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Romano IG, Johnson-Weaver B, Core SB, Jamus AN, Brackeen M, Blough B, Dey S, Huang Y, Staats H, Wetsel WC, Chackerian B, Frietze KM. A two-dose regimen of Qβ virus-like particle-based vaccines elicit protective antibodies against heroin and fentanyl. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.08.28.608988. [PMID: 39257808 PMCID: PMC11383672 DOI: 10.1101/2024.08.28.608988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
Opioid overdoses and the growing rate of opioid use disorder (OUD) are major public health concerns, particularly in the United States. Current treatment approaches for OUD have failed to slow the growth of the opioid crisis. Opioid vaccines have shown pre-clinical success in targeting multiple different opioid drugs. However, the need for many immunizations can limit their clinical implementation. In this study, we investigate the development of novel opioid vaccines by independently targeting fentanyl and the active metabolites of heroin using a bacteriophage virus-like particle (VLP) vaccine platform. We establish the successful conjugation of haptens to bacteriophage Qβ VLPs and demonstrate immunogenicity of Qβ-fentanyl, Qβ-morphine, and Qβ-6-acetylmorphine in animal models after one or two immunizations. We show that in independently or in combination, these vaccines elicit high-titer, high-avidity, and durable antibody responses. Moreover, we reveal their protective capacities against heroin or fentanyl challenge after two immunizations. Overall, these findings establish Qβ-VLP conjugated vaccines for heroin and fentanyl as very promising opioid vaccine candidates.
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2
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Luba R, Comer SD. Opioid vaccine clinical testing: lessons learned. Curr Opin Psychiatry 2024; 37:264-269. [PMID: 38726813 DOI: 10.1097/yco.0000000000000945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
PURPOSE OF REVIEW Opioid use disorder (OUD) presents a serious public health concern, with dramatic increases in opioid-overdose mortality in recent years and a small percentage of those with OUD accessing or remaining engaged with available treatments. Efforts are currently underway to identify vaccines targeting opioids, which could provide a novel and complimentary approach. The current review provides an overview of existing literature, practical considerations for designing and conducting clinical trials with vaccines for opioids, and future directions. RECENT FINDINGS This review covers the following themes: clinical trial design and selection of endpoints, timepoint selection, practical considerations and lessons learned from the first (ongoing) trial of a vaccine targeting opioids, and future directions. SUMMARY Efforts to develop and test vaccines targeting OUD are based on a foundation of preclinical work and close collaboration between preclinical and clinical researchers. Efforts to learn from shortcomings of prior clinical trials of vaccines for other substances are essential in designing and testing effective vaccines for OUD. Design and implementation of clinical trials for a vaccine for OUD requires careful balance of participant safety and strategies for retention and efforts to gather viable data to inform future work.
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Affiliation(s)
- Rachel Luba
- Department of Psychiatry, Columbia University Irving Medical Center
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA
| | - Sandra D Comer
- Department of Psychiatry, Columbia University Irving Medical Center
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA
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Romano IG, Core SB, Lee NR, Mowry C, Van Rompay KKA, Huang Y, Chackerian B, Frietze KM. A bacteriophage virus-like particle vaccine against oxycodone elicits high-titer and long-lasting antibodies that sequester drug in the blood. Vaccine 2024; 42:471-480. [PMID: 38160131 PMCID: PMC10872394 DOI: 10.1016/j.vaccine.2023.12.077] [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: 10/25/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024]
Abstract
Opioid use disorder (OUD) and opioid overdoses are public health emergencies. In 2021, 80,000 opioid overdose associated deaths were reported in the United States. Despite the availability of treatment strategies, including medications for opioid use disorder (MOUD) and naloxone, opioid overdoses continue to increase at an alarming rate. Opioid vaccines are a novel approach to combat the growing crisis with several candidates recently entering human clinical trials. In this study, we investigated Qβ bacteriophage virus-like particles (VLPs) as a vaccine platform for immunogenic display of oxycodone. A derivative of oxycodone was conjugated to pre-formed Qβ VLPs using a sulfhydryl-amine reactive heterobifunctional crosslinker with high loading of oxycodone. In mice, intramuscular immunization with Qβ-oxycodone elicited high-titer, high-avidity and long-lasting antibody responses. Qβ-oxycodone was also immunogenic after storage at ambient room temperature for over two weeks, demonstrating that the vaccine is highly thermostable. In mice, immunization with Qβ-oxycodone elicited antibodies that sequester oxycodone in the serum, an important mechanism for preventing the adverse effects of opioid activity. Finally, Qβ-oxycodone is immunogenic in nonhuman primates, eliciting serum oxycodone antibodies after intramuscular immunization of rhesus macaques. These data establish Qβ-oxycodone as a promising opioid vaccine candidate.
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Affiliation(s)
- Isabella G Romano
- Department of Molecular Genetics and Microbiology, School of Medicine, University of New Mexico, MSC 08-4660, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Susan B Core
- Department of Molecular Genetics and Microbiology, School of Medicine, University of New Mexico, MSC 08-4660, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Naomi R Lee
- Department of Chemistry and Biochemistry, Northern Arizona University, 700 S. Osborne Drive, P.O. Box 5698, Flagstaff, AZ 86011, USA
| | - Curtis Mowry
- Department of Chemistry and Chemical Biology, University of New Mexico, MSC 03-2060, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Koen K A Van Rompay
- California National Primate Research Center, University of California - Davis, One Shields Avenue, Davis, CA 95616, USA
| | - Yumei Huang
- CellMosaic, Inc, 10A Roessler Road, Woburn, MA 01801, USA
| | - Bryce Chackerian
- Department of Molecular Genetics and Microbiology, School of Medicine, University of New Mexico, MSC 08-4660, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Kathryn M Frietze
- Department of Molecular Genetics and Microbiology, School of Medicine, University of New Mexico, MSC 08-4660, 1 University of New Mexico, Albuquerque, NM 87131, USA.
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Lu T, Li X, Zheng W, Kuang C, Wu B, Liu X, Xue Y, Shi J, Lu L, Han Y. Vaccines to Treat Substance Use Disorders: Current Status and Future Directions. Pharmaceutics 2024; 16:84. [PMID: 38258095 PMCID: PMC10820210 DOI: 10.3390/pharmaceutics16010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
Addiction, particularly in relation to psychostimulants and opioids, persists as a global health crisis with profound social and economic ramifications. Traditional interventions, including medications and behavioral therapies, often encounter limited success due to the chronic and relapsing nature of addictive disorders. Consequently, there is significant interest in the development of innovative therapeutics to counteract the effects of abused substances. In recent years, vaccines have emerged as a novel and promising strategy to tackle addiction. Anti-drug vaccines are designed to stimulate the immune system to produce antibodies that bind to addictive compounds, such as nicotine, cocaine, morphine, methamphetamine, and heroin. These antibodies effectively neutralize the target molecules, preventing them from reaching the brain and eliciting their rewarding effects. By obstructing the rewarding sensations associated with substance use, vaccines aim to reduce cravings and the motivation to engage in drug use. Although anti-drug vaccines hold significant potential, challenges remain in their development and implementation. The reversibility of vaccination and the potential for combining vaccines with other addiction treatments offer promise for improving addiction outcomes. This review provides an overview of anti-drug vaccines, their mechanisms of action, and their potential impact on treatment for substance use disorders. Furthermore, this review summarizes recent advancements in vaccine development for each specific drug, offering insights for the development of more effective and personalized treatments capable of addressing the distinct challenges posed by various abused substances.
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Affiliation(s)
- Tangsheng Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; (T.L.); (X.L.); (Y.X.); (J.S.)
- School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Xue Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; (T.L.); (X.L.); (Y.X.); (J.S.)
- School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Wei Zheng
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China;
| | - Chenyan Kuang
- College of Forensic Medicine, Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, Hebei Medical University, Shijiazhuang 050017, China;
| | - Bingyi Wu
- Henan Key Laboratory of Neurorestoratology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China;
| | - Xiaoxing Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China;
| | - Yanxue Xue
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; (T.L.); (X.L.); (Y.X.); (J.S.)
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; (T.L.); (X.L.); (Y.X.); (J.S.)
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; (T.L.); (X.L.); (Y.X.); (J.S.)
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China;
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China;
| | - Ying Han
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; (T.L.); (X.L.); (Y.X.); (J.S.)
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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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6
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Bogen IL, Boix F, Andersen JM, Steinsland S, Nerem E, Mørland J. Heroin metabolism in human blood and its impact for the design of an immunotherapeutic approach against heroin effects. Basic Clin Pharmacol Toxicol 2023; 133:418-427. [PMID: 37452619 DOI: 10.1111/bcpt.13926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Immunotherapeutic interventions that block drug effects by binding drug molecules to specific antibodies in the bloodstream have shown promising effects in animal studies. For heroin, which effects are mainly mediated by the metabolites 6-acetylmorphine (6-AM; also known as 6-monoacetylmorphine or 6-MAM) and morphine, the optimal antibody specificity has been discussed. In rodents, 6-AM specific antibodies have been recommended based on the rapid metabolism of heroin to 6-AM in the bloodstream. Since the metabolic rate of heroin in blood is unsettled in humans, we examined heroin metabolism with state-of-the-art analytical methodology (UHPLC-MS/MS) in freshly drawn human whole blood incubated with a wide range of heroin concentrations (1-500 μM). The half-life of heroin was highly concentration dependent, ranging from 1.2-1.7 min for concentrations at or above 25 μM, and gradually increasing to approximately 20 min for 1 μM heroin. At concentrations that can be attained in the bloodstream shortly after an i.v. injection, approximately 70% was transformed into 6-AM within 3 min, similar to previous observations in vivo. Our results indicate that blood enzymes play a more important role for the rapid metabolism of heroin in humans than previously assumed. This points to 6-AM as an important target for an efficient immunotherapeutic approach to block heroin effects in humans.
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Affiliation(s)
- Inger Lise Bogen
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Fernando Boix
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Jannike Mørch Andersen
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
- Section for Pharmacology and Pharmaceutical Biosciences, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Synne Steinsland
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Elisabeth Nerem
- Section for Drug Abuse Research, Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
| | - Jørg Mørland
- Division of Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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F Martins ML, Loos NHC, El Yattouti M, Offeringa L, Heydari P, Hillebrand MJX, Lebre MC, Beijnen JH, Schinkel AH. P-glycoprotein (MDR1/ABCB1) Restricts Brain Penetration of the Main Active Heroin Metabolites 6-monoacetylmorphine (6-MAM) and Morphine in Mice. Pharm Res 2023; 40:1885-1899. [PMID: 37344602 DOI: 10.1007/s11095-023-03545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND & PURPOSE Heroin (diacetylmorphine; diamorphine) is a highly addictive opioid prodrug. Heroin prescription is possible in some countries for chronic, treatment-refractory opioid-dependent patients and as a potent analgesic for specific indications. We aimed to study the pharmacokinetic interactions of heroin and its main pharmacodynamically active metabolites, 6-monoacetylmorphine (6-MAM) and morphine, with the multidrug efflux transporters P-glycoprotein/ABCB1 and BCRP/ABCG2 using wild-type, Abcb1a/1b and Abcb1a/1b;Abcg2 knockout mice. METHODS & RESULTS Upon subcutaneous (s.c.) heroin administration, its blood levels decreased quickly, making it challenging to detect heroin even shortly after dosing. 6-MAM was the predominant active metabolite present in blood and most tissues. At 10 and 30 min after heroin administration, 6-MAM and morphine brain accumulation were increased about 2-fold when mouse (m)Abcb1a/1b and mAbcg2 were ablated. Fifteen minutes after direct s.c. administration of an equimolar dose of 6-MAM, we observed good intrinsic brain penetration of 6-MAM in wild-type mice. Still, mAbcb1 limited brain accumulation of 6-MAM and morphine without affecting their blood exposure, and possibly mediated their direct intestinal excretion. A minor contribution of mAbcg2 to these effects could not be excluded. CONCLUSIONS We show that mAbcb1a/1b can limit 6-MAM and morphine brain exposure. Pharmacodynamic behavioral/postural observations, while non-quantitative, supported moderately increased brain levels of 6-MAM and morphine in the knockout mouse strains. Variation in ABCB1 activity due to genetic polymorphisms or environmental factors (e.g., drug interactions) might affect 6-MAM/morphine exposure in individuals, but only to a limited extent.
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Affiliation(s)
- Margarida L F Martins
- Division of Pharmacology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands
| | - Nancy H C Loos
- Division of Pharmacology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands
| | - Malika El Yattouti
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Lianda Offeringa
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Paniz Heydari
- Division of Pharmacology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Michel J X Hillebrand
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Maria C Lebre
- Division of Pharmacology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands
| | - Jos H Beijnen
- Division of Pharmacology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Pharmaceutical Sciences, Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Faculty of Science, Utrecht, The Netherlands
| | - Alfred H Schinkel
- Division of Pharmacology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands.
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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: 8] [Impact Index Per Article: 8.0] [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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9
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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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10
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da Silva Neto L, da Silva Maia AF, Godin AM, de Almeida Augusto PS, Pereira RLG, Caligiorne SM, Alves RB, Fernandes SOA, Cardoso VN, Goulart GAC, Martins FT, das Neves MDCL, Garcia FD, de Fátima Â. Calix[ n]arene-based immunogens: A new non-proteic strategy for anti-cocaine vaccine. J Adv Res 2022; 38:285-298. [PMID: 35572397 PMCID: PMC9091763 DOI: 10.1016/j.jare.2021.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/13/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Cocaine use disorder is a significant public health issue without a current specific approved treatment. Among different approaches to this disorder, it is possible to highlight a promising immunologic strategy in which an immunogenic agent may reduce the reinforcing effects of the drug if they are able to yield sufficient specific antibodies capable to bind cocaine and/or its psychoactive metabolites before entering into the brain. Several carriers have been investigated in the anti-cocaine vaccine development; however, they generally present a very complex chemical structure, which potentially hampers the proper assessment of the coupling efficiency between the hapten units and the protein structure. Objectives The present study reports the design, synthesis and preclinical evaluation of two novel calix[n]arene-based anti-cocaine immunogens (herein named as V4N2 and V8N2) by the tethering of the hydrolysis-tolerant hapten GNE (15) on calix[4]arene and calix[8]arene moieties. Methods The preclinical assessment corresponded to the immunogenicity and dose-response evaluation of V4N2 and V8N2. The potential of the produced antibodies to reduce the passage of cocaine analogue through the blood-brain-barrier (BBB), modifying its biodistribution was also investigated. Results Both calix[n]arene-based immunogens elicited high titers of cocaine antibodies that modified the biodistribution of a cocaine radiolabeled analogue (99mTc-TRODAT-1) and decreased cocaine-induced behavior, according to an animal model. Conclusion The present results demonstrate the potential of V4N2 and V8N2 as immunogens for the treatment of cocaine use disorder.
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Affiliation(s)
- Leonardo da Silva Neto
- Department of Chemistry, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Angélica Faleiros da Silva Maia
- Department of Chemistry, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Adriana Martins Godin
- Department of Chemistry, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | | | | | - Sordaini Maria Caligiorne
- Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil
| | - Rosemeire Brondi Alves
- Department of Chemistry, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Simone Odília Antunes Fernandes
- Department of Clinical & Toxicological Analysis, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Valbert Nascimento Cardoso
- Department of Clinical & Toxicological Analysis, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Gisele Assis Castro Goulart
- Department of Pharmaceutics, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Felipe Terra Martins
- Institute of Chemistry, Universidade Federal de Goiás, Goiânia 74690-900, MG, Brazil
| | | | - Frederico Duarte Garcia
- Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil
| | - Ângelo de Fátima
- Department of Chemistry, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
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11
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Wicks C, Hudlicky T, Rinner U. Morphine alkaloids: History, biology, and synthesis. THE ALKALOIDS. CHEMISTRY AND BIOLOGY 2021; 86:145-342. [PMID: 34565506 DOI: 10.1016/bs.alkal.2021.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This chapter provides a short overview of the history of morphine since it's isolation by Sertürner in 1805. The biosynthesis of the title alkaloid as well as all total and formal syntheses of morphine and codeine published after 1996 are discussed in detail. The last section of this chapter provides a detailed overview of medicinally relevant derivatives of the title alkaloid.
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Affiliation(s)
- Christopher Wicks
- Department of Chemistry and Centre for Biotechnology, Brock University, St. Catharines, ON, Canada
| | - Tomas Hudlicky
- Department of Chemistry and Centre for Biotechnology, Brock University, St. Catharines, ON, Canada
| | - Uwe Rinner
- IMC Fachhochschule Krems/IMC University of Applied Sciences Krems, Krems, Austria.
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12
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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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13
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Park H, Lee JC, Eubanks LM, Ellis B, Zhou B, Janda KD. Improvements on a chemically contiguous hapten for a vaccine to address fentanyl-contaminated heroin. Bioorg Med Chem 2021; 41:116225. [PMID: 34034147 DOI: 10.1016/j.bmc.2021.116225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 01/22/2023]
Abstract
Unintentional overdose deaths related to opioids and psychostimulants have increased in prevalence due to the adulteration of these drugs with fentanyl. Synergistic effects between illicit compounds and fentanyl cause aggravated respiratory depression, leading to inadvertent fatalities. Traditional small-molecule therapies implemented in the expanding opioid epidemic present numerous problems since they interact with the same opioid receptors in the brain as the abused drugs. In this study, we report an optimized dual hapten for use as an immunopharmacotherapeutic tool in order to develop antibodies capable of binding to fentanyl-contaminated heroin in the periphery, thus impeding the drugs' psychoactive effects on the central nervous system. This vaccine produced antibodies with nanomolar affinities and effectively blocked opioid analgesic effects elicited by adulterated heroin. These findings provide further insight into the development of chemically contiguous haptens for broad-spectrum immunopharmacotherapies against opioid use disorders.
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Affiliation(s)
- Hyeri Park
- Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States
| | - Jinny Claire Lee
- Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States
| | - Lisa M Eubanks
- Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States
| | - Beverly Ellis
- Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States
| | - Bin Zhou
- Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States
| | - Kim D Janda
- Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States.
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14
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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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15
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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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16
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Méndez SB, Matus-Ortega M, Miramontes RH, Salazar-Juárez A. Effect of the morphine/heroin vaccine on opioid and non-opioid drug-induced antinociception in mice. Eur J Pharmacol 2021; 891:173718. [PMID: 33171151 DOI: 10.1016/j.ejphar.2020.173718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 01/08/2023]
Abstract
Pain is a common symptom in patients with opioid use disorder (OUD), which increases synthetic and illicit synthetic opioid abuse and even fatalities due to opioid overdose. Many FDA-approved drugs are available for the treatment of OUD, however, the use of these medications is limited, mainly due to the development of various side effects. Active vaccination is a new therapeutic approach but the resulting antibodies may compromise the use and efficiency of opioid and non-opioid drugs. In this study, we evaluated whether the antibodies produced by the morphine/heroin vaccine (M-TT) would alter the antinociceptive effects of opioid and non-opioid drugs. Female Balb-c mice were immunized with the M-TT vaccine. A solid-phase antibody-capture ELISA was used for monitoring antibody titer responses after each booster dose in vaccinated animals, followed by tail-flick testing. This study found that the M-TT vaccine did not affect the antinociception induced by different doses of morphine or the ability of non-opioid and synthetic opioid drugs to decrease thermal pain. Moreover, the combination of vaccination and naloxone increased the time-course of morphine antagonism relative to either vaccination or naloxone alone. These results suggest that the antibody titers generated by the M-TT vaccine 1) are capable of reducing morphine-induced antinociception and 2) are selective enough not to alter antinociception induced by non-opioid or synthetic drugs. These characteristics support its potential as a treatment agent for patients with symptoms of pain comorbid to OUD.
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17
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Robinson C, Gradinati V, Hamid F, Baehr C, Crouse B, Averick S, Kovaliov M, Harris D, Runyon S, Baruffaldi F, LeSage M, Comer S, Pravetoni M. Therapeutic and Prophylactic Vaccines to Counteract Fentanyl Use Disorders and Toxicity. J Med Chem 2020; 63:14647-14667. [PMID: 33215913 DOI: 10.1021/acs.jmedchem.0c01042] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The incidence of fatal overdoses has increased worldwide due to the widespread access to illicit fentanyl and its potent analogues. Vaccines offer a promising strategy to reduce the prevalence of opioid use disorders (OUDs) and to prevent toxicity from accidental and deliberate exposure to fentanyl and its derivatives. This study describes the development and characterization of vaccine formulations consisting of novel fentanyl-based haptens conjugated to carrier proteins. Vaccine efficacy was tested against opioid-induced behavior and toxicity in mice and rats challenged with fentanyl and its analogues. Prophylactic vaccination reduced fentanyl- and sufentanil-induced antinociception, respiratory depression, and bradycardia in mice and rats. Therapeutic vaccination also reduced fentanyl intravenous self-administration in rats. Because of their selectivity, vaccines did not interfere with the pharmacological effects of commonly used anesthetics nor with methadone, naloxone, oxycodone, or heroin. These preclinical data support the translation of vaccines as a viable strategy to counteract fentanyl use disorders and toxicity.
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Affiliation(s)
- Christine Robinson
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States
| | - Valeria Gradinati
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States
| | - Fatima Hamid
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States
| | - Carly Baehr
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States.,Department of Veterinary Population Medicine, University of Minnesota Veterinary School, Minneapolis, Minnesota 55455, United States
| | - Bethany Crouse
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States.,Department of Veterinary Population Medicine, University of Minnesota Veterinary School, Minneapolis, Minnesota 55455, United States
| | - Saadyah Averick
- Allegheny Health Network, Neuroscience Research Institute, Pittsburgh, Pennsylvania 15212, United States
| | - Marina Kovaliov
- Allegheny Health Network, Neuroscience Research Institute, Pittsburgh, Pennsylvania 15212, United States
| | - Danni Harris
- RTI International, Raleigh, North Carolina 27616, United States
| | - Scott Runyon
- RTI International, Raleigh, North Carolina 27616, United States
| | - Federico Baruffaldi
- Department of Medicine, Hennepin Healthcare Research Institute, Minneapolis, Minnesota 55415, United States
| | - Mark LeSage
- Department of Medicine, Hennepin Healthcare Research Institute, Minneapolis, Minnesota 55415, United States
| | - Sandra Comer
- Department of Psychiatry, Columbia University Irving Medical Center, and the New York State Psychiatric Institute, New York, New York 10027-6902, United States
| | - Marco Pravetoni
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States.,Center for Immunology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States
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18
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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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19
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Townsend EA, Banks ML. Preclinical Evaluation of Vaccines to Treat Opioid Use Disorders: How Close are We to a Clinically Viable Therapeutic? CNS Drugs 2020; 34:449-461. [PMID: 32248427 PMCID: PMC7223115 DOI: 10.1007/s40263-020-00722-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The ongoing opioid crisis, now into its second decade, represents a global public health challenge. Moreover, the opioid crisis has manifested despite clinical access to three approved opioid use disorder medications: the full opioid agonist methadone, the partial opioid agonist buprenorphine, and the opioid antagonist naltrexone. Although current opioid use disorder medications are underutilized, the ongoing opioid crisis has also identified the need for basic research to develop both safer and more effective opioid use disorder medications. Emerging preclinical evidence suggests that opioid-targeted vaccines or immunopharmacotherapies may be promising opioid use disorder therapeutics. One premise for this article is to critically examine whether vaccine effectiveness evaluated using preclinical antinociceptive endpoints is predictive of vaccine effectiveness on abuse-related endpoints such as drug self-administration, drug discrimination, and conditioned place preference. A second premise is to apply decades of knowledge in the preclinical evaluation of candidate small-molecule therapeutics for opioid use disorder to the preclinical evaluation of candidate opioid use disorder immunopharmacotherapies. We conclude with preclinical experimental design attributes to enhance preclinical-to-clinical translatability and potential future directions for immunopharmacotherapies to address the dynamic illicit opioid environment.
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Affiliation(s)
- E Andrew Townsend
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 410 North 12th St, Box 980613, Richmond, VA, 23298, USA
| | - Matthew L Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 410 North 12th St, Box 980613, Richmond, VA, 23298, USA.
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20
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Kvello AMS, Andersen JM, Boix F, Mørland J, Bogen IL. The role of 6-acetylmorphine in heroin-induced reward and locomotor sensitization in mice. Addict Biol 2020; 25:e12727. [PMID: 30788879 DOI: 10.1111/adb.12727] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 01/11/2023]
Abstract
We have previously demonstrated that heroin's first metabolite, 6-acetylmorphine (6-AM), is an important mediator of heroin's acute effects. However, the significance of 6-AM to the rewarding properties of heroin still remains unknown. The present study therefore aimed to examine the contribution of 6-AM to heroin-induced reward and locomotor sensitization. Mice were tested for conditioned place preference (CPP) induced by equimolar doses of heroin or 6-AM (1.25-5 μmol/kg). Psychomotor activity was recorded during the CPP conditioning sessions for assessment of drug-induced locomotor sensitization. The contribution of 6-AM to heroin reward and locomotor sensitization was further examined by pretreating mice with a 6-AM specific antibody (anti-6-AM mAb) 24 hours prior to the CPP procedure. Both heroin and 6-AM induced CPP in mice, but heroin generated twice as high CPP scores compared with 6-AM. Locomotor sensitization was expressed after repeated exposure to 2.5 and 5 μmol/kg heroin or 6-AM, but not after 1.25 μmol/kg, and we found no correlation between the expression of CPP and the magnitude of locomotor sensitization for either opioid. Pretreatment with anti-6-AM mAb suppressed both heroin-induced and 6-AM-induced CPP and locomotor sensitization. These findings provide evidence that 6-AM is essential for the rewarding and sensitizing properties of heroin; however, heroin caused stronger reward compared with 6-AM. This may be explained by the higher lipophilicity of heroin, providing more efficient drug transfer to the brain, ensuring rapid increase in the brain 6-AM concentration.
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Affiliation(s)
- Anne Marte Sjursen Kvello
- Section for Drug Abuse Research, Department of Forensic SciencesOslo University Hospital Oslo Norway
- School of Pharmacy, Faculty of Mathematics and Natural SciencesUniversity of Oslo Oslo Norway
| | - Jannike Mørch Andersen
- Section for Drug Abuse Research, Department of Forensic SciencesOslo University Hospital Oslo Norway
- School of Pharmacy, Faculty of Mathematics and Natural SciencesUniversity of Oslo Oslo Norway
| | - Fernando Boix
- Section for Drug Abuse Research, Department of Forensic SciencesOslo University Hospital Oslo Norway
| | - Jørg Mørland
- Division of Health Data and DigitalisationNorwegian Institute of Public Health Oslo Norway
| | - Inger Lise Bogen
- Section for Drug Abuse Research, Department of Forensic SciencesOslo University Hospital Oslo Norway
- Institute of Basic Medical Sciences, Faculty of MedicineUniversity of Oslo Oslo Norway
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21
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Townsend EA, Blake S, Faunce KE, Hwang CS, Natori Y, Zhou B, Bremer PT, Janda KD, Banks ML. Conjugate vaccine produces long-lasting attenuation of fentanyl vs. food choice and blocks expression of opioid withdrawal-induced increases in fentanyl choice in rats. Neuropsychopharmacology 2019; 44:1681-1689. [PMID: 31043682 PMCID: PMC6784909 DOI: 10.1038/s41386-019-0385-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/19/2019] [Accepted: 04/01/2019] [Indexed: 12/31/2022]
Abstract
The current opioid crisis remains a significant public health issue and there is a critical need for biomedical research to develop effective and easily deployable candidate treatments. One emerging treatment strategy for opioid use disorder includes immunopharmacotherapies or opioid-targeted vaccines. The present study determined the effectiveness of a fentanyl-tetanus toxoid conjugate vaccine to alter fentanyl self-administration using a fentanyl-vs.-food choice procedure in male and female rats under three experimental conditions. For comparison, continuous 7-day naltrexone (0.01-0.1 mg/kg/h) and 7-day clonidine (3.2-10 μg/kg/h) treatment effects were also determined on fentanyl-vs.-food choice. Male and female rats responded for concurrently available 18% diluted Ensure® (liquid food) and fentanyl (0-10 μg/kg/infusion) infusions during daily sessions. Under baseline and saline treatment conditions, fentanyl maintained a dose-dependent increase in fentanyl-vs.-food choice. First, fentanyl vaccine administration significantly blunted fentanyl reinforcement and increased food reinforcement for 15 weeks in non-opioid dependent rats. Second, surmountability experiments by increasing the unit fentanyl dose available during the self-administration session 10-fold empirically determined that the fentanyl vaccine produced an approximate 22-fold potency shift in fentanyl-vs.-food choice that was as effective as the clinically approved treatment naltrexone. Clonidine treatment significantly increased fentanyl-vs.-food choice. Lastly, fentanyl vaccine administration prevented the expression of withdrawal-associated increases in fentanyl-vs.-food choice following introduction of extended 12 h fentanyl access sessions. Overall, these results support the potential and further consideration of immunopharmacotherapies as candidate treatments to address the current opioid crisis.
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Affiliation(s)
- E Andrew Townsend
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Steven Blake
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Kaycee E Faunce
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA
| | - Candy S Hwang
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
- Department of Chemistry, Southern Connecticut State University, 501 Crescent St, New Haven, CT, 06515, USA
| | - Yoshihiro Natori
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
- Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Komatsushima 4-4-1, Aoba-ku, Sendai, 981-8558, Japan
| | - Bin Zhou
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Paul T Bremer
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Kim D Janda
- Departments of Chemistry and Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA, 92037, USA.
| | - Matthew L Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA.
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22
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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: 58] [Impact Index Per Article: 11.6] [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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23
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Raleigh MD, Baruffaldi F, Peterson SJ, Le Naour M, Harmon TM, Vigliaturo JR, Pentel PR, Pravetoni M. A Fentanyl Vaccine Alters Fentanyl Distribution and Protects against Fentanyl-Induced Effects in Mice and Rats. J Pharmacol Exp Ther 2019; 368:282-291. [PMID: 30409833 PMCID: PMC6346379 DOI: 10.1124/jpet.118.253674] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/07/2018] [Indexed: 11/22/2022] Open
Abstract
Fentanyl is an extremely potent synthetic opioid that has been increasingly used to adulterate heroin, cocaine, and counterfeit prescription pills, leading to an increase in opioid-induced fatal overdoses in the United States, Canada, and Europe. A vaccine targeting fentanyl could offer protection against the toxic effects of fentanyl in both recreational drug users and others in professions at risk of accidental exposure. This study focuses on the development of a vaccine consisting of a fentanyl-based hapten (F) conjugated to keyhole limpet hemocyanin (KLH) carrier protein or to GMP-grade subunit KLH (sKLH). Immunization with F-KLH in mice and rats reduced fentanyl-induced hotplate antinociception, and in rats reduced fentanyl distribution to the brain compared with controls. F-KLH did not reduce the antinociceptive effects of equianalgesic doses of heroin or oxycodone in rats. To assess the vaccine effect on fentanyl toxicity, rats immunized with F-sKLH or unconjugated sKLH were exposed to increasing subcutaneous doses of fentanyl. Vaccination with F-sKLH shifted the dose-response curves to the right for both fentanyl-induced antinociception and respiratory depression. Naloxone reversed fentanyl effects in both groups, showing that its ability to reverse respiratory depression was preserved. These data demonstrate preclinical selectivity and efficacy of a fentanyl vaccine and suggest that vaccines may offer a therapeutic option in reducing fentanyl-induced side effects.
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Affiliation(s)
- Michael D Raleigh
- Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation), Minneapolis, Minnesota (M.D.R., F.B., S.J.P., T.M.H., J.R.V., P.R.P., M.P.); Department of Medicinal Chemistry, University of Minnesota College of Pharmacy Minneapolis, Minnesota (M.L.N.); MLN BioPharma Consulting LLC (M.L.N.) Minneapolis, Minnesota; and Departments of Pharmacology (M.P.) and Medicine (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota Medical School, Minneapolis, Minnesota
| | - Federico Baruffaldi
- Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation), Minneapolis, Minnesota (M.D.R., F.B., S.J.P., T.M.H., J.R.V., P.R.P., M.P.); Department of Medicinal Chemistry, University of Minnesota College of Pharmacy Minneapolis, Minnesota (M.L.N.); MLN BioPharma Consulting LLC (M.L.N.) Minneapolis, Minnesota; and Departments of Pharmacology (M.P.) and Medicine (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota Medical School, Minneapolis, Minnesota
| | - Samantha J Peterson
- Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation), Minneapolis, Minnesota (M.D.R., F.B., S.J.P., T.M.H., J.R.V., P.R.P., M.P.); Department of Medicinal Chemistry, University of Minnesota College of Pharmacy Minneapolis, Minnesota (M.L.N.); MLN BioPharma Consulting LLC (M.L.N.) Minneapolis, Minnesota; and Departments of Pharmacology (M.P.) and Medicine (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota Medical School, Minneapolis, Minnesota
| | - Morgan Le Naour
- Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation), Minneapolis, Minnesota (M.D.R., F.B., S.J.P., T.M.H., J.R.V., P.R.P., M.P.); Department of Medicinal Chemistry, University of Minnesota College of Pharmacy Minneapolis, Minnesota (M.L.N.); MLN BioPharma Consulting LLC (M.L.N.) Minneapolis, Minnesota; and Departments of Pharmacology (M.P.) and Medicine (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota Medical School, Minneapolis, Minnesota
| | - Theresa M Harmon
- Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation), Minneapolis, Minnesota (M.D.R., F.B., S.J.P., T.M.H., J.R.V., P.R.P., M.P.); Department of Medicinal Chemistry, University of Minnesota College of Pharmacy Minneapolis, Minnesota (M.L.N.); MLN BioPharma Consulting LLC (M.L.N.) Minneapolis, Minnesota; and Departments of Pharmacology (M.P.) and Medicine (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota Medical School, Minneapolis, Minnesota
| | - Jennifer R Vigliaturo
- Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation), Minneapolis, Minnesota (M.D.R., F.B., S.J.P., T.M.H., J.R.V., P.R.P., M.P.); Department of Medicinal Chemistry, University of Minnesota College of Pharmacy Minneapolis, Minnesota (M.L.N.); MLN BioPharma Consulting LLC (M.L.N.) Minneapolis, Minnesota; and Departments of Pharmacology (M.P.) and Medicine (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota Medical School, Minneapolis, Minnesota
| | - Paul R Pentel
- Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation), Minneapolis, Minnesota (M.D.R., F.B., S.J.P., T.M.H., J.R.V., P.R.P., M.P.); Department of Medicinal Chemistry, University of Minnesota College of Pharmacy Minneapolis, Minnesota (M.L.N.); MLN BioPharma Consulting LLC (M.L.N.) Minneapolis, Minnesota; and Departments of Pharmacology (M.P.) and Medicine (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota Medical School, Minneapolis, Minnesota
| | - Marco Pravetoni
- Hennepin Healthcare Research Institute (formerly Minneapolis Medical Research Foundation), Minneapolis, Minnesota (M.D.R., F.B., S.J.P., T.M.H., J.R.V., P.R.P., M.P.); Department of Medicinal Chemistry, University of Minnesota College of Pharmacy Minneapolis, Minnesota (M.L.N.); MLN BioPharma Consulting LLC (M.L.N.) Minneapolis, Minnesota; and Departments of Pharmacology (M.P.) and Medicine (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota Medical School, Minneapolis, Minnesota
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24
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The active heroin metabolite 6-acetylmorphine has robust reinforcing effects as assessed by self-administration in the rat. Neuropharmacology 2018; 150:192-199. [PMID: 30578794 DOI: 10.1016/j.neuropharm.2018.12.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 12/14/2022]
Abstract
Previous studies have suggested that at least some of the behavioral effects of heroin might be mediated by its active metabolite 6-acetylmorphine (6-AM). The aim of the present study was to investigate the reinforcing effects of 6-AM and its role in mediating those of heroin. We used an intravenous self-administration procedure in male Sprague-Dawley rats including four phases: acquisition, extinction, reinstatement of drug-seeking, and re-acquisition. Independent groups of rats readily learned to self-administer equimolar doses (0.135 μmol/kg) of either 6-AM (44.3 μg/kg) or heroin (50 μg/kg). Under a fixed ratio 1 (FR1) schedule of reinforcement, the rate of responding was the same for 6-AM and heroin, but it was significantly higher for 6-AM than for heroin under a FR2 schedule. A non-contingent infusion ('priming') of 0.068 μmol/kg of either 6-AM or heroin reinstated non-reinforced drug-seeking (relapse). The rats readily re-acquired self-administration behaviour when given access to one of two doses (0.068 and 0.135 μmol/kg) of 6-AM or heroin. Pretreatment with a specific monoclonal antibody (mAb) against 6-AM blocked the priming effect of 6-AM, and modified the rate of lever-pressing on re-acquisition of 6-AM self-administration in a manner compatible with a shift to the right of the dose-effect curve. The mAb did not affect heroin responding. The present results show that 6-AM possesses reinforcing effects similar to those of heroin. The lack of effect of 6-AM mAb on heroin priming and heroin self-administration calls for further studies to clarify the role of heroin and its metabolites in heroin reward. This article is part of the Special Issue entitled 'Opioid Neuropharmacology: Advances in treating pain and opioid addiction'.
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25
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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]
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26
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Banks ML, Olson ME, Janda KD. Immunopharmacotherapies for Treating Opioid Use Disorder. Trends Pharmacol Sci 2018; 39:908-911. [PMID: 30343725 PMCID: PMC6472257 DOI: 10.1016/j.tips.2018.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/03/2018] [Accepted: 08/07/2018] [Indexed: 11/19/2022]
Abstract
The current opioid crisis has reinvigorated interest in the development of therapeutics for opioid use disorder (OUD), and the choice of preclinical translational endpoints is an essential consideration. Antiopioid immunopharmacotherapies (e.g., conjugate vaccines) that sequester drug peripherally, preventing opioids from reaching targeted receptors in the brain, have recently emerged as promising therapeutics.
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Affiliation(s)
- Matthew L Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Margaret E Olson
- Department of Chemistry, Department of Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Kim D Janda
- Department of Chemistry, Department of Immunology and Microbial Science, Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine, The Scripps Research Institute, La Jolla, CA 92037, USA.
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27
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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: 35] [Impact Index Per Article: 5.8] [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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28
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Hwang CS, Smith LC, Natori Y, Ellis B, Zhou B, Janda KD. Efficacious Vaccine against Heroin Contaminated with Fentanyl. ACS Chem Neurosci 2018; 9:1269-1275. [PMID: 29558798 DOI: 10.1021/acschemneuro.8b00079] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The sharp increase in overdose deaths involving illicit opioid use has been declared a national crisis in the United States. This growing number of overdose deaths can in part be attributed to the increased frequency of fentanyl contamination in the United States heroin supply. To combat this growing trend, we designed a vaccine containing a mixture of heroin and fentanyl hapten-conjugates as a proof-of-concept immunotherapy targeting a combination of these drugs. Rodents immunized with the admixture vaccine showed drug retention in serum and reduced distribution in the brain after administration of an intravenous bolus of heroin coadministered with fentanyl (10% w/w). Moreover, the admixture vaccine performed as well as or better than individual immunoconjugate vaccines in antinociception behavioral models and recognized six other fentanyl analogues with nanomolar affinity. Taken together, these data highlight the potential of an admixture vaccine against heroin contaminated with fentanyl.
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Affiliation(s)
- Candy S. Hwang
- Departments of Chemistry, Immunology and Microbial Science, Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, United States
| | - Lauren C. Smith
- Departments of Chemistry, Immunology and Microbial Science, Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, United States
| | - Yoshihiro Natori
- Departments of Chemistry, Immunology and Microbial Science, Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, United States
| | - Beverly Ellis
- Departments of Chemistry, Immunology and Microbial Science, Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, United States
| | - Bin Zhou
- Departments of Chemistry, Immunology and Microbial Science, Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, United States
| | - Kim D. Janda
- Departments of Chemistry, Immunology and Microbial Science, Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, United States
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29
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Raleigh MD, Laudenbach M, Baruffaldi F, Peterson SJ, Roslawski MJ, Birnbaum AK, Carroll FI, Runyon SP, Winston S, Pentel PR, Pravetoni M. Opioid Dose- and Route-Dependent Efficacy of Oxycodone and Heroin Vaccines in Rats. J Pharmacol Exp Ther 2018. [PMID: 29535156 DOI: 10.1124/jpet.117.247049] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Heroin and oxycodone abuse occurs over a wide range of drug doses and by various routes of administration characterized by differing rates of drug absorption. The current study addressed the efficacy of a heroin vaccine [morphine hapten conjugated to keyhole limpet hemocyanin (M-KLH)] or oxycodone vaccine [oxycodone hapten conjugated to keyhole limpet hemocyanin (OXY-KLH)] for reducing drug distribution to brain after intravenous heroin or oxycodone, or subcutaneous oxycodone. Rats immunized with M-KLH or keyhole limpet hemocyanin (KLH) control received an intravenous bolus dose of 0.26 or 2.6 mg/kg heroin. Vaccination with M-KLH increased retention of heroin and its active metabolites 6-acetylmorphine (6-AM) and morphine in plasma compared with KLH controls, and reduced total opioid (heroin + 6-AM + morphine) distribution to brain but only at the lower heroin dose. Immunization also protected against respiratory depression at the lower heroin dose. Rats immunized with OXY-KLH or KLH control received 0.22 or 2.2 mg/kg oxycodone intravenously, the molar equivalent of the heroin doses. Immunization with OXY-KLH significantly reduced oxycodone distribution to brain after either oxycodone dose, although the magnitude of effect of immunization at the higher oxycodone dose was small (12%). By contrast, vaccination with OXY-KLH was more effective when oxycodone was administered subcutaneously rather than intravenously, reducing oxycodone distribution to brain by 44% after an oxycodone dose of 2.3 mg/kg. Vaccination also reduced oxycodone-induced antinociception. These data suggest that the efficacy of OXY-KLH and M-KLH opioid vaccines is highly dependent upon opioid dose and route of administration.
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Affiliation(s)
- Michael D Raleigh
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (M.D.R., M.L., F.B., S.J.P., P.R.P., M.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (M.J.R., A.K.B.); Research Triangle Institute, Research Triangle Park, North Carolina (F.I.C., S.P.R.); Winston Biopharmaceutical Consulting, Boulder, Colorado (S.W.); and University of Minnesota Medical School (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota, Minneapolis, Minnesota
| | - Megan Laudenbach
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (M.D.R., M.L., F.B., S.J.P., P.R.P., M.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (M.J.R., A.K.B.); Research Triangle Institute, Research Triangle Park, North Carolina (F.I.C., S.P.R.); Winston Biopharmaceutical Consulting, Boulder, Colorado (S.W.); and University of Minnesota Medical School (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota, Minneapolis, Minnesota
| | - Federico Baruffaldi
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (M.D.R., M.L., F.B., S.J.P., P.R.P., M.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (M.J.R., A.K.B.); Research Triangle Institute, Research Triangle Park, North Carolina (F.I.C., S.P.R.); Winston Biopharmaceutical Consulting, Boulder, Colorado (S.W.); and University of Minnesota Medical School (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota, Minneapolis, Minnesota
| | - Samantha J Peterson
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (M.D.R., M.L., F.B., S.J.P., P.R.P., M.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (M.J.R., A.K.B.); Research Triangle Institute, Research Triangle Park, North Carolina (F.I.C., S.P.R.); Winston Biopharmaceutical Consulting, Boulder, Colorado (S.W.); and University of Minnesota Medical School (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota, Minneapolis, Minnesota
| | - Michaela J Roslawski
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (M.D.R., M.L., F.B., S.J.P., P.R.P., M.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (M.J.R., A.K.B.); Research Triangle Institute, Research Triangle Park, North Carolina (F.I.C., S.P.R.); Winston Biopharmaceutical Consulting, Boulder, Colorado (S.W.); and University of Minnesota Medical School (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota, Minneapolis, Minnesota
| | - Angela K Birnbaum
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (M.D.R., M.L., F.B., S.J.P., P.R.P., M.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (M.J.R., A.K.B.); Research Triangle Institute, Research Triangle Park, North Carolina (F.I.C., S.P.R.); Winston Biopharmaceutical Consulting, Boulder, Colorado (S.W.); and University of Minnesota Medical School (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota, Minneapolis, Minnesota
| | - F Ivy Carroll
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (M.D.R., M.L., F.B., S.J.P., P.R.P., M.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (M.J.R., A.K.B.); Research Triangle Institute, Research Triangle Park, North Carolina (F.I.C., S.P.R.); Winston Biopharmaceutical Consulting, Boulder, Colorado (S.W.); and University of Minnesota Medical School (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota, Minneapolis, Minnesota
| | - Scott P Runyon
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (M.D.R., M.L., F.B., S.J.P., P.R.P., M.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (M.J.R., A.K.B.); Research Triangle Institute, Research Triangle Park, North Carolina (F.I.C., S.P.R.); Winston Biopharmaceutical Consulting, Boulder, Colorado (S.W.); and University of Minnesota Medical School (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota, Minneapolis, Minnesota
| | - Scott Winston
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (M.D.R., M.L., F.B., S.J.P., P.R.P., M.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (M.J.R., A.K.B.); Research Triangle Institute, Research Triangle Park, North Carolina (F.I.C., S.P.R.); Winston Biopharmaceutical Consulting, Boulder, Colorado (S.W.); and University of Minnesota Medical School (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota, Minneapolis, Minnesota
| | - Paul R Pentel
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (M.D.R., M.L., F.B., S.J.P., P.R.P., M.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (M.J.R., A.K.B.); Research Triangle Institute, Research Triangle Park, North Carolina (F.I.C., S.P.R.); Winston Biopharmaceutical Consulting, Boulder, Colorado (S.W.); and University of Minnesota Medical School (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota, Minneapolis, Minnesota
| | - Marco Pravetoni
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (M.D.R., M.L., F.B., S.J.P., P.R.P., M.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (M.J.R., A.K.B.); Research Triangle Institute, Research Triangle Park, North Carolina (F.I.C., S.P.R.); Winston Biopharmaceutical Consulting, Boulder, Colorado (S.W.); and University of Minnesota Medical School (P.R.P., M.P.), and Center for Immunology (M.P.), University of Minnesota, Minneapolis, Minnesota
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30
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Hwang CS, Bremer PT, Wenthur CJ, Ho SO, Chiang S, Ellis B, Zhou B, Fujii G, Janda KD. Enhancing Efficacy and Stability of an Antiheroin Vaccine: Examination of Antinociception, Opioid Binding Profile, and Lethality. Mol Pharm 2018; 15:1062-1072. [PMID: 29420901 DOI: 10.1021/acs.molpharmaceut.7b00933] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In recent years, drug conjugate vaccines have shown promise as therapeutics for substance use disorder. As a means to improve the efficacy of a heroin conjugate vaccine, we systematically explored 20 vaccine formulations with varying combinations of carrier proteins and adjuvants. In regard to adjuvants, we explored a Toll-like receptor 9 (TLR9) agonist and a TLR3 agonist in the presence of alum. The TLR9 agonist was cytosine-guanine oligodeoxynucleotide 1826 (CpG ODN 1826), while the TLR3 agonist was virus-derived genomic doubled-stranded RNA (dsRNA). The vaccine formulations containing TLR3 or TLR9 agonist alone elicited strong antiheroin antibody titers and blockade of heroin-induced antinociception when formulated with alum; however, a combination of TLR3 and TLR9 adjuvants did not result in improved efficacy. Investigation of month-long stability of the two lead formulations revealed that the TLR9 but not the TLR3 formulation was stable when stored as a lyophilized solid or as a liquid over 30 days. Furthermore, mice immunized with the TLR9 + alum heroin vaccine gained significant protection from lethal heroin doses, suggesting that this vaccine formulation is suitable for mitigating the harmful effects of heroin, even following month-long storage at room temperature.
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Affiliation(s)
- Candy S Hwang
- Departments of Chemistry, Immunology, and Microbial Science, Skaggs Institute for Chemical Biology , The Scripps Research Institute , La Jolla , California 92037 , United States
| | - Paul T Bremer
- Departments of Chemistry, Immunology, and Microbial Science, Skaggs Institute for Chemical Biology , The Scripps Research Institute , La Jolla , California 92037 , United States
| | - Cody J Wenthur
- Departments of Chemistry, Immunology, and Microbial Science, Skaggs Institute for Chemical Biology , The Scripps Research Institute , La Jolla , California 92037 , United States
| | - Sam On Ho
- Molecular Express, Inc., Rancho Dominguez , California 90220 , United States
| | - SuMing Chiang
- Molecular Express, Inc., Rancho Dominguez , California 90220 , United States
| | - Beverly Ellis
- Departments of Chemistry, Immunology, and Microbial Science, Skaggs Institute for Chemical Biology , The Scripps Research Institute , La Jolla , California 92037 , United States
| | - Bin Zhou
- Departments of Chemistry, Immunology, and Microbial Science, Skaggs Institute for Chemical Biology , The Scripps Research Institute , La Jolla , California 92037 , United States
| | - Gary Fujii
- Molecular Express, Inc., Rancho Dominguez , California 90220 , United States
| | - Kim D Janda
- Departments of Chemistry, Immunology, and Microbial Science, Skaggs Institute for Chemical Biology , The Scripps Research Institute , La Jolla , California 92037 , United States
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Swain Y, Muelken P, LeSage MG, Gewirtz JC, Harris AC. Locomotor activity does not predict individual differences in morphine self-administration in rats. Pharmacol Biochem Behav 2018; 166:48-56. [PMID: 29409807 DOI: 10.1016/j.pbb.2018.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/31/2018] [Accepted: 01/31/2018] [Indexed: 12/19/2022]
Abstract
Understanding factors contributing to individual differences in opioid addiction vulnerability is essential for developing more effective preventions and treatments. Sensation seeking has been implicated in addiction to several drugs of abuse, yet its relationship with individual differences in opioid addiction vulnerability has not been well established. The primary goal of this study was to evaluate the relationship between locomotor activity in a novel environment, a preclinical model of sensation-seeking, and individual differences in acquisition of i.v. morphine self-administration (SA) in rats. A secondary goal was to evaluate the relationship between activity and elasticity of demand (reinforcing efficacy) for morphine measured using a behavioral economic approach. Following an initial locomotor activity screen, animals were allowed to acquire morphine SA at a unit dose of 0.5 mg/kg/infusion in 4 hour/day sessions (Experiment 1) or 0.2 mg/kg/infusion in 2 hour/day sessions (Experiment 2) until infusion rates were stable. Unit price was subsequently manipulated via progressive reductions in unit dose (Experiment 1) or increases in response requirement per infusion (Experiment 2). Activity levels were not correlated with acquisition of morphine SA in either experiment. Morphine consumption was generally well described by an exponential demand function in both experiments (R2 values > 0.95 for rats as a group), but activity did not correlate with behavioral economic measures. Locomotor activity in a novel environment did not predict individual differences in acquisition of morphine SA. These data complement findings from some human studies and suggest that the role of sensation seeking in individual differences in opioid addiction vulnerability may be limited.
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Affiliation(s)
- Yayi Swain
- Minneapolis Medical Research Foundation, Minneapolis, MN, United States; Department of Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Peter Muelken
- Minneapolis Medical Research Foundation, Minneapolis, MN, United States
| | - Mark G LeSage
- Minneapolis Medical Research Foundation, Minneapolis, MN, United States; Department of Psychology, University of Minnesota, Minneapolis, MN, United States; Department of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Jonathan C Gewirtz
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States; Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
| | - Andrew C Harris
- Minneapolis Medical Research Foundation, Minneapolis, MN, United States; Department of Psychology, University of Minnesota, Minneapolis, MN, United States; Department of Medicine, University of Minnesota, Minneapolis, MN, United States.
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Abstract
Substance use disorder, especially in relation to opioids such as heroin and fentanyl, is a significant public health issue and has intensified in recent years. As a result, substantial interest exists in developing therapeutics to counteract the effects of abused drugs. A promising universal strategy for antagonizing the pharmacology of virtually any drug involves the development of a conjugate vaccine, wherein a hapten structurally similar to the target drug is conjugated to an immunogenic carrier protein. When formulated with adjuvants and immunized, the immunoconjugate should elicit serum IgG antibodies with the ability to sequester the target drug to prevent its entry to the brain, thereby acting as an immunoantagonist. Despite the failures of first-generation conjugate vaccines against cocaine and nicotine in clinical trials, second-generation vaccines have shown dramatically improved performance in preclinical models, thus renewing the potential clinical utility of conjugate vaccines in curbing substance use disorder. This review explores the critical design elements of drug conjugate vaccines such as hapten structure, adjuvant formulation, bioconjugate chemistry, and carrier protein selection. Methods for evaluating these vaccines are discussed, and recent progress in vaccine development for each drug is summarized.
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Affiliation(s)
- Paul T Bremer
- Departments of Chemistry and Immunology, The Scripps Research Institute, La Jolla, California
| | - Kim D Janda
- Departments of Chemistry and Immunology, The Scripps Research Institute, La Jolla, California
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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.
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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
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Abstract
This paper is the thirty-eighth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2015 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia, stress and social status, tolerance and dependence, learning and memory, eating and drinking, drug abuse and alcohol, sexual activity and hormones, pregnancy, development and endocrinology, mental illness and mood, seizures and neurologic disorders, electrical-related activity and neurophysiology, general activity and locomotion, gastrointestinal, renal and hepatic functions, cardiovascular responses, respiration and thermoregulation, and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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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: 36] [Impact Index Per Article: 4.5] [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.
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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
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Kvello AMS, Andersen JM, Øiestad EL, Mørland J, Bogen IL. Pharmacological Effects of a Monoclonal Antibody against 6-Monoacetylmorphine upon Heroin-Induced Locomotor Activity and Pharmacokinetics in Mice. J Pharmacol Exp Ther 2016; 358:181-9. [PMID: 27217591 DOI: 10.1124/jpet.116.233510] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 05/19/2016] [Indexed: 12/21/2022] Open
Abstract
Immunotherapy can provide a supplemental treatment strategy against heroin use on the principle of sequestering the active drug in the bloodstream, thereby reducing its distribution to the brain. Previous studies have shown that heroin's first metabolite, 6-monoacetylmorphine (6-MAM), is the main mediator of acute heroin effects. The objective of the present study was to characterize the pharmacological potential of a monoclonal antibody against 6-MAM (anti-6-MAM mAb) to counteract the heroin response. The individual contributions from heroin and 6-MAM to heroin effects were also examined by pretreating mice with anti-6-MAM mAb (10-100 mg/kg) prior to either heroin or 6-MAM injection (1.25-2.5 μmol/kg). The opioid-induced behavioral response was assessed in a locomotor activity test, followed by opioid and antibody quantification in blood and brain tissue. Pretreatment with mAb caused a profound reduction of heroin- and 6-MAM-induced behavior, accompanied by correspondingly decreased levels of 6-MAM in brain tissue. mAb pretreatment was more efficient against 6-MAM injection than against heroin, leading to an almost complete blockade of 6-MAM-induced effects. mAb pretreatment was unable to block the immediate (5-minute) transport of active metabolites across the blood-brain barrier after heroin injection, indicating that heroin itself appears to enhance the immediate delivery of 6-MAM to the brain. The current study provides additional evidence that 6-MAM sequestration is crucial for counteracting the acute heroin response, and demonstrates the pharmacological potential of immunotherapy against heroin use.
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Affiliation(s)
- Anne Marte Sjursen Kvello
- Department of Drug Abuse Research, Domain for Forensic Sciences, Norwegian Institute of Public Health (A.M.S.K., J.M.A., E.L.Ø., J.M. and I.L.B.) and School of Pharmacy, University of Oslo (E.L.Ø.) Oslo, Norway
| | - Jannike Mørch Andersen
- Department of Drug Abuse Research, Domain for Forensic Sciences, Norwegian Institute of Public Health (A.M.S.K., J.M.A., E.L.Ø., J.M. and I.L.B.) and School of Pharmacy, University of Oslo (E.L.Ø.) Oslo, Norway
| | - Elisabeth Leere Øiestad
- Department of Drug Abuse Research, Domain for Forensic Sciences, Norwegian Institute of Public Health (A.M.S.K., J.M.A., E.L.Ø., J.M. and I.L.B.) and School of Pharmacy, University of Oslo (E.L.Ø.) Oslo, Norway
| | - Jørg Mørland
- Department of Drug Abuse Research, Domain for Forensic Sciences, Norwegian Institute of Public Health (A.M.S.K., J.M.A., E.L.Ø., J.M. and I.L.B.) and School of Pharmacy, University of Oslo (E.L.Ø.) Oslo, Norway
| | - Inger Lise Bogen
- Department of Drug Abuse Research, Domain for Forensic Sciences, Norwegian Institute of Public Health (A.M.S.K., J.M.A., E.L.Ø., J.M. and I.L.B.) and School of Pharmacy, University of Oslo (E.L.Ø.) Oslo, Norway
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Ohia-Nwoko O, Kosten TA, Haile CN. Animal Models and the Development of Vaccines to Treat Substance Use Disorders. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2016; 126:263-91. [PMID: 27055616 DOI: 10.1016/bs.irn.2016.02.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The development of pharmacotherapies for substance use disorders (SUDs) is a high priority in addiction research. At present, there are no approved pharmacotherapies for cocaine and methamphetamine use disorders, while treatments for nicotine and opioid use are moderately effective. Indeed, many of these treatments can cause adverse drug side effects and have poor medication compliance, which often results in increased drug relapse rates. An alternative to these traditional pharmacological interventions is immunotherapy or vaccines that can target substances associated with SUDs. In this chapter, we discuss the current knowledge on the efficacy of preclinical vaccines, particularly immunogens that target methamphetamine, cocaine, nicotine, or opioids to attenuate drug-induced behaviors in animal models of SUDs. We also review vaccines (and antibodies) against cocaine, nicotine, and methamphetamine that have been assessed in human clinical trials. While preclinical studies indicate that several vaccines show promise, these findings have not necessarily translated to the clinical population. Thus, continued effort to design more effective vaccine immunogens using SUD animal models is necessary in order to support the use of immunotherapy as a viable option for individuals with SUDs.
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Affiliation(s)
- O Ohia-Nwoko
- University of Houston, Houston, TX, United States; Texas Institute for Measurement, Evaluation and Statistics (TIMES), University of Houston, Houston, TX, United States
| | - T A Kosten
- University of Houston, Houston, TX, United States; Texas Institute for Measurement, Evaluation and Statistics (TIMES), University of Houston, Houston, TX, United States
| | - C N Haile
- University of Houston, Houston, TX, United States; Texas Institute for Measurement, Evaluation and Statistics (TIMES), University of Houston, Houston, TX, United States.
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Correction: Pharmacokinetic Correlates of the Effects of a Heroin Vaccine on Heroin Self-Administration in Rats. PLoS One 2015; 10:e0126889. [PMID: 25893574 PMCID: PMC4404329 DOI: 10.1371/journal.pone.0126889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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