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Scientists have developed a vaccine against fentanyl that could prevent addiction to powerful opioid and even prevent overdoses, according to a new study.
Fentanyl is now present in the blood of 90% of people who die as a result of an overdose.
Synthetic opioid is much more potent than heroin, and addictive.
As people consume more and more of this drug, they become tolerant, need more to reach a high level, exposing them to an increasingly serious risk of fatal overdose.
However, a new vaccine developed has the potential to block the effects of the drug on the brain and short-circuit its addiction, and possibly even stop overdoses, suggest the first rat experiments performed by Scripps Research .
A vaccine that teaches the immune system to recognize and bind to fentanyl, preventing it from reaching the brain and causing peaks in activity, addictions or overdoses, has been revealed promising in rats
FENTANYL IS MORE POWERFUL THAN MORPHINE OR HEROIN – THE SCIENTIST WANTS TO STOP ADDICTION BEFORE STARTING
In 2017, 28,400 Americans died from fentanyl overdoses.
This drug, which is up to 100 times more powerful than morphine, has become the main target of the fight against the opioid epidemic.
Fentanyl mixes with heroin and even illicit drugs, such as cocaine, which means that people end up taking and sometimes overdosing, without even wanting or wanting to consume it.
It is unclear how many users of fentanyl seek or prefer it over those who end up using it unintentionally, but its addictive profile means that once the drug has been consumed, he can continue to pursue it, if not more. higher doses of other opioids.
Just like heroin addiction or prescription opioids, the addition of fentanyl is so intense and physiological that users should not quit smoking, but should instead be treated with non-prescription therapies. long-acting addictive drugs, such as buprenorphine.
The use of these variations of opiates is and will remain the best way to treat these addictions.
But if fentanyl addiction could be stopped before it started, it would be all the more ideal to stop the overdose epidemic.
Scripps Research researchers are experimenting with a way to do just that.
THE IMMUNE SYSTEM DOES NOT SEE OPIOIDS AS A THREAT, BUT A VACCINE CAN LEARN ABOUT
Vaccines work by activating the immune system against certain pathogens.
The body is not equipped with antibodies against opioids. The scientists had to convince the immune system to react and block fentanyl.
To do this, they used a modified form of fentanyl molecule, called hapten, and mixed it with a tetanus toxoid vaccine to boost the immune system.
The tetanus vaccine is a "vector" that wakes up immune cells called B cells and alerts them of the presence of an invader.
Although these cells do not normally see fentanyl as an invader, a certain type of virus binds to the hapten.
Once they have encountered the hapten, the immune cells begin to produce a brand new antibody – an antibody that will recognize, attack, and match fentanyl.
This means that when fentanyl is introduced into the bloodstream, the newly struck antibodies will find it and bind to it.
Normally, the fentanyl molecules are small enough to pass the blood-brain barrier, where the drug activates the opioid receptors, creating a "high" effect and depressing the nervous system.
But with the manufactured antibody fixed on it, the combined molecules are too big to break through the barrier, blocking the effects it would have on the brain.
In fact, "the antibody would bind the drug, like a baseball in a baseball glove, so the drug is bound and unable to cross the blood-brain barrier," said Dr. Howard Taylor, director laboratory at the American Addiction Centers.
"It would neutralize the drug and make it null and void."
RATS VACCINED LOST TASTE AT FENTANYL FOR MONTHS
To test their vaccine, scientists at Scripps trained rats to inject fentanyl – not literally; the rats walked on levers that released the drug into catheters with which they were able – and to feed themselves.
The rats learned the taste of fentanyl and returned frequently.
But that changed once they were vaccinated.
The rats received two doses of the vaccine, two weeks apart.
It took four weeks for behavioral change to become apparent, but then, for 15 weeks, the animals became less interested in the drug lever and more interested in their food.
And they did not show signs of fentanyl withdrawal, which would normally be signaled by the more frequent return of rats to fentanyl lever and less to the food lever.
Perhaps more importantly, the rats did not return often enough to fentanyl to cause overdoses.
Even after the first two doses had run out of steam, a third booster dose of the fentanyl vaccine restored all its effects.
Overall, the effects were similar to those of current opioid dependence drugs, such as naltrexone.
At best, such a vaccine could prevent drug addiction, overdoses and withdrawals, and could have a longer duration of action with doses less frequent than conventional treatments.
"I think it's very exciting," Dr. Taylor said.
"It's certainly promising, but of course, these drugs – whether it's fentanyl or heroin – it's possible that there's a specific antibody against each one of them. [in the vaccines].
"It would be great if you could have a generic."
WHY A VACCINE AGAINST AN OPIOID CAN NOT BE ENOUGH
Other scientists are currently experimenting with the creation of vaccines combined with haptens for fentanyl and heroin.
"Maybe you could take a cocktail with 10 different antibodies and 'poof', you have a vaccine that is suitable for 10 different antibodies," said Dr. Taylor.
"If you could identify an antibody against an opioid, the others would probably be close enough."
But there are other problems. It is unclear how the vaccine would work in humans, how many doses one might need or how long its effects could last.
Experts say that we will probably be in at least five years before the use of opioid dependence vaccines – if they prove to be safe and effective in testing.
In addition, it may never be usable in patients with compromised immune systems, which is a common trait among injection drug users.
In addition, note the researchers, the effects are not yet instantaneous.
However, if the vaccine continues on its promising path, it could be used in combination with treatments such as buprenorphine to help reduce cravings or even make the drug totally unattractive to people on addiction treatment, speculates Dr. Taylor.
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