芬太尼疫苗可能成為阿片類藥物危機的「遊戲規則改變者」
資料來源：梅根布魯克斯 / 2022 年 11 月 18 日 / Medscape / 財團法人台灣紅絲帶基金會編譯
美國德克薩斯州的研究人員開發出一種疫苗，可以阻斷芬太尼的欣快作用，芬太尼是一種強效合成阿片類藥物，在美國越來越多地與阿片類藥物過量致死有關。
在對雄性和雌性小鼠的研究中，該疫苗產生了顯著且持久水平的抗芬太尼抗體，這些抗體在降低藥物的鎮痛作用、行為和生理作用方面非常有效。
該疫苗可防止芬太尼進入大腦。 「因此，個人不會感受到欣快的影響，並且可以『回到馬車上』以保持清醒」，德克薩斯州休斯頓大學的首席研究員、休斯頓大學藥物發現研究所的創始成員、醫學博士 Colin Haile 說。在新聞稿中。該研究於 10 月 26 日線上發表在《藥劑學》雜誌上。
「抗芬太尼抗體對芬太尼和芬太尼衍生物具有特異性，不會與其他阿片類藥物（如嗎啡）發生交叉反應。這意味著接種疫苗的人仍然可以接受其他阿片類藥物的鎮痛治療」，海爾說.
該疫苗不會對免疫小鼠造成任何不良影響。該研究團隊計畫在未來幾個月內開始生產臨床級疫苗，並計畫很快地進行人體臨床試驗。
研究人員指出，如果在臨床試驗中證明安全有效，該疫苗可能成為試圖戒掉阿片類藥物的人們的一種預防復吸的藥物，從而對美國的阿片類藥物流行產生重大影響。
正如 Medscape Medical News 先前報導的那樣，美國在 2021 年記錄了超過 107,000 例藥物過量死亡——據聯邦衛生官員稱，這是歷史新高——而芬太尼與這些死亡中的大部分有關。
資深作者、休斯頓大學發育、認知和行為神經科學計畫主任 Therese Kosten 博士稱，新的芬太尼疫苗是潛在的「遊戲規則改變者」。
「芬太尼的使用和過量是一種特殊的治療挑戰，由於其藥效學，目前的藥物無法充分解決，並且使用短效納洛酮 [Narcan] 管理急性過量並不適當有效，因為通常需要多劑量的納洛酮來逆轉芬太尼的致命影響」，科斯滕說。
這項研究的資金由國防部通過由 RTI 國際酒精和物質使用障礙藥物療法聯盟管理的酒精和物質濫用障礙計畫提供，該計畫多年來一直資助 Haile 的實驗室開發抗芬太尼疫苗。
作者沒有相關的利益衝突。休斯頓大學代表四名研究人員提交了一項臨時專利，其中包含與芬太尼疫苗相關的技術。
藥劑學。 2022 年 10 月 26 日在線發布。摘要
Fentanyl Vaccine a Potential ‘Game Changer’ for Opioid Crisis
Megan Brooks / November 18, 2022 Medscape
Texas-based researchers have developed a vaccine that blocks the euphoric effects of fentanyl, a potent synthetic opioid that is increasingly involved in opioid overdose deaths in the United States.
In studies in male and female mice, the vaccine generated significant and long-lasting levels of anti-fentanyl antibodies that were highly effective at reducing the antinociceptive, behavioral, and physiological effects of the drug.
The vaccine prevents fentanyl from entering the brain. “Thus, the individual will not feel the euphoric effects and can ‘get back on the wagon’ to sobriety,” lead investigator Colin Haile, MD, PhD, with University of Houston in Texas and founding member of the UH Drug Discovery Institute, said in a news release. The study was published online October 26 in the journal Pharmaceutics.
“The anti-fentanyl antibodies were specific to fentanyl and a fentanyl derivative and did not cross-react with other opioids, such as morphine. That means a vaccinated person would still be able to be treated for pain relief with other opioids,” said Haile.
The vaccine did not cause any adverse effects in the immunized mice. The research team plans to start manufacturing clinical-grade vaccine in the coming months with clinical trials in humans planned soon.
If proven safe and effective in clinical testing, the vaccine could have major implications for the nation’s opioid epidemic by becoming a relapse prevention agent for people trying to quit using opioids, the researchers note.
As previously reported by Medscape Medical News, the US in 2021 recorded more than 107,000 drug overdose deaths — a record high, according to federal health officials — and fentanyl was involved in most of these deaths.
Senior author Therese Kosten, PhD, director of the UH Developmental, Cognitive & Behavioral Neuroscience program, calls the new fentanyl vaccine a potential “game changer.”
“Fentanyl use and overdose is a particular treatment challenge that is not adequately addressed with current medications because of its pharmacodynamics, and managing acute overdose with the short-acting naloxone [Narcan] is not appropriately effective as multiple doses of naloxone are often needed to reverse fentanyl’s fatal effects,” said Kosten.
Funding for the study was provided by the Department of Defense through the Alcohol and Substance Abuse Disorders Program managed by RTI International’s Pharmacotherapies for Alcohol and Substance Use Disorders Alliance, which has funded Haile’s lab for several years to develop the anti-fentanyl vaccine. The authors have no relevant conflicts of interest. A provisional patent has been submitted by the University of Houston on behalf of four of the investigators containing technology related to the fentanyl vaccine.
Pharmaceutics. Published online October 26, 2022. Abstract