1
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Méndez SB, Matus-Ortega M, Miramontes RH, Salazar-Juárez A. The effect of chronic stress on the immunogenicity and immunoprotection of the M 6-TT vaccine in female mice. Physiol Behav 2023; 271:114345. [PMID: 37704173 DOI: 10.1016/j.physbeh.2023.114345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/13/2023] [Accepted: 07/23/2023] [Indexed: 09/15/2023]
Abstract
Active vaccination is an effective therapeutic option to reduce the reinforcing effects of opioids. Several studies showed that chronic stress affects the immune system decreasing the efficiency of some vaccines. Heroin withdrawal is a stressor and it is a stage in which the patient who abuses heroin is vulnerable to stress affects the immune response and consequently its immunoprotective capacity, then, the objective was to determine the effect of heroin-withdrawal and heroin-withdrawal plus immobilization, on the immune (immunogenicity) and protective response (behavioral response) of morphine-6-hemisuccinate-tetanus toxoid (M6-TT) vaccine in animals of two inbred mice strains with different sensitivity to drug-opioid and stress. Female BALB/c and C57Bl/6 inbred mice were immunized with the M6-TT. A solid-phase antibody-capture ELISA was used to monitor antibody titer responses after each booster dose in vaccinated animals. During the vaccination period, the animals were subjected to two different stress conditions: drug-withdrawal (DW) and immobilization (IMM). The study used tail-flick testing to evaluate the heroin-induced antinociceptive effects. Additionally, heroin-induced locomotor activity was evaluated. Stress decreased the heroin-specific antibody titer generated by the M6-TT vaccine in the two inbred mouse strains evaluated. In the two stress conditions, the antibody titer was not able to decrease the heroin-induced antinociceptive effects and locomotor activity. These findings suggest that stress decreases the production of antibodies and the immunoprotective capacity of the M6-TT vaccine. This observation is important to determine the efficacy of active vaccination as a potential therapy for patients with opioid drug use disorder, since these patients during drug-withdrawal present stress disorders, which could affect the efficacy of therapy such as active vaccination.
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Affiliation(s)
- Susana Barbosa Méndez
- Subdirección de Investigaciones Clínicas, Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Instituto Nacional de Psiquiatría, México DF 14370, México
| | - Maura Matus-Ortega
- Subdirección de Investigaciones Clínicas, Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Instituto Nacional de Psiquiatría, México DF 14370, México
| | - Ricardo Hernández Miramontes
- Subdirección de Investigaciones Clínicas, Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Instituto Nacional de Psiquiatría, México DF 14370, México
| | - Alberto Salazar-Juárez
- Subdirección de Investigaciones Clínicas, Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Instituto Nacional de Psiquiatría, México DF 14370, México.
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2
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Powers N, Massena C, Crouse B, Smith M, Hicks L, Evans JT, Miller S, Pravetoni M, Burkhart D. Self-Adjuvanting TLR7/8 Agonist and Fentanyl Hapten Co-Conjugate Achieves Enhanced Protection against Fentanyl Challenge. Bioconjug Chem 2023; 34:1811-1821. [PMID: 37758302 PMCID: PMC10587865 DOI: 10.1021/acs.bioconjchem.3c00347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/12/2023] [Indexed: 10/03/2023]
Abstract
Currently approved pharmacotherapies for opioid use disorders (OUDs) and overdose reversal agents are insufficient to slow the spread of OUDs due to the proliferation of fentanyl. This is evident in the 31% rise in drug overdose deaths from 2019 to 2022, with rates increasing from 21.6 to 28.3 overdoses per 100,000 deaths. Vaccines are a potential alternative or adjunct therapy for the treatment of several substance use disorders (nicotine, cocaine) but have shown limited clinical success due to suboptimal antibody titers. In this study, we demonstrate that coconjugation of a Toll-like receptor 7/8 (TLR7/8) agonist (UM-3006) alongside a fentanyl-based hapten (F1) on the surface of the carrier protein cross-reactive material 197 (CRM) significantly increased generation of high-affinity fentanyl-specific antibodies. This demonstrated enhanced protection against fentanyl challenges relative to an unconjugated (admix) adjuvant control in mice. Inclusion of aluminum hydroxide (alum) adjuvant further increased titers and enhanced protection, as determined by analysis of fentanyl concentration in serum and brain tissue. Collectively, our findings present a promising approach to enhance the efficacy of antiopioid vaccines, underscoring the need for extensive exploration of TLR7/8 agonist conjugates as a compelling strategy to combat opioid use disorders.
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Affiliation(s)
- Noah Powers
- Center
for Translational Medicine, Department of Biomedical and Pharmaceutical
Sciences, University of Montana, 32 Campus Drive, Skaggs Building, Missoula, Montana 59801, United States
| | - Casey Massena
- Center
for Translational Medicine, Department of Biomedical and Pharmaceutical
Sciences, University of Montana, 32 Campus Drive, Skaggs Building, Missoula, Montana 59801, United States
| | - Bethany Crouse
- Department
of Pharmacology, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Mira Smith
- Center
for Translational Medicine, Department of Biomedical and Pharmaceutical
Sciences, University of Montana, 32 Campus Drive, Skaggs Building, Missoula, Montana 59801, United States
| | - Linda Hicks
- Center
for Translational Medicine, Department of Biomedical and Pharmaceutical
Sciences, University of Montana, 32 Campus Drive, Skaggs Building, Missoula, Montana 59801, United States
| | - Jay T. Evans
- Center
for Translational Medicine, Department of Biomedical and Pharmaceutical
Sciences, University of Montana, 32 Campus Drive, Skaggs Building, Missoula, Montana 59801, United States
| | - Shannon Miller
- Center
for Translational Medicine, Department of Biomedical and Pharmaceutical
Sciences, University of Montana, 32 Campus Drive, Skaggs Building, Missoula, Montana 59801, United States
| | - Marco Pravetoni
- Department
of Psychiatry and Behavioral Sciences, University
of Washington School of Medicine, Seattle, Washington 98195, United States
| | - David Burkhart
- Center
for Translational Medicine, Department of Biomedical and Pharmaceutical
Sciences, University of Montana, 32 Campus Drive, Skaggs Building, Missoula, Montana 59801, United States
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3
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Crouse B, Miller SM, Muelken P, Hicks L, Vigliaturo JR, Marker CL, Guedes AGP, Pentel PR, Evans JT, LeSage MG, Pravetoni M. A TLR7/8 agonist increases efficacy of anti-fentanyl vaccines in rodent and porcine models. NPJ Vaccines 2023; 8:107. [PMID: 37488109 PMCID: PMC10366150 DOI: 10.1038/s41541-023-00697-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/22/2023] [Indexed: 07/26/2023] Open
Abstract
Opioid use disorders (OUD) and overdose are public health threats worldwide. Widespread access to highly potent illicit synthetic opioids such as fentanyl is driving the recent rise in fatal overdoses. Vaccines containing fentanyl-based haptens conjugated to immunogenic carrier proteins offer a long-lasting, safe, and cost-effective strategy to protect individuals from overdose upon accidental or deliberate exposure to fentanyl and its analogs. Prophylactic or therapeutic active immunization with an anti-fentanyl vaccine induces the production of fentanyl-specific antibodies that bind the drug in the blood and prevent its distribution to the brain, which reduces its reinforcing effects and attenuates respiratory depression and bradycardia. To increase the efficacy of a lead anti-fentanyl vaccine, this study tested whether the incorporation of synthetic toll-like receptor (TLR) 4 and TLR7/8 agonists as vaccine adjuvants would increase vaccine efficacy against fentanyl challenge, overdose, and self-administration in either rats or Hanford miniature pigs. Formulation of the vaccine with a nucleolipid TLR7/8 agonist enhanced its immunogenicity and efficacy in preventing fentanyl-induced respiratory depression, analgesia, bradycardia, and self-administration in either rats or mini-pigs. These studies support the use of TLR7/8 adjuvants in vaccine formulations to improve their clinical efficacy against OUD and potentially other substance use disorders (SUD).
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Affiliation(s)
- Bethany Crouse
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, USA
- HealthPartners Institute, Research and Evaluation Division, 8170 33rd Ave S, Bloomington, MN, 55425, USA
| | - Shannon M Miller
- Department of Biomedical and Pharmaceutical Sciences, Center for Translational Medicine, University of Montana, Missoula, MT, USA
- Inimmune Corporation, Missoula, MT, USA
| | - Peter Muelken
- Department of Medicine, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Linda Hicks
- Department of Biomedical and Pharmaceutical Sciences, Center for Translational Medicine, University of Montana, Missoula, MT, USA
| | - Jennifer R Vigliaturo
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Cheryl L Marker
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
- Luvo Bioscience, 7500W. Henrietta Road, Rush, NY, 14543, USA
| | - Alonso G P Guedes
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Paul R Pentel
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
- Department of Medicine, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Jay T Evans
- Department of Biomedical and Pharmaceutical Sciences, Center for Translational Medicine, University of Montana, Missoula, MT, USA
- Inimmune Corporation, Missoula, MT, USA
| | - Mark G LeSage
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
- Department of Medicine, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA.
- Center for Immunology, University of Minnesota Medical School, Minneapolis, MN, USA.
- 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.
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4
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Miller SM, Crouse B, Hicks L, Amin H, Cole S, Bazin HG, Burkhart DJ, Pravetoni M, Evans JT. A lipidated TLR7/8 adjuvant enhances the efficacy of a vaccine against fentanyl in mice. NPJ Vaccines 2023; 8:97. [PMID: 37429853 PMCID: PMC10333387 DOI: 10.1038/s41541-023-00694-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/22/2023] [Indexed: 07/12/2023] Open
Abstract
Opioid use disorders (OUD) and opioid-related fatal overdoses are a public health concern in the United States. Approximately 100,000 fatal opioid-related overdoses occurred annually from mid-2020 to the present, the majority of which involved fentanyl or fentanyl analogs. Vaccines have been proposed as a therapeutic and prophylactic strategy to offer selective and long-lasting protection against accidental or deliberate exposure to fentanyl and closely related analogs. To support the development of a clinically viable anti-opioid vaccine suitable for human use, the incorporation of adjuvants will be required to elicit high titers of high-affinity circulating antibodies specific to the target opioid. Here we demonstrate that the addition of a synthetic TLR7/8 agonist, INI-4001, but not a synthetic TLR4 agonist, INI-2002, to a candidate conjugate vaccine consisting of a fentanyl-based hapten, F1, conjugated to the diphtheria cross-reactive material (CRM), significantly increased generation of high-affinity F1-specific antibody concentrations, and reduced drug distribution to the brain after fentanyl administration in mice.
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Affiliation(s)
- Shannon M Miller
- Department of Biomedical and Pharmaceutical Sciences, Center for Translational Medicine, University of Montana, Missoula, MT, USA
- Inimmune Corporation, Missoula, MT, USA
| | - Bethany Crouse
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, USA
| | - Linda Hicks
- Department of Biomedical and Pharmaceutical Sciences, Center for Translational Medicine, University of Montana, Missoula, MT, USA
| | - Hardik Amin
- Department of Biomedical and Pharmaceutical Sciences, Center for Translational Medicine, University of Montana, Missoula, MT, USA
| | - Shelby Cole
- Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Helene G Bazin
- Department of Biomedical and Pharmaceutical Sciences, Center for Translational Medicine, University of Montana, Missoula, MT, USA
- Inimmune Corporation, Missoula, MT, USA
| | - David J Burkhart
- Department of Biomedical and Pharmaceutical Sciences, Center for Translational Medicine, University of Montana, Missoula, MT, USA
- Inimmune Corporation, Missoula, MT, USA
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
- Center for Immunology, University of Minnesota, Minneapolis, MN, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Jay T Evans
- Department of Biomedical and Pharmaceutical Sciences, Center for Translational Medicine, University of Montana, Missoula, MT, USA.
- Inimmune Corporation, Missoula, MT, USA.
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5
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Luba R, Martinez S, Jones J, Pravetoni M, Comer SD. Immunotherapeutic strategies for treating opioid use disorder and overdose. Expert Opin Investig Drugs 2023; 32:77-87. [PMID: 36696567 PMCID: PMC10035039 DOI: 10.1080/13543784.2023.2173062] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Development and implementation of effective treatments for opioid use disorder (OUD) and prevention of overdose are urgent public health needs. Though existing medications for OUD (MOUD) are effective, barriers to initiation and retention in treatment persist. Therefore, development of novel treatments, especially those may complement existing treatments, is needed. AREAS COVERED This review provides an overview of vaccines for substance use disorders (SUD) and mechanisms underlying their function and efficacy. Next, we focus on existing preclinical and clinical trials of SUD vaccines. We focus briefly on related strategies before providing an expert opinion on prior, current, and future work on vaccines for OUD. We included published findings from preclinical and clinical trials found on PubMed and ScienceDirect as well as ongoing or initiated trials listed on ClinicalTrials.gov. EXPERT OPINION The present opioid overdose and OUD crises necessitate urgent development and implementation of effective treatments, especially those that offer protection from overdose and can serve as adjuvants to existing medications. Promising preclinical trial results paired with careful efforts to develop vaccines that account for prior SUD vaccine shortcomings offer hope for current and future clinical trials of opioid vaccines. Clinical advantages of opioid vaccines appear to outnumber disadvantages, which may result in improved treatment options.
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Affiliation(s)
- Rachel Luba
- New York State Psychiatric Institute/Columbia University Irving Medical Center Division on Substance Use Disorders
| | - Suky Martinez
- New York State Psychiatric Institute/Columbia University Irving Medical Center Division on Substance Use Disorders
| | - Jermaine Jones
- New York State Psychiatric Institute/Columbia University Irving Medical Center Division on Substance Use Disorders
| | - Marco Pravetoni
- University of Washington, School of Medicine, Department of Psychiatry and Behavioral Sciences, Department of Pharmacology, Center for Medication Development for Substance Use Disorders and Overdose, Seattle, WA
| | - Sandra D Comer
- New York State Psychiatric Institute/Columbia University Irving Medical Center Division on Substance Use Disorders
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6
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Hossain MK, Davidson M, Kypreos E, Feehan J, Muir JA, Nurgali K, Apostolopoulos V. Immunotherapies for the Treatment of Drug Addiction. Vaccines (Basel) 2022; 10:vaccines10111778. [PMID: 36366287 PMCID: PMC9697687 DOI: 10.3390/vaccines10111778] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
Substance use disorders (SUD) are a serious public health concern globally. Existing treatment platforms suffer from a lack of effectiveness. The development of immunotherapies against these substances of abuse for both prophylactic and therapeutic use has gained tremendous importance as an alternative and/or supplementary to existing therapies. Significant development has been made in this area over the last few decades. Herein, we highlight the vaccine and other biologics development strategies, preclinical, clinical updates along with challenges and future directions. Articles were searched in PubMed, ClinicalTrial.gov, and google electronic databases relevant to development, preclinical, clinical trials of nicotine, cocaine, methamphetamine, and opioid vaccines. Various new emerging vaccine development strategies for SUD were also identified through this search and discussed. A good number of vaccine candidates demonstrated promising results in preclinical and clinical phases and support the concept of developing a vaccine for SUD. However, there have been no ultimate success as yet, and there remain some challenges with a massive push to take more candidates to clinical trials for further evaluation to break the bottleneck.
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Affiliation(s)
- Md Kamal Hossain
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
| | - Majid Davidson
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
| | - Erica Kypreos
- College of Health and Biomedicine, Victoria University, Melbourne, VIC 3021, Australia
| | - Jack Feehan
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
- Regenerative Medicine and Stem Cells Program, Australian Institute of Musculoskeletal Science (AIMSS), Melbourne, VIC 3021, Australia
| | - Joshua Alexander Muir
- College of Health and Biomedicine, Victoria University, Melbourne, VIC 3021, Australia
| | - Kulmira Nurgali
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
- Department of Medicine Western Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3021, Australia
- Immunology Program, Australian Institute of Musculoskeletal Science (AIMSS), Melbourne, VIC 3021, Australia
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
- Regenerative Medicine and Stem Cells Program, Australian Institute of Musculoskeletal Science (AIMSS), Melbourne, VIC 3021, Australia
- Correspondence:
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7
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Hamid FA, Marker CL, Raleigh MD, Khaimraj A, Winston S, Pentel PR, Pravetoni M. Pre-clinical safety and toxicology profile of a candidate vaccine to treat oxycodone use disorder. Vaccine 2022; 40:3244-3252. [DOI: 10.1016/j.vaccine.2022.03.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/17/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
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8
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Crouse B, Zhang L, Robinson C, Ban Y, Vigliaturo JR, Roy S, Pravetoni M. Housing conditions and microbial environment do not affect the efficacy of vaccines for treatment of opioid use disorders in mice and rats. Hum Vaccin Immunother 2021; 17:4383-4392. [PMID: 34411500 PMCID: PMC8828096 DOI: 10.1080/21645515.2021.1954442] [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: 04/21/2021] [Revised: 06/21/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022] Open
Abstract
Vaccines offer a promising prophylactic and therapeutic intervention to counteract opioid use disorders (OUD) and fatal overdoses. Vaccines generate opioid-specific antibodies that bind the target opioid, reducing drug distribution to the brain and preventing drug-induced behavioral and pharmacological effects. Due to their selectivity, anti-opioid vaccines can be administered in combination with FDA-approved medications. Because patients with OUD or other substance use disorders may be affected by other multifactorial co-morbidities, such as infection or depression, it is important to test whether vaccine efficacy is modified by factors that may impact individual innate or adaptive immunity. To that end, this study tested whether housing conditions would affect the efficacy of two lead vaccine formulations targeting oxycodone and fentanyl in male mice and rats, and further analyzed whether differences in the gastrointestinal (GI) microbiome would be correlated with either vaccine efficacy or housing conditions. Results showed that housing mice and rats in either conventional (non-controlled) or specific pathogen-free (SPF, sterile barrier maintained) environment did not affect vaccine-induced antibody responses against oxycodone and fentanyl, nor their efficacy against oxycodone- and fentanyl-induced antinociception, respiratory depression, and bradycardia. Differences in the GI microbiome detected via 16S rRNA gene sequencing were related to the housing environment. This study supports use of anti-opioid vaccines in clinical populations that may display deficits in microbiome function.
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Affiliation(s)
- Bethany Crouse
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, USA
| | - Li Zhang
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Christine Robinson
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Yuguang Ban
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jennifer R Vigliaturo
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Sabita Roy
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, USA
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA
- University of Minnesota Center for Immunology, Minneapolis, MN, USA
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Chow SL, Sasson C, Benjamin IJ, Califf RM, Compton WM, Oliva EM, Robson C, Sanchez EJ. Opioid Use and Its Relationship to Cardiovascular Disease and Brain Health: A Presidential Advisory From the American Heart Association. Circulation 2021; 144:e218-e232. [PMID: 34407637 DOI: 10.1161/cir.0000000000001007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The misuse of opioids continues to be epidemic, resulting in dependency and a recent upsurge in drug overdoses that have contributed to a significant decrease in life expectancy in the United States. Moreover, recent data suggest that commonly used opioids for the management of pain may produce undesirable pharmacological actions and interfere with critical medications commonly used in cardiovascular disease and stroke; however, the impact on outcomes remains controversial. The American Heart Association developed an advisory statement for health care professionals and researchers in the setting of cardiovascular and brain health to synthesize the current literature, to provide approaches for identifying patients with opioid use disorder, and to address pain management and overdose. A literature and internet search spanning from January 1, 2012, to February 15, 2021, and limited to epidemiology studies, reviews, consensus statements, and guidelines in human subjects was conducted. Suggestions and considerations listed in this document are based primarily on published evidence from this review whenever possible, as well as expert opinion. Several federal and institutional consensus documents and clinical resources are currently available to both patients and clinicians; however, none have specifically addressed cardiovascular disease and brain health. Although strategic tools and therapeutic approaches for recognition of opioid use disorder and safe opioid use are available for health care professionals who manage patients with cardiovascular disease and stroke, high-quality evidence does not currently exist. Therefore, there is an urgent need for more research to identify the most effective approaches to improve care for these patients.
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10
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The M3-TT Vaccine Decreases the Antinociceptive Effects of Morphine and Heroin in Mice. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00621-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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11
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Huseby Kelcher AM, Baehr CA, Hamid FA, Hart GT, Pravetoni M. Contribution of Antibody-Mediated Effector Functions to the Mechanism of Efficacy of Vaccines for Opioid Use Disorders. THE JOURNAL OF IMMUNOLOGY 2021; 207:860-867. [PMID: 34281999 DOI: 10.4049/jimmunol.2100204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/28/2021] [Indexed: 12/28/2022]
Abstract
Vaccines and mAbs offer promising strategies to treat substance use disorders (SUDs) and prevent overdose. Despite vaccines and mAbs against SUDs demonstrating proof of efficacy, selectivity, and safety in animal models, it is unknown whether the mechanism of action of these immunotherapeutics relies exclusively on the formation of Ab/drug complexes, or also involves Ab-mediated effector functions. Hence, this study tested whether the efficacy of active and passive immunization against drugs of abuse requires phagocytosis, the intact Fc portion of the anti-drug Ab, FcγRs, or the neonatal FcR (FcRn). The efficacy of a lead vaccine against oxycodone was not diminished in mice after depletion of macrophages or granulocytes. Anti-oxycodone F(ab')2 fragments resulted in lower serum levels of F(ab')2 compared with intact mAbs, and F(ab')2s were not as effective as the parent mAbs in reducing distribution of oxycodone to the brain. The efficacy of vaccines and mAbs against oxycodone was preserved in either FcγIII or FcγI-IV ablated mice, suggesting that FcγRs are not required for Ab efficacy. Finally, both active and passive immunization against oxycodone in FcRn-/- mice yielded reduced efficacy compared with wild-type control mice. These data identified a role for FcRn, but not for phagocytosis or Fc-dependent effector functions, in mediating the efficacy of vaccines and mAbs against SUD. This study supports rational design of vaccines and mAbs engineered for maximal neutralization activity and optimal FcRn binding.
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Affiliation(s)
| | - Carly A Baehr
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN
| | - Fatima A Hamid
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN
| | - Geoffrey T Hart
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN; and.,Center for Immunology, University of Minnesota Medical School, Minneapolis, MN
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN; .,Center for Immunology, University of Minnesota Medical School, Minneapolis, MN
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12
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Barbosa-Méndez S, Matus-Ortega M, Hernández-Miramontes R, Salazar-Juárez A. The morphine/heroin vaccine decreased the heroin-induced antinociceptive and reinforcing effects in three inbred strains mouse. Int Immunopharmacol 2021; 98:107887. [PMID: 34186279 DOI: 10.1016/j.intimp.2021.107887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/25/2022]
Abstract
Clinical trials have indicated that a vaccine must be immunogenic in genetically diverse human populations and that immunogenicity and protective efficacy in animal models are two key indices required for the approval of a new vaccine. Additionally, the immune response (immunogenicity) and immunoprotection are dependent on the mouse strain. Therefore, the objective of the present study was to determine the immune response (immunogenicity) and the protective efficacy (behavioral response) in three inbred mouse strains immunized with the M6TT vaccine. Female BALB/c, C57Bl/6, and DBA/2 inbred mice were immunized with the M6-TT vaccine. A solid-phase antibody-capture ELISA was used to monitor antibody titer responses after each booster dose in vaccinated animals. The study used tail-flick testing to evaluate the antinociceptive effects induced by heroin. Additionally, heroin-induced locomotor activity and place preference were evaluated. The M6-TT vaccine was able to generate a specific antibody titer in the three inbred mouse strains evaluated. The antibodies reduced the antinociceptive effect of different doses of heroin. In addition, they decreased the heroin-induced locomotor activity and place preference. These findings suggest that the M6-TT vaccine generates a powerful immunogenic response capable of reducing the antinociceptive and reinforcing effects of heroin in different inbred mouse strains, which supports its possible future use in clinical trials in genetically diverse human populations.
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Affiliation(s)
- Susana Barbosa-Méndez
- Subdirección de Investigaciones Clínicas, Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Instituto Nacional de Psiquiatría, México DF 14370, Mexico
| | - Maura Matus-Ortega
- Subdirección de Investigaciones Clínicas, Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Instituto Nacional de Psiquiatría, México DF 14370, Mexico
| | - Ricardo Hernández-Miramontes
- Subdirección de Investigaciones Clínicas, Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Instituto Nacional de Psiquiatría, México DF 14370, Mexico
| | - Alberto Salazar-Juárez
- Subdirección de Investigaciones Clínicas, Laboratorio de Neurofarmacología Conductual, Microcirugía y Terapéutica Experimental, Instituto Nacional de Psiquiatría, México DF 14370, Mexico.
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13
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Pharmacological mechanisms underlying the efficacy of antibodies generated by a vaccine to treat oxycodone use disorder. Neuropharmacology 2021; 195:108653. [PMID: 34126123 DOI: 10.1016/j.neuropharm.2021.108653] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/07/2021] [Accepted: 06/06/2021] [Indexed: 11/24/2022]
Abstract
Therapeutic vaccines offer a viable strategy to treat opioid use disorders (OUD) complementary to current pharmacotherapies. The candidate Oxy(Gly)4-sKLH vaccine targeting oxycodone displayed pre-clinical proof of efficacy, selectivity and safety, and it is now undergoing clinical evaluation. To further support its implementation in the clinic, this study tested critical in vivo neuropsychopharmacological properties of the Oxy(Gly)4-sKLH vaccine in rats. While repeated immunizations with Oxy(Gly)4-sKLH were necessary to maintain the antibody response overtime, exposure to free oxycodone did not boost oxycodone-specific antibody levels in vaccinated rats, limiting concerns of immune-related side effects. Immunization with Oxy(Gly)4-sKLH achieved sustained antibody titers over a period of five months following initial vaccination, supporting its potential for providing long-lasting protection. In vivo studies of selectivity showed that vaccination prevented oxycodone-induced but not methadone-induced antinociception, while still preserving the opioid antagonist naloxone's pharmacological effects. Vaccination did not interfere with fentanyl-induced antinociception or fentanyl distribution to the brain. These in vivo data confirm the previously reported in vitro selectivity profile of Oxy(Gly)4-sKLH. Vaccination extended oxycodone's half-life up to 25 h compared to control. While vaccination reduced the reinforcing efficacy of oxycodone in an intravenous self-administration model, signs of toxicity were not observed. These rodent studies confirm that active immunization with Oxy(Gly)4-sKLH induces highly specific and long-lasting antibodies which are effective in decreasing the reinforcing effects of oxycodone while preserving the efficacy of medications used to treat OUD and overdose.
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14
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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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15
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Fulenwider HD, Nennig SE, Hafeez H, Price ME, Baruffaldi F, Pravetoni M, Cheng K, Rice KC, Manvich DF, Schank JR. Sex differences in oral oxycodone self-administration and stress-primed reinstatement in rats. Addict Biol 2020; 25:e12822. [PMID: 31830773 DOI: 10.1111/adb.12822] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 07/08/2019] [Accepted: 07/18/2019] [Indexed: 01/15/2023]
Abstract
The opioid epidemic has become a severe public health problem, with approximately 130 opioid-induced deaths occurring each day in the United States. Prescription opioids are responsible for approximately 40% of these deaths. Oxycodone is one of the most commonly abused prescription opioids, but despite its prevalent misuse, the number of preclinical studies investigating oxycodone-seeking behaviors is relatively limited. Furthermore, preclinical oxycodone studies that include female subjects are even more scarce, and it is critical that future work includes both sexes. Additionally, the oral route of administration is one of the most common routes for recreational users, especially in the early stages of drug experimentation. However, currently, only two studies have been published investigating operant oral oxycodone self-administration in rodents. Therefore, the primary goal of the present study was to establish an oral oxycodone operant self-administration model in adult male and female rats, as well as to examine a potential mechanism of stress-primed reinstatement. We found that females consumed significantly more oral oxycodone than males in operant self-administration sessions. We also found that active oxycodone self-administration was reduced by mu opioid receptor antagonism and by substitution of water for oxycodone solution. Lastly, we induced stress-primed reinstatement and found that this behavior was significantly attenuated by antagonism of the neurokinin-1 receptor, consistent with our prior work examining stress-induced reinstatement of alcohol- and cocaine-seeking.
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Affiliation(s)
- Hannah D. Fulenwider
- Department of Physiology and Pharmacology, College of Veterinary Medicine University of Georgia Athens Georgia USA
| | - Sadie E. Nennig
- Department of Physiology and Pharmacology, College of Veterinary Medicine University of Georgia Athens Georgia USA
| | - Hiba Hafeez
- Department of Physiology and Pharmacology, College of Veterinary Medicine University of Georgia Athens Georgia USA
| | - Michaela E. Price
- Department of Physiology and Pharmacology, College of Veterinary Medicine University of Georgia Athens Georgia USA
| | | | - Marco Pravetoni
- Hennepin Healthcare Research Institute Minneapolis Minnesota USA
- Department of Pharmacology University of Minnesota Medical School Minneapolis Minnesota USA
- Center for Immunology University of Minnesota Medical School Minneapolis Minnesota USA
| | - Kejun Cheng
- Drug Design and Synthesis Section NIH/NIDA/NIAAA Rockville Maryland USA
| | - Kenner C. Rice
- Drug Design and Synthesis Section NIH/NIDA/NIAAA Rockville Maryland USA
| | - Daniel F. Manvich
- Department of Cell Biology and Neuroscience Rowan University School of Osteopathic Medicine Stratford New Jersey USA
| | - Jesse R. Schank
- Department of Physiology and Pharmacology, College of Veterinary Medicine University of Georgia Athens Georgia USA
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16
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Crouse B, Robinson C, Huseby Kelcher A, Laudenbach M, Abrahante JE, Pravetoni M. Mechanisms of interleukin 4 mediated increase in efficacy of vaccines against opioid use disorders. NPJ Vaccines 2020; 5:99. [PMID: 33101712 PMCID: PMC7578047 DOI: 10.1038/s41541-020-00247-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/10/2020] [Indexed: 12/12/2022] Open
Abstract
Opioid use disorders (OUD) affect over 27 million people worldwide. Anti-opioid vaccines offer a promising strategy to treat OUD and prevent overdose. Using immunomodulation of cytokine signaling to increase vaccine efficacy, this study found that blocking IL-4 improved the efficacy of vaccines targeting oxycodone and fentanyl in male and female mice. Genetic deletion of the IL-4 receptor, STAT6, or antibody-based depletion of IL-13, did not increase vaccine efficacy against opioids, suggesting the involvement of type I IL-4 receptors. Enhancement of vaccine efficacy with blockade of IL-4 was associated with improved germinal center formation in secondary lymphoid organs and selective transcriptome signatures in the activated CD4+ T cell population subset. These data suggest that IL-4 is both a pharmacological target and a potential biomarker of vaccine efficacy against OUD.
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Affiliation(s)
- Bethany Crouse
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455 USA.,Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN 55455 USA
| | - Christine Robinson
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455 USA
| | - April Huseby Kelcher
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455 USA.,Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55455 USA
| | - Megan Laudenbach
- Hennepin Healthcare Research Institute, Minneapolis, MN 55404 USA
| | - Juan E Abrahante
- University of Minnesota Informatics Institute, Minneapolis, MN 55455 USA
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN 55455 USA.,Center for Immunology, University of Minnesota, Minneapolis, MN 55455 USA
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17
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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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18
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Gradinati V, Baruffaldi F, Abbaraju S, Laudenbach M, Amin R, Gilger B, Velagaleti P, Pravetoni M. Polymer-mediated delivery of vaccines to treat opioid use disorders and to reduce opioid-induced toxicity. Vaccine 2020; 38:4704-4712. [PMID: 32439214 DOI: 10.1016/j.vaccine.2020.05.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/05/2020] [Accepted: 05/09/2020] [Indexed: 11/15/2022]
Abstract
Vaccines offer a potential strategy to treat opioid use disorders (OUD) and to reduce the incidence of opioid-related overdoses. Vaccines induce opioid-specific polyclonal antibodies that selectively and effectively bind the target opioid and prevent its distribution across the blood-brain barrier. Because antibody-mediated reduction of drug distribution to the brain reduces drug-induced behavior and toxicity, vaccine efficacy depends on the quantity and quality of the antibody response. This study tested whether polymer-mediated delivery could improve vaccine efficacy against opioids as well as eliminate the need for booster injections normally required for a successful immunization. A series of novel biodegradable biocompatible thermogelling pentablock co-polymers were used to formulate a candidate vaccine against oxycodone in mice and rats. Polymer-based delivery of the anti-oxycodone vaccine was equally or more effective than administration in aluminum adjuvant in generating oxycodone-specific antibodies and in reducing oxycodone-induced effects and oxycodone distribution to the brain in mice and rats. The composition and release kinetics of the polymer formulations determined vaccine efficacy. Specifically, a formulation consisting of three simultaneous injections of the anti-oxycodone vaccine formulated in three different polymers with slow, intermediate, and fast release kinetics was more effective than an immunization regimen consisting of three sequential injections with the vaccine adsorbed on aluminum. The novel three-phased polymer vaccine formulation was effective in blocking oxycodone-induced antinociception, respiratory depression and bradycardia in rats.
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Affiliation(s)
- Valeria Gradinati
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States; University of Minnesota Medical School, Department of Pharmacology, Minneapolis, MN, United States
| | | | | | - Megan Laudenbach
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States
| | - Rasidul Amin
- Symmetry Biosciences, Raleigh, NC, United States
| | - Brian Gilger
- North Carolina State University, NC, United States
| | | | - Marco Pravetoni
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States; University of Minnesota Medical School, Department of Pharmacology, Minneapolis, MN, United States; University of Minnesota, Center for Immunology, Minneapolis, MN, United States.
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19
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Foerster J, Molęda A. Virus-Like Particle-Mediated Vaccination against Interleukin-13 May Harbour General Anti-Allergic Potential beyond Atopic Dermatitis. Viruses 2020; 12:v12040438. [PMID: 32294982 PMCID: PMC7232523 DOI: 10.3390/v12040438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/31/2020] [Accepted: 04/09/2020] [Indexed: 12/23/2022] Open
Abstract
Virus-like particle (VLP)-based anti-infective prophylactic vaccination has been established in clinical use. Although validated in proof-of-concept clinical trials in humans, no VLP-based therapeutic vaccination against self-proteins to modulate chronic disease has yet been licensed. The present review summarises recent scientific advances, identifying interleukin-13 as an excellent candidate to validate the concept of anti-cytokine vaccination. Based on numerous clinical studies, long-term elimination of IL-13 is not expected to trigger target-related serious adverse effects and is likely to be safer than combined targeting of IL-4/IL-13. Furthermore, recently published results from large-scale trials confirm that elimination of IL-13 is highly effective in atopic dermatitis, an exceedingly common condition, as well as eosinophilic esophagitis. The distinctly different mode of action of a polyclonal vaccine response is discussed in detail, suggesting that anti-IL-13 vaccination has the potential of outperforming monoclonal antibody-based approaches. Finally, recent data have identified a subset of follicular T helper cells dependent on IL-13 which selectively trigger massive IgE accumulation in response to anaphylactoid allergens. Thus, prophylactic IL-13 vaccination may have broad application in a number of allergic conditions.
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MESH Headings
- Animals
- Anti-Allergic Agents/administration & dosage
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/immunology
- Antibodies, Neutralizing/immunology
- Cytokines/metabolism
- Dermatitis, Atopic/immunology
- Dermatitis, Atopic/metabolism
- Dermatitis, Atopic/prevention & control
- Humans
- Interleukin-13/antagonists & inhibitors
- Interleukin-13/immunology
- Ligands
- T-Lymphocytes, Helper-Inducer/immunology
- T-Lymphocytes, Helper-Inducer/metabolism
- Vaccination
- Vaccines, Virus-Like Particle/administration & dosage
- Vaccines, Virus-Like Particle/immunology
- Vaccines, Virus-Like Particle/therapeutic use
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20
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Pravetoni M, Comer SD. Development of vaccines to treat opioid use disorders and reduce incidence of overdose. Neuropharmacology 2019; 158:107662. [PMID: 31173759 DOI: 10.1016/j.neuropharm.2019.06.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/01/2019] [Accepted: 06/02/2019] [Indexed: 02/06/2023]
Abstract
Vaccines offer a promising therapeutic strategy to treat substance use disorders (SUD). Vaccines have shown extensive preclinical proof of selectivity, safety, and efficacy against opioids, nicotine, cocaine, methamphetamine, and designer drugs. Despite clinical evaluation of vaccines targeting nicotine and cocaine showing proof of concept for this approach, no vaccine for SUD has yet reached the market. This review first discusses how vaccines for treatment of opioid use disorders (OUD) and reduction of opioid-induced fatal overdoses fit within the current medication assisted treatment (MAT) portfolio, and then summarizes ongoing efforts toward translation of vaccines targeting heroin, oxycodone, fentanyl, and other opioids. This article is part of the Special Issue entitled 'New Vistas in Opioid Pharmacology'.
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Affiliation(s)
- Marco Pravetoni
- University of Minnesota Medical School, Departments of Pharmacology and Medicine, Minneapolis, MN, USA; Hennepin Healthcare Research Institute, Minneapolis, MN, USA.
| | - Sandra D Comer
- Columbia University Irving Medical Center, Department of Psychiatry, The New York State Psychiatric Institute, New York, NY, USA
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21
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Baruffaldi F, Raleigh MD, King SJ, Roslawski MJ, Birnbaum AK, Hassler C, Carroll FI, Runyon SP, Winston S, Pentel PR, Pravetoni M. Formulation and Characterization of Conjugate Vaccines to Reduce Opioid Use Disorders Suitable for Pharmaceutical Manufacturing and Clinical Evaluation. Mol Pharm 2019; 16:2364-2375. [PMID: 31018096 DOI: 10.1021/acs.molpharmaceut.8b01296] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This study focused on formulating conjugate vaccines targeting oxycodone and heroin for technology transfer, good manufacturing practice (GMP), and clinical evaluation. Lead vaccines used the highly immunogenic carrier protein keyhole limpet hemocyanin (KLH), which poses formulation problems because of its size. To address this barrier to translation, an oxycodone-based hapten conjugated to GMP-grade subunit KLH (OXY-sKLH) and adsorbed on alum adjuvant was studied with regard to carbodiimide coupling reaction time, buffer composition, purification methods for conjugates, conjugate size, state of aggregation, and protein/alum ratio. Vaccine formulations were screened for post-immunization antibody levels and efficacy in reducing oxycodone distribution to the brain in rats. While larger conjugates were more immunogenic, their size prevented characterization of the haptenation ratio by standard analytical methods and sterilization by filtration. To address this issue, conjugation chemistry and vaccine formulation were optimized for maximal efficacy, and conjugate size was measured by dynamic light scattering prior to adsorption to alum. An analogous heroin vaccine (M-sKLH) was also optimized for conjugation chemistry, formulated in alum, and characterized for potency against heroin in rats. Finally, this study found that the efficacy of OXY-sKLH was preserved when co-administered with M-sKLH, supporting the proof of concept for a bivalent vaccine formulation targeting both heroin and oxycodone. This study suggests methods for addressing the unique formulation and characterization challenges posed by conjugating small molecules to sKLH while preserving vaccine efficacy.
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Affiliation(s)
- F Baruffaldi
- Hennepin Healthcare Research Institute , Minneapolis , Minnesota 55404 , United States
| | - M D Raleigh
- Hennepin Healthcare Research Institute , Minneapolis , Minnesota 55404 , United States
| | - S J King
- Hennepin Healthcare Research Institute , Minneapolis , Minnesota 55404 , United States
| | - M J Roslawski
- University of Minnesota College of Pharmacy , Minneapolis , Minnesota 55455 , United States
| | - A K Birnbaum
- University of Minnesota College of Pharmacy , Minneapolis , Minnesota 55455 , United States
| | - C Hassler
- RTI International , Research Triangle Park , North Carolina 27709-2194 , United States
| | - F I Carroll
- RTI International , Research Triangle Park , North Carolina 27709-2194 , United States
| | - S P Runyon
- RTI International , Research Triangle Park , North Carolina 27709-2194 , United States
| | - S Winston
- Winston Biopharmaceutical Consulting , 4475 Laguna Place #215 , Boulder , Colorado 80303 , United States
| | - P R Pentel
- Hennepin Healthcare Research Institute , Minneapolis , Minnesota 55404 , United States
| | - M Pravetoni
- Hennepin Healthcare Research Institute , Minneapolis , Minnesota 55404 , United States
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22
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Robinson C, Baehr C, Schmiel SE, Accetturo C, Mueller DL, Pravetoni M. Alum adjuvant is more effective than MF59 at prompting early germinal center formation in response to peptide-protein conjugates and enhancing efficacy of a vaccine against opioid use disorders. Hum Vaccin Immunother 2019; 15:909-917. [PMID: 30625019 DOI: 10.1080/21645515.2018.1558697] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Opioid use disorders (OUD) and fatal overdoses are a national emergency in the United States. Therapeutic vaccines offer a promising strategy to treat OUD and reduce the incidence of overdose. Immunization with opioid-based haptens conjugated to immunogenic carriers elicits opioid-specific antibodies that block opioid distribution to the brain and reduce opioid-induced behavior and toxicity in pre-clinical models. This study tested whether the efficacy of a lead oxycodone conjugate vaccine was improved by formulation in either aluminum hydroxide or the squalene-based oil-in-water emulsion MF59 adjuvant, which was recently FDA-approved for influenza vaccines in subjects 65+ years old. In adult BALB/c mice, alum formulation was more effective than MF59 at promoting the early expansion of hapten-specific B cells and the production of oxycodone-specific serum IgG antibodies, as well as blocking oxycodone distribution to the brain and oxycodone-induced motor activity. Alum was also more effective than MF59 at promoting early differentiation of peptide-specific MHCII-restricted CD4+ Tfh and GC-Tfh cells in adult C57Bl/6 mice immunized with a model peptide-protein conjugate. In contrast, alum and MF59 were equally effective in promoting hapten-specific B cells and peptide-specific MHCII-restricted CD4+ T cell differentiation in older C57Bl/6 mice. These data suggest that alum is a more effective adjuvant than MF59 for conjugate vaccines targeting synthetic small molecule haptens or peptide antigens in adult, but not aged, mice.
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Affiliation(s)
- Christine Robinson
- a Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation) , Minneapolis, MN , USA
| | - Carly Baehr
- a Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation) , Minneapolis, MN , USA.,b Department of Veterinary Population Medicine , University of Minnesota , Minneapolis, MN, , USA
| | | | - Claudia Accetturo
- d Department of Pharmaceutics , Universita degli Studi di Milano , Milan , Italy
| | - Daniel L Mueller
- e Center for Immunology , University of Minnesota , Minneapolis, MN , USA.,f Department of Medicine , University of Minnesota , Minneapolis, MN , USA
| | - Marco Pravetoni
- a Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation) , Minneapolis, MN , USA.,e Center for Immunology , University of Minnesota , Minneapolis, MN , USA.,f Department of Medicine , University of Minnesota , Minneapolis, MN , USA.,g Department of Pharmacology , University of Minnesota , Minneapolis, MN , USA
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Affiliation(s)
- Carly Baehr
- 0000000419368657grid.17635.36Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN USA ,0000 0000 9206 4546grid.414021.2Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation), Minneapolis, MN USA
| | - Marco Pravetoni
- Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation), Minneapolis, MN, USA. .,Departments of Medicine and Pharmacology, Center for Immunology, University of Minnesota, Minneapolis, MN, USA.
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Baruffaldi F, Kelcher AH, Laudenbach M, Gradinati V, Limkar A, Roslawski M, Birnbaum A, Lees A, Hassler C, Runyon S, Pravetoni M. Preclinical Efficacy and Characterization of Candidate Vaccines for Treatment of Opioid Use Disorders Using Clinically Viable Carrier Proteins. Mol Pharm 2018; 15:4947-4962. [PMID: 30240216 DOI: 10.1021/acs.molpharmaceut.8b00592] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Vaccines may offer a new treatment strategy for opioid use disorders and opioid-related overdoses. To speed translation, this study evaluates opioid conjugate vaccines containing components suitable for pharmaceutical manufacturing and compares analytical assays for conjugate characterization. Three oxycodone-based haptens (OXY) containing either PEGylated or tetraglycine [(Gly)4] linkers were conjugated to a keyhole limpet hemocyanin (KLH) carrier protein via carbodiimide (EDAC) or maleimide chemistry. The EDAC-conjugated OXY(Gly)4-KLH was most effective in reducing oxycodone distribution to the brain in mice. Vaccine efficacy was T cell-dependent. The lead OXY hapten was conjugated to the KLH, tetanus toxoid, diphtheria cross-reactive material (CRM), as well as the E. coli-expressed CRM (EcoCRM) and nontoxic tetanus toxin heavy chain fragment C (rTTHc) carrier proteins. All vaccines induced early hapten-specific B cell expansion and showed equivalent efficacy against oxycodone in mice. However, some hapten-protein conjugates were easier to characterize for molecular weight and size. Finally, heroin vaccines formulated with either EcoCRM or KLH were equally effective in reducing heroin-induced antinociception and distribution to the brain of heroin and its metabolites in mice. This study identifies vaccine candidates and vaccine components for further development.
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Affiliation(s)
- Federico Baruffaldi
- Hennepin Healthcare Research Institute (HHRI, formerly Minneapolis Medical Research Foundation or MMRF) , 701 Park Avenue , Minneapolis , Minnesota 55415 , United States
| | - April Huseby Kelcher
- Hennepin Healthcare Research Institute (HHRI, formerly Minneapolis Medical Research Foundation or MMRF) , 701 Park Avenue , Minneapolis , Minnesota 55415 , United States
| | - Megan Laudenbach
- Hennepin Healthcare Research Institute (HHRI, formerly Minneapolis Medical Research Foundation or MMRF) , 701 Park Avenue , Minneapolis , Minnesota 55415 , United States
| | - Valeria Gradinati
- Hennepin Healthcare Research Institute (HHRI, formerly Minneapolis Medical Research Foundation or MMRF) , 701 Park Avenue , Minneapolis , Minnesota 55415 , United States.,Dipartimento di Chimica e Tecnologie Farmaceutiche, Socrates Program , Universitá degli Studi di Milano , Milan 20122 , Italy
| | - Ajinkya Limkar
- University of Minnesota , Minneapolis , Minnesota 55455 , United States
| | | | - Angela Birnbaum
- University of Minnesota , Minneapolis , Minnesota 55455 , United States
| | - Andrew Lees
- Fina Biosolutions, LLC , Rockville , Maryland 20850 , United States
| | - Carla Hassler
- RTI International , Research Triangle Park , North Carolina 27709-2194 , United States
| | - Scott Runyon
- RTI International , Research Triangle Park , North Carolina 27709-2194 , United States
| | - Marco Pravetoni
- Hennepin Healthcare Research Institute (HHRI, formerly Minneapolis Medical Research Foundation or MMRF) , 701 Park Avenue , Minneapolis , Minnesota 55415 , United States.,Departments of Medicine and Pharmacology, Center for Immunology , University of Minnesota , Minneapolis , Minnesota 55455 , United States
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