minneapolis, MN, USA
| | - Therese A Kosten
- Department of Psychology, University of Houston, Houston, TX, USA.,Texas Institute of Measurement Evaluation and Statistics, University of Houston, Houston, TX, USA
| | - Thomas R Kosten
- Department of Psychology, University of Houston, Houston, TX, USA.,Texas Institute of Measurement Evaluation and Statistics, University of Houston, Houston, TX, USA
| | - Elizabeth B Norton
- Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA, USA.
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30
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Vaccine design through transition state mimicry of heroin hydrolysis. Tetrahedron Lett 2021. [DOI: 10.1016/j.tetlet.2021.153045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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31
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Lei X, Xu X, Liu L, Kuang H, Xu L, Hao C, Xu C. Rapid quantitative determination of fentanyl in human urine and serum using a gold-based immunochromatographic strip sensor. J Mater Chem B 2021; 8:8573-8584. [PMID: 32814936 DOI: 10.1039/d0tb01509a] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Fentanyl is a typical opioid that is used in surgical anesthesia. However, when abused, fentanyl can lead to addiction and even death. To better control the use of fentanyl, it is necessary to develop rapid and sensitive detection methods. In this study, an ultrasensitive monoclonal antibody (mAb) was prepared and used to develop an indirect competitive enzyme-linked immunosorbent assay (ic-ELISA) and a colloidal gold-based immunochromatographic strip (CG-ICS) for the analysis of fentanyl in urine and serum. Under optimum conditions, the anti-fentanyl mAb belonging to the subtype of IgG2b showed a half-maximal inhibitory concentration (IC50) of 0.11 ng mL-1 and a linear range of detection of 0.020-0.50 ng mL-1. Fenanyl-spiked original urine and serum diluted eight times were used for the analysis of fentanyl by ic-ELISA and CG-ICS. IC50 from the standard curves was 0.46 ng mL-1 for urine and 2.6 ng mL-1 for serum in ic-ELISA and 1.6 ng mL-1 for urine and 6.27 ng mL-1 for serum in CG-ICS. The recovery test revealed that the ic-ELISA and CG-ICS, with a recovery rate of 87.0-108.4% and a coefficient of variation of 3.3-10.9%, were the same reliable tools as the liquid chromatography tandem mass spectrometry for fentanyl analysis in real samples.
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Affiliation(s)
- Xianlu Lei
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Xinxin Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Liqiang Liu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Hua Kuang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Liguang Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Changlong Hao
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Chuanlai Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
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32
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Kluters S, Steinhauser K, Pfänder R, Studts J. Introduction and clearance of beta-glucan in the downstream processing of monoclonal antibodies. Biotechnol Prog 2021; 37:e3149. [PMID: 33743183 PMCID: PMC9285507 DOI: 10.1002/btpr.3149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/02/2021] [Accepted: 03/18/2021] [Indexed: 11/28/2022]
Abstract
β‐Glucan process‐related impurities can be introduced into biopharmaceutical products via upstream or downstream processing or via excipients. This study obtained a comprehensive process‐mapping dataset for five monoclonal antibodies to assess β‐glucan introduction and clearance during development and production runs at various scales. Overall, 198 data points were available for analysis. The greatest β‐glucan concentrations were found in the depth‐filtration filtrate (37–2,745 pg/ml). Load volume correlated with β‐glucan concentration in the filtrate, whereas flush volume was of secondary importance. Cation‐exchange chromatography significantly cleared β‐glucans. Furthermore, β‐glucan leaching from the Planova 20N virus removal filter was reduced by increasing the flush volume (1 vs. 10 L/m2). β‐glucan concentrations after filter flush with 10 L/m2 were consistently <10 pg/ml. No or only limited β‐glucan clearance was attained via ultrafiltration/diafiltration (UF/DF). However, during the first run with monoclonal antibody (mAb) 4, β‐glucan concentration in the UF/DF retentate was 10.8 pg/mg, potentially due to β‐glucan leaching from the first run with a regenerated cellulose membrane. Overall, β‐glucan levels in the final mAb drug substance were 1–12 pg/mg. Assuming high doses of 1,000–5,000 mg, a β‐glucan contamination at 20 pg/mg would translate to 20–100 ng/dose, which is below the previously suggested threshold for product safety (≤500 ng/dose).
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Affiliation(s)
- Simon Kluters
- Late Stage DSP Development, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riß, Baden-Württemberg, Germany
| | - Karin Steinhauser
- Late Stage DSP Development, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riß, Baden-Württemberg, Germany
| | - Roland Pfänder
- Late Stage DSP Development, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riß, Baden-Württemberg, Germany
| | - Joey Studts
- Late Stage DSP Development, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riß, Baden-Württemberg, Germany
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33
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Lin M, Lee JC, Blake S, Ellis B, Eubanks LM, Janda KD. Broadly Neutralizing Synthetic Cannabinoid Vaccines. JACS AU 2021; 1:31-40. [PMID: 34467269 PMCID: PMC8395583 DOI: 10.1021/jacsau.0c00057] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Indexed: 05/11/2023]
Abstract
Synthetic cannabinoids (SCs) constitute a significant portion of psychoactive substances forming a major public health risk. Due to the wide variety of SCs, broadly neutralizing antibodies generated by active immunization present an intriguing pathway to combat cannabinoid use disorder. Here, we probed hapten design for antibody affinity and cross reactivity against two classes of SCs. Of the 10 haptens screened, 3 vaccine groups revealed submicromolar IC50, each targeting 5-6 compounds in our panel of 22 drugs. Moreover, SCs were successfully sequestered when administered by vaping or intraperitoneal injection, which was confirmed within animal models by observing locomotion, body temperature, and pharmacokinetics. We also discovered synergistic effects to simultaneously blunt two drug classes through an admixture vaccine approach. Collectively, our study provides a comprehensive foundation for the development of vaccines against SCs.
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France CP, Ahern GP, Averick S, Disney A, Enright HA, Esmaeli-Azad B, Federico A, Gerak LR, Husbands SM, Kolber B, Lau EY, Lao V, Maguire DR, Malfatti MA, Martinez G, Mayer BP, Pravetoni M, Sahibzada N, Skolnick P, Snyder EY, Tomycz N, Valdez CA, Zapf J. Countermeasures for Preventing and Treating Opioid Overdose. Clin Pharmacol Ther 2020; 109:578-590. [PMID: 33113208 DOI: 10.1002/cpt.2098] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/15/2020] [Indexed: 02/06/2023]
Abstract
The only medication available currently to prevent and treat opioid overdose (naloxone) was approved by the US Food and Drug Administration (FDA) nearly 50 years ago. Because of its pharmacokinetic and pharmacodynamic properties, naloxone has limited utility under some conditions and would not be effective to counteract mass casualties involving large-scale deployment of weaponized synthetic opioids. To address shortcomings of current medical countermeasures for opioid toxicity, a trans-agency scientific meeting was convened by the US National Institute of Allergy and Infectious Diseases/National Institutes of Health (NIAID/NIH) on August 6 and 7, 2019, to explore emerging alternative approaches for treating opioid overdose in the event of weaponization of synthetic opioids. The meeting was initiated by the Chemical Countermeasures Research Program (CCRP), was organized by NIAID, and was a collaboration with the National Institute on Drug Abuse/NIH (NIDA/NIH), the FDA, the Defense Threat Reduction Agency (DTRA), and the Biomedical Advanced Research and Development Authority (BARDA). This paper provides an overview of several presentations at that meeting that discussed emerging new approaches for treating opioid overdose, including the following: (1) intranasal nalmefene, a competitive, reversible opioid receptor antagonist with a longer duration of action than naloxone; (2) methocinnamox, a novel opioid receptor antagonist; (3) covalent naloxone nanoparticles; (4) serotonin (5-HT)1A receptor agonists; (5) fentanyl-binding cyclodextrin scaffolds; (6) detoxifying biomimetic "nanosponge" decoy receptors; and (7) antibody-based strategies. These approaches could also be applied to treat opioid use disorder.
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Affiliation(s)
- Charles P France
- Department of Pharmacology, Addiction Research, Treatment and Training Center of Excellence, University of Texas Health Science Center, San Antonio, Texas, USA
| | | | - Saadyah Averick
- Neuroscience Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Alex Disney
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | | | - Babak Esmaeli-Azad
- CellCure (Stem Cell Division of CiBots, Inc.), San Diego, California, USA
| | - Arianna Federico
- CellCure (Stem Cell Division of CiBots, Inc.), San Diego, California, USA
| | - Lisa R Gerak
- Department of Pharmacology, Addiction Research, Treatment and Training Center of Excellence, University of Texas Health Science Center, San Antonio, Texas, USA
| | | | | | - Edmond Y Lau
- Lawrence Livermore National Laboratory, Livermore, California, USA
| | - Victoria Lao
- Lawrence Livermore National Laboratory, Livermore, California, USA
| | - David R Maguire
- Department of Pharmacology, Addiction Research, Treatment and Training Center of Excellence, University of Texas Health Science Center, San Antonio, Texas, USA
| | | | - Girardo Martinez
- CellCure (Stem Cell Division of CiBots, Inc.), San Diego, California, USA
| | - Brian P Mayer
- Lawrence Livermore National Laboratory, Livermore, California, USA
| | - Marco Pravetoni
- Department of Pharmacology, Center for Immunology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | | | - Phil Skolnick
- Opiant Pharmaceuticals, Inc., Santa Monica, California, USA
| | - Evan Y Snyder
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California, USA
| | - Nestor Tomycz
- Neuroscience Institute, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
| | - Carlos A Valdez
- Lawrence Livermore National Laboratory, Livermore, California, USA
| | - Jim Zapf
- CellCure (Stem Cell Division of CiBots, Inc.), San Diego, California, USA
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35
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Baehr C, Kelcher AH, Khaimraj A, Reed DE, Pandit SG, AuCoin D, Averick S, Pravetoni M. Monoclonal Antibodies Counteract Opioid-Induced Behavioral and Toxic Effects in Mice and Rats. J Pharmacol Exp Ther 2020; 375:469-477. [PMID: 32980813 DOI: 10.1124/jpet.120.000124] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/23/2020] [Indexed: 01/13/2023] Open
Abstract
Monoclonal antibodies (mAbs) and vaccines have been proposed as medical countermeasures to treat opioid use disorder (OUD) and prevent opioid overdose. In contrast to current pharmacotherapies (e.g., methadone, buprenorphine, naltrexone, and naloxone) for OUD and overdose, which target brain opioid receptors, mAbs and vaccine-generated polyclonal antibodies sequester the target opioid in the serum and reduce drug distribution to the brain. Furthermore, mAbs offer several potential clinical benefits over approved medications, such as longer serum half-life, higher selectivity, reduced side effects, and no abuse liability. Using magnetic enrichment to isolate opioid-specific B cell lymphocytes prior to fusion with myeloma partners, this study identified a series of murine hybridoma cell lines expressing mAbs with high affinity for opioids of clinical interest, including oxycodone, heroin and its active metabolites, and fentanyl. In mice, passive immunization with lead mAbs against oxycodone, heroin, and fentanyl reduced drug-induced antinociception and the distribution of the target opioid to the brain. In mice and rats, mAb pretreatment reduced fentanyl-induced respiratory depression and bradycardia, two risk factors for opioid-related overdose fatality. Overall, these results support use of mAbs to counteract toxic effects of opioids and other chemical threats. SIGNIFICANCE STATEMENT: The incidence of fatal overdoses due to the widespread access to heroin, prescription opioids, and fentanyl suggests that current Food and Drug Administration-approved countermeasures are not sufficient to mitigate the opioid epidemic. Monoclonal antibodies (mAbs) may provide acute protection from overdose by binding to circulating opioids in serum. Use of mAbs prophylactically, or after exposure in combination with naloxone, may reduce hospitalization and increase survival.
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Affiliation(s)
- Carly Baehr
- Departments of Pharmacology (C.B., A.H.K., A.K., M.P.), Veterinary Population Medicine (C.B.), and Psychiatry and Behavioral Sciences (A.H.K.), University of Minnesota Medical School, Minneapolis, Minnesota; Reno School of Medicine, University of Nevada, Reno, Nevada (D.E.R., S.G.P., D.A.); Allegheny Health Network, Pittsburgh, Pennsylvania (S.A.); and Center for Immunology, University of Minnesota, Minneapolis, Minnesota (M.P.)
| | - April Huseby Kelcher
- Departments of Pharmacology (C.B., A.H.K., A.K., M.P.), Veterinary Population Medicine (C.B.), and Psychiatry and Behavioral Sciences (A.H.K.), University of Minnesota Medical School, Minneapolis, Minnesota; Reno School of Medicine, University of Nevada, Reno, Nevada (D.E.R., S.G.P., D.A.); Allegheny Health Network, Pittsburgh, Pennsylvania (S.A.); and Center for Immunology, University of Minnesota, Minneapolis, Minnesota (M.P.)
| | - Aaron Khaimraj
- Departments of Pharmacology (C.B., A.H.K., A.K., M.P.), Veterinary Population Medicine (C.B.), and Psychiatry and Behavioral Sciences (A.H.K.), University of Minnesota Medical School, Minneapolis, Minnesota; Reno School of Medicine, University of Nevada, Reno, Nevada (D.E.R., S.G.P., D.A.); Allegheny Health Network, Pittsburgh, Pennsylvania (S.A.); and Center for Immunology, University of Minnesota, Minneapolis, Minnesota (M.P.)
| | - Dana E Reed
- Departments of Pharmacology (C.B., A.H.K., A.K., M.P.), Veterinary Population Medicine (C.B.), and Psychiatry and Behavioral Sciences (A.H.K.), University of Minnesota Medical School, Minneapolis, Minnesota; Reno School of Medicine, University of Nevada, Reno, Nevada (D.E.R., S.G.P., D.A.); Allegheny Health Network, Pittsburgh, Pennsylvania (S.A.); and Center for Immunology, University of Minnesota, Minneapolis, Minnesota (M.P.)
| | - Sujata G Pandit
- Departments of Pharmacology (C.B., A.H.K., A.K., M.P.), Veterinary Population Medicine (C.B.), and Psychiatry and Behavioral Sciences (A.H.K.), University of Minnesota Medical School, Minneapolis, Minnesota; Reno School of Medicine, University of Nevada, Reno, Nevada (D.E.R., S.G.P., D.A.); Allegheny Health Network, Pittsburgh, Pennsylvania (S.A.); and Center for Immunology, University of Minnesota, Minneapolis, Minnesota (M.P.)
| | - David AuCoin
- Departments of Pharmacology (C.B., A.H.K., A.K., M.P.), Veterinary Population Medicine (C.B.), and Psychiatry and Behavioral Sciences (A.H.K.), University of Minnesota Medical School, Minneapolis, Minnesota; Reno School of Medicine, University of Nevada, Reno, Nevada (D.E.R., S.G.P., D.A.); Allegheny Health Network, Pittsburgh, Pennsylvania (S.A.); and Center for Immunology, University of Minnesota, Minneapolis, Minnesota (M.P.)
| | - Saadyah Averick
- Departments of Pharmacology (C.B., A.H.K., A.K., M.P.), Veterinary Population Medicine (C.B.), and Psychiatry and Behavioral Sciences (A.H.K.), University of Minnesota Medical School, Minneapolis, Minnesota; Reno School of Medicine, University of Nevada, Reno, Nevada (D.E.R., S.G.P., D.A.); Allegheny Health Network, Pittsburgh, Pennsylvania (S.A.); and Center for Immunology, University of Minnesota, Minneapolis, Minnesota (M.P.)
| | - Marco Pravetoni
- Departments of Pharmacology (C.B., A.H.K., A.K., M.P.), Veterinary Population Medicine (C.B.), and Psychiatry and Behavioral Sciences (A.H.K.), University of Minnesota Medical School, Minneapolis, Minnesota; Reno School of Medicine, University of Nevada, Reno, Nevada (D.E.R., S.G.P., D.A.); Allegheny Health Network, Pittsburgh, Pennsylvania (S.A.); and Center for Immunology, University of Minnesota, Minneapolis, Minnesota (M.P.)
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Barrientos RC, Bow EW, Whalen C, Torres OB, Sulima A, Beck Z, Jacobson AE, Rice KC, Matyas GR. Novel Vaccine That Blunts Fentanyl Effects and Sequesters Ultrapotent Fentanyl Analogues. Mol Pharm 2020; 17:3447-3460. [PMID: 32787282 PMCID: PMC7482402 DOI: 10.1021/acs.molpharmaceut.0c00497] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
![]()
Active
immunization is an emerging potential modality to combat
fatal overdose amid the opioid epidemic. In this study, we described
the design, synthesis, formulation, and animal testing of an efficacious
vaccine against fentanyl. The vaccine formulation is composed of a
novel fentanyl hapten conjugated to tetanus toxoid (TT) and adjuvanted
with liposomes containing monophosphoryl lipid A adsorbed on aluminum
hydroxide. The linker and hapten N-phenyl-N-(1-(4-(3-(tritylthio)propanamido)phenethyl)piperidin-4-yl)propionamide
were conjugated sequentially to TT using amine-N-hydroxysuccinimide-ester
and thiol–maleimide reaction chemistries, respectively. Conjugation
was facile, efficient, and reproducible with a protein recovery of
>98% and a hapten density of 30–35 per carrier protein molecule.
In mice, immunization induced high and robust antibody endpoint titers
in the order of >106 against the hapten. The antisera
bound
fentanyl, carfentanil, cyclopropyl fentanyl, para-fluorofentanyl, and furanyl fentanyl in vitro with
antibody-drug dissociation constants in the range of 0.36–4.66
nM. No cross-reactivity to naloxone, naltrexone, methadone, or buprenorphine
was observed. In vivo, immunization shifted the antinociceptive
dose–response curve of fentanyl to higher doses. Collectively,
these preclinical results showcased the desired traits of a potential
vaccine against fentanyl and demonstrated the feasibility of immunization
to combat fentanyl-induced effects.
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Affiliation(s)
- Rodell C Barrientos
- Laboratory of Adjuvant and Antigen Research, U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States.,U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Bethesda, Maryland 20817, United States
| | - Eric W Bow
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, Department of Health and Human Services, National Institutes of Health, 9800 Medical Center Drive, Bethesda, Maryland 20892-3373, United States
| | - Connor Whalen
- Laboratory of Adjuvant and Antigen Research, U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
| | - Oscar B Torres
- Laboratory of Adjuvant and Antigen Research, U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States.,U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Bethesda, Maryland 20817, United States
| | - Agnieszka Sulima
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, Department of Health and Human Services, National Institutes of Health, 9800 Medical Center Drive, Bethesda, Maryland 20892-3373, United States
| | - Zoltan Beck
- Laboratory of Adjuvant and Antigen Research, U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States.,U.S. Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Bethesda, Maryland 20817, United States
| | - Arthur E Jacobson
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, Department of Health and Human Services, National Institutes of Health, 9800 Medical Center Drive, Bethesda, Maryland 20892-3373, United States
| | - Kenner C Rice
- Drug Design and Synthesis Section, Molecular Targets and Medications Discovery Branch, Intramural Research Program, National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, Department of Health and Human Services, National Institutes of Health, 9800 Medical Center Drive, Bethesda, Maryland 20892-3373, United States
| | - Gary R Matyas
- Laboratory of Adjuvant and Antigen Research, U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, Maryland 20910, United States
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Townsend EA, Bremer PT, Faunce KE, Negus SS, Jaster AM, Robinson HL, Janda KD, Banks ML. Evaluation of a Dual Fentanyl/Heroin Vaccine on the Antinociceptive and Reinforcing Effects of a Fentanyl/Heroin Mixture in Male and Female Rats. ACS Chem Neurosci 2020; 11:1300-1310. [PMID: 32271538 DOI: 10.1021/acschemneuro.0c00064] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Opioid-targeted vaccines represent an emerging treatment strategy for opioid use disorder. To determine whether concurrent vaccination against two commonly abused opioids (fentanyl and heroin) would confer broader spectrum opioid coverage, the current study evaluated dual fentanyl/heroin conjugate vaccine effectiveness using a warm water tail-withdrawal and a fentanyl/heroin-vs-food choice procedure in male and female rats across a 105-day observation period. Vaccine administration generated titers of high-affinity antibodies to both fentanyl and heroin sufficient to decrease the antinociceptive potency of fentanyl (25-fold), heroin (4.6-fold), and a 1:27 fentanyl/heroin mixture (7.5-fold). Vaccination did not alter the antinociceptive potency of the structurally dissimilar opioid agonist methadone. For comparison, continuous treatment with a naltrexone dose (0.032 mg/kg/h) shown previously to produce clinically relevant plasma-naltrexone levels decreased the antinociceptive potency of fentanyl, heroin, and the 1:27 fentanyl/heroin mixture by approximately 20-fold. Naltrexone treatment also shifted the potency of 1:27 fentanyl/heroin mixture in a drug-vs-food choice self-administration procedure 4.3-fold. In contrast, vaccination did not attenuate 1:27 fentanyl/heroin mixture self-administration in the drug-vs-food choice procedure. These data demonstrate that a vaccine can simultaneously attenuate the thermal antinociceptive effects of two structurally dissimilar opioids. However, the vaccine did not attenuate fentanyl/heroin mixture self-administration, suggesting a greater magnitude of vaccine responsiveness is required to decrease opioid reinforcement relative to antinociception.
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Affiliation(s)
- E. Andrew Townsend
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298, United States
| | - Paul T. Bremer
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, United States
| | - Kaycee E. Faunce
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298, United States
| | - S. Stevens Negus
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298, United States
| | - Alaina M. Jaster
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298, United States
| | - Hannah L. Robinson
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298, United States
| | - Kim D. Janda
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, United States
| | - Matthew L. Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, Virginia 23298, United States
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38
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Wang W, Finnegan TJ, Lei Z, Zhu X, Moore CE, Shi K, Badjić JD. Tuning the allosteric sequestration of anticancer drugs for developing cooperative nano-antidotes. Chem Commun (Camb) 2020; 56:1271-1274. [DOI: 10.1039/c9cc09373g] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Dual-cavity baskets, carrying six γ-aminobutyric acids sequester anticancer anthracyclines in a cooperative manner to be of interest for creating nano-antidotes.
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Affiliation(s)
- Weikun Wang
- Department of Chemistry & Biochemistry
- The Ohio State University
- 43210 Columbus
- USA
| | - Tyler J. Finnegan
- Department of Chemistry & Biochemistry
- The Ohio State University
- 43210 Columbus
- USA
| | - Zhiquan Lei
- Department of Chemistry & Biochemistry
- The Ohio State University
- 43210 Columbus
- USA
| | - Xingrong Zhu
- Department of Chemistry & Biochemistry
- The Ohio State University
- 43210 Columbus
- USA
| | - Curtis E. Moore
- Department of Chemistry & Biochemistry
- The Ohio State University
- 43210 Columbus
- USA
| | - Kejia Shi
- Department of Chemistry & Biochemistry
- The Ohio State University
- 43210 Columbus
- USA
| | - Jovica D. Badjić
- Department of Chemistry & Biochemistry
- The Ohio State University
- 43210 Columbus
- USA
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39
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The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies. Transl Psychiatry 2019; 9:282. [PMID: 31712552 PMCID: PMC6848196 DOI: 10.1038/s41398-019-0625-0] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/10/2019] [Accepted: 10/20/2019] [Indexed: 12/11/2022] Open
Abstract
Fentanyl is a powerful opioid anesthetic and analgesic, the use of which has caused an increasing public health threat in the United States and elsewhere. Fentanyl was initially approved and used for the treatment of moderate to severe pain, especially cancer pain. However, recent years have seen a growing concern that fentanyl and its analogs are widely synthesized in laboratories and adulterated with illicit supplies of heroin, cocaine, methamphetamine, and counterfeit pills, contributing to the exponential growth in the number of drug-related overdose deaths. This review summarizes the recent epidemic and evolution of illicit fentanyl use, its pharmacological mechanisms and side effects, and the potential clinical management and prevention of fentanyl-related overdoses. Because social, economic, and health problems that are related to the use of fentanyl and its analogs are growing, there is an urgent need to implement large-scale safe and effective harm reduction strategies to prevent fentanyl-related overdoses.
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40
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Tenney RD, Blake S, Bremer PT, Zhou B, Hwang CS, Poklis JL, Janda KD, Banks ML. Vaccine blunts fentanyl potency in male rhesus monkeys. Neuropharmacology 2019; 158:107730. [PMID: 31369740 PMCID: PMC6745253 DOI: 10.1016/j.neuropharm.2019.107730] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/25/2019] [Accepted: 07/28/2019] [Indexed: 11/30/2022]
Abstract
One proposed factor contributing to the increased frequency of opioid overdose deaths is the emergence of novel synthetic opioids, including illicit fentanyl and fentanyl analogues. A treatment strategy currently under development to address the ongoing opioid crisis is immunopharmacotherapies or opioid-targeted vaccines. The present study determined the effectiveness and selectivity of a fentanyl-tetanus toxoid conjugate vaccine to alter the behavioral effects of fentanyl and a structurally dissimilar mu-opioid agonist oxycodone in male rhesus monkeys (n = 3-4). Fentanyl and oxycodone produced dose-dependent suppression of behavior in an assay of schedule-controlled responding and antinociception in an assay of thermal nociception (50 °C). Acute naltrexone (0.032 mg/kg) produced an approximate 10-fold potency shift for fentanyl to decrease operant responding. The fentanyl vaccine was administered at weeks 0, 2, 4, 9, 19, and 44 and fentanyl or oxycodone potencies in both behavioral assays were redetermined over the course of 49 weeks. The vaccine significantly and selectively shifted fentanyl potency at least 10-fold in both assays at several time points over the entire experimental period. Mid-point titer levels correlated with fentanyl antinociceptive potency shifts. Antibody affinity for fentanyl as measured by a competitive binding assay improved over time to approximately 3-4 nM. The fentanyl vaccine also increased fentanyl plasma levels approximately 6-fold consistent with the hypothesis that the vaccine sequesters fentanyl in the blood. Overall, these results support the continued development and evaluation of this fentanyl vaccine in humans to address the ongoing opioid crisis.
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Affiliation(s)
- Rebekah D Tenney
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Steven Blake
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Paul T Bremer
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Bin Zhou
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Candy S Hwang
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Justin L Poklis
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Kim D Janda
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA.
| | - Matthew L Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
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