Preliminary research from this week found that patients taking opioids for chronic pain may produce antibodies to the medication, which may help explain some of the side effects of long-term opioid use; these antibodies may also hamper efforts to make opioid vaccines, which scientists hope opioid use could treat addiction better than existing drugs.
Researchers from the University of Wisconsin-Madison and the Scripps Research Institute in California took blood samples from 19 volunteers who took opioid painkillers for chronic back pain. They then tested these samples for antibodies against opioids, by exposing the blood to proteins bound to the commonly used opioids hydrocodone and oxycodone. In 10 of these patients, they found opioid-specific antibodies. Those with a higher dose of opioid therapy had higher levels of these antibodies, while three control patients who did not take opioids for their pain did not have up to very low levels.
The findings were presented this week at the American Chemical Society Fall 2020 Virtual Meeting. This means that the results are based on preliminary data that have not yet been peer reviewed. The sample size of 19 patients is also very small, so these conclusions are far from controlled science.
But if true, the authors say, these antibodies may be part of the reason why people taking opioids may develop symptoms such as hyperalgesia, where a person’s sensitivity to pain becomes so extreme that even normal harmless sensations become painful. One theory that the researchers are investigating is that opioids of these drugs can bind to carbohydrates in the body, which is why things are called with advanced glycation end products (AGEs). These AGEs are linked to chronic inflammatory conditions such as diabetes and clogged arteries, which also affect the immune system.
The authors also speculate that these native immune responses may reduce the effectiveness of potential faxes for addiction to opioid use. Some scientists, including the authors of the study, hope to create vaccines that could induce a temporary anti-inflammatory response to the opioids we receive from a prescription pill or illegal medication. The antibodies will adhere to the molecules of these drugs as they enter the system, blocking them from entering the brain and causing the effects associated with abusing opioids, such as an addictive euphoria. These vaccines, it is theoretical, would prevent cravings symptoms better than other medications currently available, although they could also be used in combination with current medication-assisted therapy.
G / O Media can get a commission
In the study, the volunteers produced IgM antibodies against opioids, which are short-term antibodies that normally last a few weeks. But the vaccines these researchers and others hope to develop try to produce IgG antibodies, which typically last longer than IgM ones. The concern is that having this weaker native response will make it harder for the body to respond to the vaccine and produce a more effective host of antibodies.
Opioid vaccines are not universally seen as a good idea, with some advocates for shear reduction arguing that the resources needed to develop them should be used to support other measures to help people struggling with drug use, such as providing affordable housing and greater access to existing treatments. But if the authors are right, then even getting to the point where a vaccine for opioid abuse is effective will be harder than expected. Previous attempts to create vaccines for nicotine and cocaine addiction have also failed, albeit for several reasons.
“To confirm these results and help us understand who good vaccine candidates may be, we need to find a larger cohort of individuals, track their opiate use history, and find out if this is a useful biomarker for subsequent vaccine protection against overdose and for clinical outcomes such as hyperalgesia, ”said study author Cody Wenthur, a professor at the UW-Madison School of Pharmacy, in a statement. released by the university.
By studying these antibodies now, the researchers hope to better understand how they can advance their vaccines.
.
