1
|
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.
Collapse
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:
| |
Collapse
|
2
|
Pagovich OE, Stiles KM, Camilleri AE, Russo AR, Nag S, Crystal RG. Gene therapy in a murine model of chronic eosinophilic leukemia-not otherwise specified (CEL-NOS). Leukemia 2022; 36:525-531. [PMID: 34545183 DOI: 10.1038/s41375-021-01400-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 05/15/2021] [Accepted: 08/23/2021] [Indexed: 02/08/2023]
Abstract
Chronic eosinophilic leukemia-not otherwise specified (CEL-NOS) is a rare, aggressive, fatal disease characterized by blood eosinophilia and dysfunction of organs infiltrated with eosinophils. Clinically, the disease manifests with weight loss, cough, weakness, diarrhea, and multi-organ dysfunction that is unresponsive to therapy. We developed a one-time gene therapy for CEL-NOS using an adeno-associated virus (AAV) expressing an anti-eosinophil monoclonal antibody (AAVrh.10mAnti-Eos) to provide sustained suppression of eosinophil numbers in blood, thus reducing eosinophil tissue invasion and organ dysfunction. A novel CEL-NOS model was developed in NOD-scid IL2rγnull (NSG) mice by administration of AAV expressing the cytokine IL5 (AAVrh.10mIL5), resulting in marked peripheral and tissue eosinophilia of the heart, lung, liver, and spleen, and eventually death. Mice were administered AAVrh.10mAnti-Eos (1011 genome copies) 4 wk after administration of AAVrh.10mIL5 and evaluated for anti-eosinophil antibody expression, blood eosinophil counts, organ eosinophil invasion, and survival. AAVrh.10mAnti-Eos expressed persistent levels of the anti-eosinophil antibody for >24 wk. Strikingly, CEL-NOS treated mice had markedly lower blood eosinophil levels and reduced mortality when compared with control treated mice. These results suggest that a single treatment with AAVrh.10mAnti-Eos has the potential to provide substantial therapeutic benefit to patients with CEL-NOS, a fatal malignant disorder.
Collapse
Affiliation(s)
- Odelya E Pagovich
- Department of Genetic Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Katie M Stiles
- Department of Genetic Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Anna E Camilleri
- Department of Genetic Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Anthony R Russo
- Department of Genetic Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Saparja Nag
- Department of Genetic Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Ronald G Crystal
- Department of Genetic Medicine, Weill Cornell Medical College, New York, NY, USA.
| |
Collapse
|
3
|
Smith LC, George O. Advances in smoking cessation pharmacotherapy: Non-nicotinic approaches in animal models. Neuropharmacology 2020; 178:108225. [PMID: 32758566 DOI: 10.1016/j.neuropharm.2020.108225] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 12/22/2022]
Abstract
The landscape of worldwide tobacco use is changing, with a decrease in traditional smoking and an exponential rise in electronic cigarette use. No new nicotine cessation pharmacotherapies have come to market in the last 10 years. The current therapies that have been approved by the United States Food and Drug Administration for nicotine cessation include nicotine replacement therapy, varenicline, a nicotinic acetylcholine receptor partial agonist, and the atypical antidepressant bupropion. Nicotine replacement therapy and varenicline both act on nicotinic acetylcholine receptors. Bupropion inhibits the dopamine transporter, the norepinephrine transporter, and the nicotinic acetylcholine receptors to inhibit smoking behavior. Notwithstanding these treatments, rates of successful nicotine cessation in clinical trials remain low. Recent pharmacological approaches to improve nicotine cessation rates in animal models have turned their focus away from activating nicotinic acetylcholine receptors. The present review focuses on such pharmacological approaches, including nicotine vaccines, anti-nicotine antibodies, nicotine-degrading enzymes, cannabinoids, and metformin. Both immunopharmacological and enzymatic approaches rely on restricting and degrading nicotine within the periphery, thus preventing psychoactive effects of nicotine on the central nervous system. In contrast, pharmacologic inhibition of the enzymes which degrade nicotine could affect smoking behavior. Cannabinoid receptor agonists and antagonists interact with the dopamine reward pathway and show efficacy in reducing nicotine addiction-like behaviors in preclinical studies. Metformin is currently approved by the Food and Drug Administration for the treatment of diabetes. It activates specific intracellular kinases that may protect against the lower metabolism, higher oxidation, and inflammation that are associated with nicotine withdrawal. Further studies are needed to investigate non-nicotinic targets to improve the treatment of tobacco use disorder. This article is part of the special issue on 'Contemporary Advances in Nicotine Neuropharmacology'.
Collapse
Affiliation(s)
- Lauren C Smith
- Department of Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA, 92037, USA; Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, CA, 92093, USA
| | - Olivier George
- Department of Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Road, La Jolla, CA, 92037, USA; Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, CA, 92093, USA.
| |
Collapse
|
4
|
Hay CE, Ewing LE, Hambuchen MD, Zintner SM, Small JC, Bolden CT, Fantegrossi WE, Margaritis P, Owens SM, Peterson EC. The Development and Characterization of an scFv-Fc Fusion-Based Gene Therapy to Reduce the Psychostimulant Effects of Methamphetamine Abuse. J Pharmacol Exp Ther 2020; 374:16-23. [PMID: 32245884 DOI: 10.1124/jpet.119.261180] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 03/31/2020] [Indexed: 12/17/2022] Open
Abstract
Methamphetamine (METH) continues to be among the most addictive and abused drugs in the United States. Unfortunately, there are currently no Food and Drug Administration-approved pharmacological treatments for METH-use disorder. We have previously explored the use of adeno-associated viral (AAV)-mediated gene transfer of an anti-METH monoclonal antibody. Here, we advance our approach by generating a novel anti-METH single-chain variable fragment (scFv)-Fc fusion construct (termed 7F9-Fc) packaged into AAV serotype 8 vector (called AAV-scFv-Fc) and tested in vivo and ex vivo. A range of doses [1 × 1010, 1 × 1011, and 1 × 1012 vector copies (vcs)/mouse] were administered to mice, eliciting a dose-dependent expression of 7F9-Fc in serum with peak circulating concentrations of 48, 1785, and 3831 µg/ml, respectively. Expressed 7F9-Fc exhibited high-affinity METH binding, IC50 = 17 nM. Between days 21 and 35 after vector administration, at both 1 × 1011 vc/mouse and 1 × 1012 vc/mouse doses, the AAV-7F9-Fc gene therapy significantly decreased the potency of METH in locomotor assays. On day 116 post-AAV administration, mice expressing 7F9-Fc sequestered over 2.5 times more METH in the serum than vehicle-treated mice, and METH concentrations in the brain were reduced by 1.2 times the value for vehicle mice. These data suggest that an AAV-delivered anti-METH Fc fusion antibody could be used to persistently reduce concentrations of METH in the central nervous system. SIGNIFICANCE STATEMENT: In this manuscript, we describe the testing of a novel antimethamphetamine (METH) single-chain variable fragment-Fc fusion protein delivered in mice using gene therapy. The results suggest that the gene therapy delivery system can lead to the production of significant antibody concentrations that mitigate METH's psychostimulant effects in mice over an extended time period.
Collapse
Affiliation(s)
- Charles E Hay
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (C.E.H., L.E.E., M.D.H., C.T.B., W.E.F., S.M.O., E.C.P,); The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (S.M.Z., J.C.S., P.M.,); The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (P.M.); and Department of Pediatrics, The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania (P.M.)
| | - Laura E Ewing
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (C.E.H., L.E.E., M.D.H., C.T.B., W.E.F., S.M.O., E.C.P,); The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (S.M.Z., J.C.S., P.M.,); The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (P.M.); and Department of Pediatrics, The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania (P.M.)
| | - Michael D Hambuchen
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (C.E.H., L.E.E., M.D.H., C.T.B., W.E.F., S.M.O., E.C.P,); The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (S.M.Z., J.C.S., P.M.,); The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (P.M.); and Department of Pediatrics, The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania (P.M.)
| | - Shannon M Zintner
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (C.E.H., L.E.E., M.D.H., C.T.B., W.E.F., S.M.O., E.C.P,); The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (S.M.Z., J.C.S., P.M.,); The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (P.M.); and Department of Pediatrics, The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania (P.M.)
| | - Juliana C Small
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (C.E.H., L.E.E., M.D.H., C.T.B., W.E.F., S.M.O., E.C.P,); The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (S.M.Z., J.C.S., P.M.,); The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (P.M.); and Department of Pediatrics, The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania (P.M.)
| | - Chris T Bolden
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (C.E.H., L.E.E., M.D.H., C.T.B., W.E.F., S.M.O., E.C.P,); The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (S.M.Z., J.C.S., P.M.,); The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (P.M.); and Department of Pediatrics, The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania (P.M.)
| | - William E Fantegrossi
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (C.E.H., L.E.E., M.D.H., C.T.B., W.E.F., S.M.O., E.C.P,); The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (S.M.Z., J.C.S., P.M.,); The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (P.M.); and Department of Pediatrics, The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania (P.M.)
| | - Paris Margaritis
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (C.E.H., L.E.E., M.D.H., C.T.B., W.E.F., S.M.O., E.C.P,); The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (S.M.Z., J.C.S., P.M.,); The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (P.M.); and Department of Pediatrics, The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania (P.M.)
| | - S Michael Owens
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (C.E.H., L.E.E., M.D.H., C.T.B., W.E.F., S.M.O., E.C.P,); The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (S.M.Z., J.C.S., P.M.,); The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (P.M.); and Department of Pediatrics, The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania (P.M.)
| | - Eric C Peterson
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (C.E.H., L.E.E., M.D.H., C.T.B., W.E.F., S.M.O., E.C.P,); The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (S.M.Z., J.C.S., P.M.,); The Raymond G. Perelman Center for Cellular and Molecular Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (P.M.); and Department of Pediatrics, The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania (P.M.)
| |
Collapse
|
5
|
Crystal RG. My Pathway to Gene Therapy. Hum Gene Ther 2020; 31:273-282. [DOI: 10.1089/hum.2020.29112.rgc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ronald G. Crystal
- Department of Genetic Medicine, Weill Cornell Medical College, New York, New York
| |
Collapse
|
6
|
Myagkova MA, Morozova VS. Vaccines for substance abuse treatment: new approaches in the immunotherapy of addictions. Russ Chem Bull 2018. [DOI: 10.1007/s11172-018-2290-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
7
|
Development and testing of AAV-delivered single-chain variable fragments for the treatment of methamphetamine abuse. PLoS One 2018; 13:e0200060. [PMID: 29958300 PMCID: PMC6025879 DOI: 10.1371/journal.pone.0200060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/11/2018] [Indexed: 01/27/2023] Open
Abstract
Methamphetamine (METH) substance abuse disorders have major impact on society, yet no medications have proven successful at preventing METH relapse or cravings. Anti-METH monoclonal antibodies can reduce METH brain concentrations; however, this therapy has limitations, including the need for repeated dosing throughout the course of addiction recovery. An adeno-associated viral (AAV)-delivered DNA sequence for a single-chain variable fragment could offer long-term, continuous expression of anti-METH antibody fragments. For these studies, we injected mice via tail vein with 1 x 1012 vector genomes of two AAV8 scFv constructs and measured long-term expression of the antibody fragments. Mice expressed each scFv for at least 212 days, achieving micromolar scFv concentrations in serum. In separate experiments 21 days and 50 days after injecting mice with AAV-scFvs mice were challenged with METH in vivo. The circulating scFvs were capable of decreasing brain METH concentrations by up to 60% and sequestering METH in serum for 2 to 3 hrs. These results suggest that AAV-delivered scFv could be a promising therapy to treat methamphetamine abuse.
Collapse
|
8
|
Heekin RD, Shorter D, Kosten TR. Current status and future prospects for the development of substance abuse vaccines. Expert Rev Vaccines 2017; 16:1067-1077. [PMID: 28918668 DOI: 10.1080/14760584.2017.1378577] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Substance use disorders (SUD) are a significant threat to both individual and public health. To date, SUD pharmacotherapy has focused primarily on agonist medications (i.e. nicotine replacement therapy for tobacco use disorder; methadone and buprenorphine for opioid use disorder), antagonist medications (i.e. naltrexone for opioid use disorder), and aversive therapy (i.e. disulfiram for alcohol use disorder). Pharmacotherapeutic approaches utilizing an immunological framework for medication development represent an important focus of study for treatment of these illnesses. Areas covered: This review discusses vaccines for treatment of substance use disorders. Using PubMed ( https://www.ncbi.nlm.nih.gov/pubmed/ ), we searched both preclinical and human clinical trials of vaccines for treatment of nicotine, cocaine, methamphetamine, and opioid use disorders. In addition, we searched for recently developed strategies for enhancement of the immunologic response through alteration of conjugate molecules and adjuvants. Expert commentary: Despite challenges in human clinical trials of SUD vaccines, a number of strategies have been introduced which may ultimately improve efficacy. These challenges, as well as their implications for vaccine development, are discussed. Additionally, the optimal conditions for research study and treatment are considered.
Collapse
Affiliation(s)
- R David Heekin
- a Menninger Department of Psychiatry and Behavioral Sciences , Baylor College of Medicine , Houston , TX , USA
| | - Daryl Shorter
- a Menninger Department of Psychiatry and Behavioral Sciences , Baylor College of Medicine , Houston , TX , USA.,b Research Service Line, Michael E. DeBakey VA Medical Center , Houston , TX , USA
| | - Thomas R Kosten
- a Menninger Department of Psychiatry and Behavioral Sciences , Baylor College of Medicine , Houston , TX , USA.,b Research Service Line, Michael E. DeBakey VA Medical Center , Houston , TX , USA
| |
Collapse
|
9
|
Pravetoni M. Biologics to treat substance use disorders: Current status and new directions. Hum Vaccin Immunother 2016; 12:3005-3019. [PMID: 27441896 DOI: 10.1080/21645515.2016.1212785] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Biologics (vaccines, monoclonal antibodies (mAb), and genetically modified enzymes) offer a promising class of therapeutics to treat substance use disorders (SUD) involving abuse of opioids and stimulants such as nicotine, cocaine, and methamphetamine. In contrast to small molecule medications targeting brain receptors, biologics for SUD are larger molecules that do not cross the blood-brain barrier (BBB), but target the drug itself, preventing its distribution to the brain and blunting its effects on the central nervous system (CNS). Active and passive immunization approaches rely on antibodies (Ab) that bind drugs of abuse in serum and block their distribution to the brain, preventing the rewarding effects of drugs and addiction-related behaviors. Alternatives to vaccines and anti-drug mAb are genetically engineered human or bacterial enzymes that metabolize drugs of abuse, lowering the concentration of free active drug. Pre-clinical and clinical data support development of effective biologics for SUD.
Collapse
Affiliation(s)
- Marco Pravetoni
- a Minneapolis Medical Research Foundation, and University of Minnesota Medical School, Departments of Medicine and Pharmacology , Center for Immunology , Minneapolis , MN , USA
| |
Collapse
|
10
|
McCluskie MJ, Evans DM, Zhang N, Benoit M, McElhiney SP, Unnithan M, DeMarco SC, Clay B, Huber C, Deora A, Thorn JM, Stead DR, Merson JR, Davis HL. The effect of preexisting anti-carrier immunity on subsequent responses to CRM197 or Qb-VLP conjugate vaccines. Immunopharmacol Immunotoxicol 2016; 38:184-96. [PMID: 27121368 DOI: 10.3109/08923973.2016.1165246] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
CONTEXT Certain antigens, such as haptens (small molecules), short peptides, and carbohydrates (e.g. bacterial polysaccharides) are non- or poorly immunogenic unless conjugated to a carrier molecule that provides a structural scaffold for antigen presentation as well as T cell help required for B-cell activation and maturation. However, the carriers themselves are immunogenic and resulting carrier-specific immune responses may impact the immunogenicity of other conjugate vaccines using the same carrier that are administered subsequently. OBJECTIVE Herein, using two different carriers (cross-reactive material 197, CRM and Qb-VLP), we examined in mice the impact that preexisting anti-carrier antibodies (Ab) had on subsequent immune responses to conjugates with either the same or a different carrier. METHOD For this purpose, we used two nicotine hapten conjugates (NIC7-CRM or NIC-Qb), two IgE peptide conjugates (Y-CRM or Y-Qb), and a pneumococcal polysaccharide conjugate (Prevnar 13(®)). RESULTS Prior exposure to CRM or Qb-VLP significantly reduced subsequent responses to the conjugated antigen having the homologous carrier, with the exception of Prevnar 13® where anti-polysaccharide responses were similar to those in animals without preexisting anti-carrier Ab. CONCLUSION Collectively, the data suggest that the relative sizes of the antigen and carrier, as well as the conjugation density for a given conjugate impact the extent of anti-carrier suppression. All animals developed anti-carrier responses with repeat vaccination and the differences in Ab titer between groups with and without preexisting anti-carrier responses became less apparent; however, anti-carrier effects were more durable for Ab function.
Collapse
Affiliation(s)
- Michael J McCluskie
- a Pfizer Vaccine Immunotherapeutics , Ottawa Laboratories , Ottawa , ON , Canada
| | - Dana M Evans
- a Pfizer Vaccine Immunotherapeutics , Ottawa Laboratories , Ottawa , ON , Canada
| | - Ningli Zhang
- a Pfizer Vaccine Immunotherapeutics , Ottawa Laboratories , Ottawa , ON , Canada
| | - Michelle Benoit
- a Pfizer Vaccine Immunotherapeutics , Ottawa Laboratories , Ottawa , ON , Canada
| | - Susan P McElhiney
- b Pfizer Vaccine Research and Early Development , Pearl River , NY , USA
| | - Manu Unnithan
- b Pfizer Vaccine Research and Early Development , Pearl River , NY , USA
| | - Suzanne C DeMarco
- c Pfizer Biotherapeutics Pharmaceutical Sciences , St. Louis , MO , USA
| | - Bryan Clay
- d Pfizer Vaccine Immunotherapeutics , La Jolla , CA , USA
| | | | - Aparna Deora
- c Pfizer Biotherapeutics Pharmaceutical Sciences , St. Louis , MO , USA
| | - Jennifer M Thorn
- c Pfizer Biotherapeutics Pharmaceutical Sciences , St. Louis , MO , USA
| | - David R Stead
- d Pfizer Vaccine Immunotherapeutics , La Jolla , CA , USA
| | - James R Merson
- d Pfizer Vaccine Immunotherapeutics , La Jolla , CA , USA
| | - Heather L Davis
- a Pfizer Vaccine Immunotherapeutics , Ottawa Laboratories , Ottawa , ON , Canada
| |
Collapse
|
11
|
Is immunotherapy an opportunity for effective treatment of drug addiction? Vaccine 2015; 33:6545-51. [PMID: 26432911 DOI: 10.1016/j.vaccine.2015.09.079] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 09/22/2015] [Accepted: 09/23/2015] [Indexed: 12/31/2022]
Abstract
Immunotherapy has a great potential of becoming a new therapeutic strategy in the treatment of addiction to psychoactive drugs. It may be used to treat addiction but also to prevent neurotoxic complications of drug overdose. In preclinical studies two immunological methods have been tested; active immunization, which relies on the administration of vaccines and passive immunization, which relies on the administration of monoclonal antibodies. Until now researchers have succeeded in developing vaccines and/or antibodies against addiction to heroin, cocaine, methamphetamine, nicotine and phencyclidine. Their effectiveness has been confirmed in preclinical studies. At present, clinical studies are being conducted for vaccines against nicotine and cocaine and also anti-methamphetamine monoclonal antibody. These preclinical and clinical studies suggest that immunotherapy may be useful in the treatment of addiction and drug overdose. However, there are a few problems to be solved. One of them is controlling the level of antibodies due to variability between subjects. But even obtaining a suitable antibody titer does not guarantee the effectiveness of the vaccine. Additionally, there is a risk of intentional or unintentional overdose. As vaccines prevent passing of drugs through the blood/brain barrier and thereby prevent their positive reinforcement, some addicted patients may erroneously seek higher doses of psychoactive substances to get "high". Consequently, vaccination should be targeted at persons who have a strong motivation to free themselves from drug dependency. It seems that immunotherapy may be an opportunity for effective treatment of drug addiction if directed to adequate candidates for treatment. For other addicts, immunotherapy may be a very important element supporting psycho- and pharmacotherapy.
Collapse
|
12
|
McCluskie MJ, Thorn J, Gervais DP, Stead DR, Zhang N, Benoit M, Cartier J, Kim IJ, Bhattacharya K, Finneman JI, Merson JR, Davis HL. Anti-nicotine vaccines: Comparison of adjuvanted CRM197 and Qb-VLP conjugate formulations for immunogenicity and function in non-human primates. Int Immunopharmacol 2015; 29:663-671. [PMID: 26404190 DOI: 10.1016/j.intimp.2015.09.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/02/2015] [Accepted: 09/14/2015] [Indexed: 12/22/2022]
Abstract
Anti-nicotine vaccines comprise nicotine-like haptens conjugated to a carrier protein plus adjuvant(s). Unfortunately, those tested clinically have failed to improve overall long term quit rates. We had shown in mice that carrier, hapten, linker, hapten load (number of haptens per carrier molecule), aggregation and adducts, as well as adjuvants influence the function of antibodies (Ab) induced. Herein, we tested an optimized antigen, NIC7-CRM, comprised of 5-aminoethoxy-nicotine (NIC7) conjugated to genetically detoxified diphtheria toxin (CRM197), with hapten load of ~16, no aggregation (~100% monomer) and minimal adducts. NIC7-CRM was tested in non-human primates (NHP) and compared to NIC-VLP, which has the same hapten and carrier as the clinical-stage CYT002-NicQb but a slightly different linker and lower hapten load. With alum as sole adjuvant, NIC7-CRM was superior to NIC-VLP for Ab titer, avidity and ex vivo function (83% and 27% nicotine binding at 40ng/mL respectively), but equivalent for in vivo function after intravenous [IV] nicotine challenge (brain levels reduced ~10%). CpG adjuvant added to NIC7-CRM/alum further enhanced the Ab responses and both ex vivo function (100% bound) and in vivo function (~80% reduction in brain). Thus, both optimal antigen design and CpG adjuvant were required to achieve a highly functional vaccine. The compelling NHP data with NIC7-CRM with alum/CpG supported human testing, currently underway.
Collapse
Affiliation(s)
| | - Jennifer Thorn
- Pfizer Biotherapeutics Pharmaceutical Sciences, St. Louis, MO, USA
| | | | - David R Stead
- Pfizer Vaccine Immunotherapeutics, La Jolla, CA, USA
| | - Ningli Zhang
- Pfizer Vaccine Immunotherapeutics, Ottawa Laboratories, Ottawa, ON, Canada
| | - Michelle Benoit
- Pfizer Vaccine Immunotherapeutics, Ottawa Laboratories, Ottawa, ON, Canada
| | - Janna Cartier
- Pfizer Vaccine Immunotherapeutics, Ottawa Laboratories, Ottawa, ON, Canada
| | - In-Jeong Kim
- Pfizer Vaccine Immunotherapeutics, Ottawa Laboratories, Ottawa, ON, Canada
| | | | - Jari I Finneman
- Pfizer Biotherapeutics Pharmaceutical Sciences, St. Louis, MO, USA
| | | | - Heather L Davis
- Pfizer Vaccine Immunotherapeutics, Ottawa Laboratories, Ottawa, ON, Canada
| |
Collapse
|
13
|
Abstract
Drug addiction is a serious problem worldwide. One therapy being investigated is vaccines against drugs of abuse. The antibodies elicited against the drug can take up the drug and prevent it from reaching the reward centers in the brain. Few such vaccines have entered clinical trials, but research is going on apace. Many studies are very promising and more clinical trials should be coming out in the near future.
Collapse
Affiliation(s)
- Berma Kinsey
- Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| |
Collapse
|
14
|
de Villiers SHL, Cornish KE, Troska AJ, Pravetoni M, Pentel PR. Increased efficacy of a trivalent nicotine vaccine compared to a dose-matched monovalent vaccine when formulated with alum. Vaccine 2013; 31:6185-93. [PMID: 24176492 DOI: 10.1016/j.vaccine.2013.10.051] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 09/11/2013] [Accepted: 10/16/2013] [Indexed: 10/26/2022]
Abstract
Vaccination against nicotine is a potential treatment for tobacco smoking. Clinical trials show effect only in high antibody responders; therefore it is necessary to increase the effectiveness of nicotine vaccines. The use of a multivalent vaccine that activates several B cell populations is a possible approach to increase antibody response. The aim of this study was to investigate whether three different nicotine immunogens could be mixed to generate independent responses resulting in additive antibody titers, and whether this would alter nicotine distribution to a greater extent than antibodies generated by a monovalent vaccine. When immunogens were administered s.c. with alum adjuvant, the trivalent vaccine generated significantly higher titers and prevented the distribution of an i.v. nicotine dose to brain to a greater extent than an equivalent dose of a monovalent vaccine. The number of rats with antibody titers >1:10,000 was significantly increased in the trivalent group compared to the monovalent group. There were no correlations between the titers generated by the different nicotine immunogens in the trivalent vaccine, supporting the hypothesis that the immunogens generated independent responses from distinct populations of B cells. In contrast, when administered i.p. in Freund's adjuvant, the trivalent nicotine vaccine was not more immunogenic than its component monovalent vaccine. Vaccine immunogenicity was suppressed if unconjugated protein was added to the monovalent vaccine formulated in Freund's adjuvant, compared to monovalent vaccine alone. These data suggest a protein-protein interaction that affects titers negatively and is apparent when the vaccines are formulated with Freund's adjuvant. In summary, a trivalent nicotine vaccine formulated with alum showed significantly higher efficacy than a dose-matched monovalent vaccine and may offer a strategy for increasing nicotine vaccine immunogenicity. This approach may be generalizable to other nicotine immunogens or vaccines for other addictive drugs.
Collapse
Affiliation(s)
- Sabina H L de Villiers
- Center of Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN 55455, USA; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Minneapolis Medical Research Foundation, Minneapolis, MN 55404, USA.
| | | | | | | | | |
Collapse
|