Active immunization against nicotine alters the distribution of nicotine but not the metabolism to cotinine in the rat

The predominantly human sequence, high-affinity anticocaine monoclonal antibody (mAb) 2E2 was cleared slowly from mouse blood by a first-order process with an elimination t 1/2 of 8.1 days. Infused 2E2 also produced a dramatic dose-dependent increase in plasma cocaine concentrations and a concomitant decrease in the brain cocaine concentrations produced by an i.v. injection of cocaine HCl (0.56 mg/kg). At the highest dose of 2E2 tested (3:1, mAb/drug), cocaine was not detectable in the brain. Pharmacokinetic studies showed that the normal disappearance of cocaine from plasma was described by a two-compartment pharmacokinetic model with distribution t 1/2␣ and terminal elimination t 1/2␤ values of 1.9 and 26.1 min, respectively. In the presence of an equimolar dose of mAb 2E2, there was a 26-fold increase in the area under the plasma cocaine concentration-time curve (AUC) relative to the AUC in the absence of 2E2. Consequently, 2E2 decreased the volume of distribution of cocaine from 6.0 to 0.20 l/kg, which approximated that of 2E2 (0.28 l/kg). However, cocaine was still rapidly cleared from plasma, and its elimination was now described by a single-compartment model with an elimination t 1/2 of 17 min. Importantly, 2E2 also produced a 4.5-fold (78%) decrease in the cocaine AUC in the brain. Therefore, the effect of 2E2 on plasma and brain cocaine concentrations was predominantly caused by a change in the distribution of cocaine with negligible effects on its rate of clearance. These data support the concept of immunotherapy for drug abuse.Despite decades of basic and clinical research there is still no approved pharmacotherapy for the prevention of relapse in cocaine abusers (Vocci and Ling, 2005). The drug-induced reinstatement (priming) of drug self-administration behavior represents an animal model of relapse (DeWitt and Stewart, 1981) with the concentration of cocaine in the body a critical determinant of the probability of reinstating cocaine selfadministration (Norman et al., 1999(Norman et al., , 2002. Because the site of action of cocaine is presumably in the brain, decreasing the concentrations reaching the brain would be expected to decrease the probability of relapse. Antibodies with high affinity and specificity for cocaine would be expected to act as pharmacokinetic antagonists by sequestering cocaine in the peripheral circulation and preventing its entry to the brain. Indeed, active immunization of animals with hapten-carrier conjugates can elicit the production of polyclonal anticocaine antibodies with sufficient levels and affinity for cocaine that they can reduce the amount of cocaine entering the brain (Fox et al., 1996). Active immunization has also been shown to attenuate the behavioral effects (Carrera et al., 1995;Fox et al., 1996;Ettinger et al., 1997) and the priming effect (Carrera et al., 2000) of systemically administered cocaine in rats. Furthermore, the ability of active immunization to produce levels of polyclonal anticocaine antibodies in humans (Kosten et al., 2002) that we...

Section: Discussionsupporting

confidence: 88%

A Chimeric Human/Murine Anticocaine Monoclonal Antibody Inhibits the Distribution of Cocaine to the Brain in Mice

Norman¹,

Tabet²,

Norman³

et al. 2006

“…This pharmacokinetic model requires that 2E2 binding of cocaine does not slow the rate of elimination of cocaine in rats, which is consistent with what was observed in mice (Norman et al, 2007). Because anti-nicotine antibodies have been reported to decrease nicotine clearance in some studies (Keyler et al, 1999(Keyler et al, , 2005 but not in others (de Villiers et al, 2004), verification of our prediction will require additional studies that will be conducted as additional supplies of 2E2 are available.…”

Section: Discussionsupporting

confidence: 77%

The Effect of a Chimeric Human/Murine Anti-Cocaine Monoclonal Antibody on Cocaine Self-Administration in Rats

Norman¹,

Norman²,

Buesing³

et al. 2008

The predominantly human sequence anti-cocaine monoclonal antibody (mAb), 2E2, has high affinity and specificity for cocaine and antagonizes cocaine distribution to the brain in mice. To determine whether 2E2 can alter the self-administration of cocaine in rats, both cocaine-induced reinstatement (priming) of self-administration, and the rates of cocaine consumption were assessed during daily sessions. After self-administration training, the rats' cocaine priming threshold values were stable over a 2-week baseline period. Furthermore, the rates of cocaine consumption at unit doses of 0.3 and 3.0 mol/kg were steady within sessions and stable between sessions. Then, 2E2 (120 mg/kg i.v.) or an equivalent dose of nonspecific human polyclonal IgG (control) was infused and daily sessions continued. 2E2 produced an initial, approximately 3-fold, increase in the cocaine priming threshold that declined toward baseline values over the subsequent 3 weeks, with an effect t 1/2 of approximately 4 days. In contrast to the substantial increase in the cocaine priming threshold, 2E2 produced only modest dose-dependent increases (42 and 18%) in the cocaine consumption rates, and these also gradually declined toward baseline values. There was no significant effect of the control IgG on the priming threshold or rates of consumption of cocaine. After infusion, antibody blood concentrations declined over time, and a two-compartment pharmacokinetic model generated values for the distribution and elimination half-lives of 0.5 and 11.6 days for 2E2 and 0.4 and 6.0 days for control IgG. 2E2 had a long-lasting effect on cocaine-induced priming, which may predict its efficacy as an immunotherapy for cocaine abuse.The drug-induced reinstatement (priming) of drug selfadministration behavior represents an animal model of some aspects of the relapse process (de Wit and Stewart, 1981;Shalev et al., 2002) in addicts. The cumulative concentration of cocaine is a critical determinant of the probability of reinstating cocaine self-administration in rats (Norman et al., , 2002. Because the site of action for cocaine is presumably in the brain, decreasing the drug concentrations reaching the brain would be expected to decrease the probability of relapse. Antibodies with high affinity and specificity for cocaine are hypothesized to sequester cocaine in the peripheral circulation and reduce its entry to the brain (Kosten and Owens, 2005). Pharmacokinetic antagonism is defined as a decrease in the concentration of an agonist at its site of action. Typically, the mechanism by which this is achieved is by increasing the rate of agonist clearance (Rang et al., 2007). Although this may occur with antibody Fab fragments targeting slowly cleared drugs such as digoxin (Bateman, 2004), this would not occur with monoclonal antibodies (mAb) targeting rapidly cleared drugs such as cocaine or nicotine (Keyler et al., 2005). Antibodies generally act as chemical antagonists by binding to and thereby reversibly inactivating drugs. As a consequence, anti-drug an...

“…Because the nicotine-specific antibodies elicited by either vaccination or passive immunization seem to affect nicotine pharmacokinetics in a similar manner, these data support the hypothesis that the primary effect of both vaccination and passive immunization is to slow rather than to prevent the distribution of nicotine to brain. The duration of antibody effect on nicotine distribution is not entirely clear, but effects persisting for up to 25 to 60 min have been reported previously (Satoskar et al, 2003;de Villiers et al, 2004). Limited data are available from analogous studies of vaccination or passive immunization for other drugs of abuse.…”

Section: Antibody Effects On Nicotine Distribution In Rats 663mentioning

confidence: 94%

Differential Effects of Passive Immunization with Nicotine-Specific Antibodies on the Acute and Chronic Distribution of Nicotine to Brain in Rats

Pentel¹,

Dufek²,

Roiko³

et al. 2006

Vaccination against nicotine blocks or attenuates nicotine-related behaviors relevant to addiction in rats. Passive immunization with nicotine-specific antibodies is an alternative to vaccination with the potential advantages of allowing control of antibody dose and affinity. In the current study, the effects of two antibodies on the distribution of nicotine to brain were evaluated during chronic nicotine administration in rats; the monoclonal antibody Nic311 (K d ϭ 60 nM) and nicotine-specific antiserum (K d ϭ 1.6 nM). Nicotine was administered via repeated i.v. bolus doses over 2 days and antibody was administered during the first day. Neither antibody appreciably reduced the chronic accumulation of nicotine in brain, despite high protein binding of nicotine in serum (98.9%) and a 73% reduction in the unbound serum nicotine concentration with the highest Nic311 dose. However, both antibodies substantially reduced the early distribution of nicotine to brain 5 min after a dose. The higher affinity antibody was no more effective than Nic311. The highest Nic311 dose produced serum antibody levels 10 times higher than those reported with vaccination. The efficacy of Nic311 was dose-related, with the highest dose producing a 76% decrease in the early distribution of nicotine to brain. These findings, along with previous data, suggest that the primary effect of passive immunization is to slow, rather than prevent, the distribution of nicotine to brain. In the setting of chronic nicotine dosing, antibodies with a moderate affinity for nicotine produced substantial effects on the early distribution of nicotine to brain and were as effective as higher affinity antibodies.