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NEWS AND VIEWS |
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Year : 2011 | Volume
: 2
| Issue : 2 | Page : 143-144 |
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A vaccine against cocaine abuse
G Sivagnanam
Section Editor, Journal of Pharmacology and Pharmacotherapeutics, India
Date of Web Publication | 6-Jun-2011 |
Correspondence Address: G Sivagnanam Indira Gandhi Medical College and Research Institute, Kadhirkamam, Puducherry India
 Source of Support: None, Conflict of Interest: None  | Check |

How to cite this article: Sivagnanam G. A vaccine against cocaine abuse. J Pharmacol Pharmacother 2011;2:143-4 |
News | |  |
As of now, there is no vaccine (FDA-approved) for any drug addiction. "Researchers have produced a lasting anti-cocaine immunity in mice by giving them a safe vaccine that combines bits of the common cold virus with a particle that mimics cocaine……" [1]
(RE)View | |  |
Principle
Vaccination promises to be a novel approach, wherein the elicited specific antibodies against a habituating drug (e.g., cocaine) block its access to the brain. The mechanism appears to result from the binding of the drug with the elicited circulating IgG antibodies, making the complex impermeable to the blood-brain barrier so that the drug stays in the periphery, leaving the subject deprived of the "high" (euphoria) .
Evidence
Adenovirus (Ad) gene transfer vectors are potent immunogens. By covalently linking cocaine to the capsid proteins of Ad vector, a novel vaccine platform was developed. This vaccine evoked a high-titer anticocaine antibody in mice that completely and persistently reversed the hyperlocomotor activity of cocaine. [2]
TA-CD is an active cocaine vaccine coupled to recombinant cholera toxin B, developed by Xenova, a UK-based biopharmaceutical company. [3] Two doses of TA-CD (82 mcg; 360 mcg) at weeks 1, 3, 5 and 9 were administered to 10 cocaine-dependent men not seeking drug treatment and the effects of cocaine (0 mg, 25 mg, 50 mg) were determined before vaccine and weekly thereafter. Those with higher antibody production had an immediate (within 4 min of cocaine smoking) 55-81% reduction in ratings of good drug effect and substantially decreased the intoxicating effects of cocaine. Self-reported cocaine use tended to decrease as a function of antibody titer. [4]
Related points to ponder
Unlike opiates, there are no effective drugs to manage cocaine dependence. It is mainly managed by behavioral therapy, although with low success rates. [5]
Cocaine abuse is widespread around the world, and the allergic reactions must be rare compared with other substances of abuse, like opiates. [6],[7]
Specific antibodies when bound to methamphetamine [8] or morphine [9] significantly prolong the t½ of the respective drug in circulation while for cocaine, experimental evidences show that there is no change in t½. Hence, it is suggested that cocaine is an ideal target for a vaccine as the elicited antibodies might bind subsequent active drug once the previous dose of the drug is cleared. [10]
Antibodies to cocaine persisted for at least 6 months in the dependent subjects in a Phase IIa study involving a 14-week trial. [11]
Take home message
The vaccine will be of use only for motivated abusers to quit as the effects of the vaccine can be overcome by increasing the amount of cocaine used, as indicated by quantitative urine tests for benzoylecgonine (cocaine metabolite). [10]
References | |  |
1. | Available from: http://www.healthnewsdigest.com/news/Research_270/Vaccine_Blocks_Cocaine_High_in_Mice.shtml. [Last accessed on 2011 Jan 5].  |
2. | Hicks MJ, De BP, Rosenberg JB, Davidson JT, Moreno AY, Janda KD, et al. Cocaine analog coupled to disrupted adenovirus: A vaccine strategy to evoke high-titer immunity against addictive drugs. Mol Ther 2011;19:612-9.  [PUBMED] [FULLTEXT] |
3. | Martell BA, Mitchell E, Poling J, Gonsai K, Kosten TR. Vaccine Pharmacotherapy for the Treatment of Cocaine Dependence. Biol Psychiatry 2005;58:158-64  |
4. | Haney M, Gunderson EW, Jiang H, Collins ED, Foltin RW. Cocaine-specific antibodies blunt the subjective effects of smoked cocaine in humans. Biol Psychiatry 2010;67:59-65.  [PUBMED] [FULLTEXT] |
5. | Simpson DD, Joe GW, Fletcher BW, Hubbard RL, Anglin MD. A national evaluation of treatment outcomes for cocaine dependence. Arch Gen Psychiatry 1999;56:507-14.  [PUBMED] [FULLTEXT] |
6. | MacPherson RD, Willcox C, Chow C, Wang A. Anaesthetist′s responses to patients′ self-reported drug allergies. Br J Anaesth 2006;97:634-9.  [PUBMED] [FULLTEXT] |
7. | Nasser SM, Ewan PW. Opiate-sensitivity: Clinical characteristics and the role of skin prick testing.th Clin Exp Allergy 2001;31:1014-20.  |
8. | Laurenzana EM, Byrnes-Blake KA, Milesi-Halle A, Gentry WB, Williams DK, Owens SM. Use of anti-(+)-methamphetamine monoclonal antibody to significantly alter (+)-methamphetamine and (+)-amphetamine disposition in rats. Drug Metab Dispos 2003;31:1320-6.  |
9. | Hill JH, Wainer BH, Fitch FW, Rothberg RM. Delayed clearance of morphine from the circulation of rabbits immunized with morphine-6-hemisuccinate bovine serum albumin. J Immunol 1975;114:1363-8.  [PUBMED] [FULLTEXT] |
10. | Orson FM, Kinsey BM, Singh RA, Wu Y, Kosten TR. Vaccines for cocaine abuse. Hum Vaccin 2009;5:194-9.  [PUBMED] [FULLTEXT] |
11. | Martell BA, Mitchell E, Poling J, Gonsai K, Kosten TR. Vaccine pharmacotherapy for the treatment of cocaine dependence. Biol Psychiatry 2005;58:158-64.  [PUBMED] [FULLTEXT] |
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