Immunotherapeutic strategies for treating opioid use disorder and overdose

Luba, Rachel; Martinez, Suky; Jones, Jermaine D.; Pravetoni, Marco; Comer, Sandra D.

doi:10.1080/13543784.2023.2173062

Cited by 6 publications

(5 citation statements)

References 110 publications

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“…Initial design and approval of ongoing and planned clinical trials of opioid vaccines relies on a strong interdisciplinary team of preclinical and clinical researchers as well as a strong understanding of the strengths and weaknesses of prior clinical trials targeting other substances (primarily nicotine and cocaine; see [10 ▪▪ ] for review [15–24]). Use of a randomized, placebo-controlled, double-blinded design is ideal.…”

Section: Trial Design and Selected Endpointsmentioning

confidence: 99%

“…Use of a randomized, placebo-controlled, double-blinded design is ideal. Manufacturing of the vaccine, in-vitro testing, and extensive preclinical research are essential steps for identifying potential vaccine targets, and selecting vaccine components (adjuvants, carrier proteins, and haptens; see [10 ▪▪ ] for review) that are most likely to be safe, well tolerated, and effective at generating immune response in humans. In support of the current clinical trial, preclinical work aided selection of a target drug molecule, adjuvant, and carrier protein.…”

Section: Trial Design and Selected Endpointsmentioning

confidence: 99%

“…Vaccines for OUD function by eliciting an immune response towards a target opioid drug molecule (e.g. oxycodone, heroin, or fentanyl) [8,9,10 ▪▪ ]. Once an immune response is generated, administration or use of the targeted opioid produces antidrug antibodies.…”

Section: Introductionmentioning

confidence: 99%

“…Once an immune response is generated, administration or use of the targeted opioid produces antidrug antibodies. These antibodies bind to and sequester drug molecules in the blood, preventing passage across the blood–brain barrier (BBB) and blocking or drastically reducing subjective, reinforcing, or respiratory-depressant effects of the targeted opioid [8,9,10 ▪▪ ]. Vaccines for OUD have several potential advantages and a wealth of preclinical data support the potential for vaccines to elicit highly specific antiopioid antibodies [11,12,13 ▪ ].…”

Section: Introductionmentioning

confidence: 99%

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Opioid vaccine clinical testing: lessons learned

Luba,

Comer

2024

Current Opinion in Psychiatry

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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 and 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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Section: Trial Design and Selected Endpointsmentioning

confidence: 99%

Section: Trial Design and Selected Endpointsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Opioid vaccine clinical testing: lessons learned

Luba,

Comer

2024

Current Opinion in Psychiatry

Self Cite

View full text Add to dashboard Cite

show abstract

“…Clinical therapeutic vaccines are variable in individual response to active immunization arising from specific vaccine components, vaccine dose and schedule of vaccination, individual and/or baseline differences in immune response, sex, age, genotype, and individual drug use patterns [ 8 ]. However, clinical advantages of anti-drug vaccines seem to outweigh their disadvantages, potentially leading to enhanced treatment options in the field of addiction treatment [ 9 , 10 ]. In this review, we will delve into the intriguing domain of anti-drug vaccines, elucidating their mechanisms, current developmental status, and their potential to revolutionize addiction treatment.…”

Section: Introductionmentioning

confidence: 99%

Vaccines to Treat Substance Use Disorders: Current Status and Future Directions

Lu,

Li,

Zheng

et al. 2024

Pharmaceutics

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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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Kidney fibrosis molecular mechanisms Spp1 influences fibroblast activity through transforming growth factor beta smad signaling

Ding,

Xu,

et al. 2024

iScience

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Immunotherapeutic strategies for treating opioid use disorder and overdose

Cited by 6 publications

References 110 publications

Opioid vaccine clinical testing: lessons learned

Opioid vaccine clinical testing: lessons learned

Vaccines to Treat Substance Use Disorders: Current Status and Future Directions

Kidney fibrosis molecular mechanisms Spp1 influences fibroblast activity through transforming growth factor beta smad signaling

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