The use of immunotherapy in the treatment of drug addiction: a literature review



Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

BAKGRAUND. This study addresses the pressing issue of finding new treatments for drug addiction. The article briefly assesses the dynamics of illicit use of new psychoactive substances, characterizes various approaches to treating drug use disorders, and analyzes the main factors hindering the successful use of immunotherapy for opioid addiction. The authors emphasize the need for further research into ways to optimize the immune response and address the risk of drug transition during immunotherapy.

AIM: – To conduct a systematic review of published research results in the field of drug addiction treatment, critically analyze the evidence base on the effectiveness of opioid vaccines and monoclonal antibodies, and assess the prospects for their practical application.

METHODS: The theoretical and methodological basis of the study was based on the data of scientific publications presented in international (PubMed, Web of Science) and Russian (RSCI, Scientific Electronic Library) bibliometric databases, as well as materials from the annual reports of the International Narcotics Control Board and materials from the State Narcotics Committee. The "depth of immersion" was 56 years.

RESULTS. Immunotherapy is considered one of the most promising areas of research in the treatment of substance use disorders, particularly opiates and opioids. Vaccines that block psychoactive substances are currently being developed by research centers and biotechnology companies in the United States, Mexico, China, Russia, and several other countries. Despite promising results, no opioid immunotherapy regimen has been approved for human use, so further research is needed to evaluate safety, efficacy, and long-term outcomes.

CONCLUSION. A scientific review has shown that, despite numerous studies, there is currently no conclusive evidence of the effectiveness of vaccines and monoclonal antibodies against drug addiction. This may be due to low antibody levels or an unstable antibody response, variability in antibody responses among individuals, and continued drug use despite the presence of antibodies.

Full Text

Restricted Access

About the authors

Ekaterina Alexeichuk

Saint Petersburg State Chemical-Pharmaceutical University, Saint Petersburg, Russia

Author for correspondence.
Email: kati1882@mail.ru
ORCID iD: 0000-0001-9241-9519
SPIN-code: 8730-4623
Scopus Author ID: 59367070600

кандидат фармацевтических наук, доцент кафедры управления и экономики фармации

Russian Federation, 197022, Russia, St. Petersburg, vn.ter.g. municipal district Aptekarsky Island, st. Professora Popova, 14, lit. A

Yuri Miroshnichenko

Saint Petersburg State Chemical-Pharmaceutical University, Saint Petersburg, Russia

Email: miryv61@gmail.com
ORCID iD: 0000-0002-3645-2071
SPIN-code: 9723-1148
Scopus Author ID: 56958409800

Professor, Doctor of Pharmaceutical Sciences, Director of the Institute of International Educational Programs

Russian Federation, 197022, Russia, St. Petersburg, vn.ter.g. municipal district Aptekarsky Island, st. Professora Popova, 14, lit. A

Svetlana Shport

V.P. Serbsky National Medical Research Center of Psychiatry and Narcology, Moscow, Russia

Email: shport.s@serbsky.ru
ORCID iD: 0000-0003-0739-4121
SPIN-code: 2926-9305
Scopus Author ID: 8315485700

Doctor of Medical Sciences, General Director

Russian Federation, 119034, Russia, Moscow, Maly Kropotkinsky per., 23

Anatoly Sakharov

National Scientific Center for Narcology – a branch V.P. Serbsky National Medical Research Center for Psychiatry and Narcology, Moscow, Russia

Email: sakharov.a@serbsky.ru
ORCID iD: 0000-0001-8835-6607
SPIN-code: 1441-4806
Scopus Author ID: 57573600700

Associate Professor, Doctor of Medical Sciences, Director

Russian Federation, 109559, Russia, Moscow, st. Stavropolskaya, 27, building 7.

References

  1. Hosztafi S, Galambos AR, Köteles I, Karádi DÁ, Fürst S, Al-Khrasani M. Opioid-Based Haptens: Development of Immunotherapy. Int J Mol Sci. 2024 Jul 16;25(14):7781. doi: 10.3390/ijms25147781. PMID: 39063024; PMCID: PMC11277321.
  2. Report of the International Committee for Drug Control for 2025 (E/INCB/2025/1.)
  3. Berzina A.G., Ulyanova L.I., Savina M.A., Burkova A.A. The effect of antiidiotypic antibodies to morphine on the behavior of vaccinated rats in an experiment with using the preparation of nanoparticles from birch bark triterpenoids as an adjuvant // Issues of narcology. – 2023. – Vol. 35, No 3. – P. 85–97. (In Russ).
  4. Bremer P.T., Janda K.D. Conjugate vaccine immunotherapy for substance use disorder // Pharmacological Reviews. 2017. Vol. 69, No 3. P. 298–315. doi: 10.1124/pr.117.013904
  5. Bloom BT, Bushell MJ. Vaccines against Drug Abuse-Are We There Yet? Vaccines (Basel). 2022 May 27;10(6):860. doi: 10.3390/vaccines10060860. PMID: 35746468; PMCID: PMC9230984.
  6. Morozova V.S., Myagkova M.A., Suslov V.V., Kedik S.A. Vaccines for the Treatment and Prevention of Drug Addiction // Development and Registration of Medicines. – 2016. – No. 4 (17). – Pp. 68–74. – EDN WYZAOM. (In Russ).
  7. Bonese KF, Wainer BH, Fitch FW, et al. Changes in heroin self-administration by a rhesus monkey after morphine immunisation. Nature 1974; 252:708–710.
  8. Patent 2548802 of the Russian Federation. Immunogen for the Treatment and Prevention of Opioid Addiction / N.B. Gamaleya, A.G. Berzina, K.A. Shestakov, G.D. Kapanadze, A.O. Revyakin, and Yu.V. Fokin. A61K 39/395. 2015. (In Russ).
  9. Search for Effective Antibodies to Morphine Derivatives / A.G. Berzina, D.Kh. Ismailova, D.V. Khvostov, [et al.] // Biomedicine. – 2025. – Vol. 21, No. 2. – Pp. 17-26. – doi: 10.33647/2074-5982-21-2-17-26. – EDN RCEQTN. (In Russ).
  10. Gamaleya N.B., Berzina A.G., Shestakov K.A., Kapanadze G.D., Revyakin A.O., Fokin Yu.V. Immunogen for the Treatment and Prevention of Opioid Addiction. Russian Federation Patent No. 2548802, published on April 20, 2015. (In Russ).
  11. Berzina A.G., Ulyanova L.I., Savina M.A., Burkova A.A. The effect of anti-idiotype antibodies to morphine on the behavior of vaccinated rats in an experiment using nanoparticles of birch triterpenoids as an adjuvant. Issues of Narcology. 2023; 35(3):85-97. (In Russ).
  12. Karkishchenko V.N., Berzina A.G., Klimova T.A., Gamaleya N.B., Ageldinov R.A., Kuznetsov A.E., Korsun I.C., Nesterov M.S., Ulyanova L.I. Formation, Characterization, and In Vivo Testing of Liposomalized Anti-Idiotypic Antibodies to Morphine Derivatives. Biomedicine. 2021;17(4):8–17. (In Russ).
  13. M.D. Hambuchen, D. Rüedi-Bettschen, D.K. Williams, H. Hendrickson, S.M. Owens. Treatment of rats with an anti-(+)-methamphetamine monoclonal antibody shortens the duration of action of repeated (+)-methamphetamine challenges over a one month period // Vaccine. 2014. V. 32(47). P. 6213-6219.
  14. Patent No. 2745374 C1 Russian Federation, IPC A61K 39/395, A61P 25/36. Monoclonal antiidiotypic antibody AI-K11B with antigenic properties of morphine: No. 2020109408: application 03.03.2020: published 24.03.2021 / A.V. Trofimov, N.P. Gorbunov, A.M. Ishchenko [et al.]; applicant Federal State Unitary Enterprise State Research Institute of Particularly Pure Biopreparations of the Federal Medical and Biological Agency, Federal State Budgetary Institution V.P. Serbsky National Medical Research Center of Psychiatry and Narcology of the Ministry of Health of the Russian Federation. – EDN JTLQHH. (In Russ).
  15. Patent No. 2717989 C1, Russian Federation, IPC C07K 16/42. Monoclonal anti-idiotype antibody AI-G1 with morphine-like antigenic properties: No. 2019121282: filed on July 4, 2019: published on March 27, 2020 / A.V. Trofimov, N.P. Gorbunov, A.M. Ishchenko [et al.]; applicant Federal State Unitary Enterprise State Research Institute of Particularly Pure Biopreparations of the Federal Medical and Biological Agency, Federal State Budgetary Institution V.P. Serbsky National Medical Research Center of Psychiatry and Narcology of the Ministry of Health of the Russian Federation. – EDN XMQLOC. (In Russ).
  16. United States Food and Drug Administration. Overdose prevention framework [Internet] United States Food and Drug Administration. 2022. [cited 2022 Jan 9]. Available from: https://www.fda.gov/media/160381/download.
  17. Bell J, Strang J. Medication treatment of opioid use disorder. Biol Psychiatry 2020;87:82–88. Provides an overview of the strengths and weaknesses of the current medications to treat opioid use disorder.
  18. Martinez S, Harris H, Chao T, Luba R, Pravetoni M, Comer SD, Jones JD. The potential role of opioid vaccines and monoclonal antibodies in the opioid overdose crisis. Expert Opin Investig Drugs. 2023 Mar;32(3):181-185. doi: 10.1080/13543784.2023.2187286. Epub 2023 Mar 6. PMID: 36863002; PMCID: PMC10065938.
  19. Hicks D, Baehr C, Silva-Ortiz P, Khaimraj A, Luengas D, Hamid FA, Pravetoni M. Advancing humanized monoclonal antibody for counteracting fentanyl toxicity towards clinical development. Hum Vaccin Immunother. 2022 Nov 30;18(6):2122507. doi: 10.1080/21645515.2022.2122507. Epub 2022 Oct 4. PMID: 36194773; PMCID: PMC9746415.
  20. Akbarzadeh A., Norouzian D., Farhangi A., et al. Immunotherapy of 347 volunteer outpatient morphine addicts by human therapeutic morphine vaccine in Kermanshah province of Iran. J. Pharmacol. Toxicol 2008;4:30–35.
  21. Akbarzadeh A, Norouzian D, Farhangi A, et al. Study of human therapeutic morphine vaccine: safety and immunogenicity. Asian J Biochem 2006; 2:58–65.
  22. Myagkova, M. A. Vaccines for the Treatment of Chemical Addictions - a New Approach in the Immunotherapy of Diseases / M. A. Myagkova, V. S. Morozova // Proceedings of the Academy of Sciences. Chemical Series. – 2018. – No. 10. – Pp. 1781-1793. (In Russ).
  23. Hoogsteder PH, Kotz D, van Spiegel PI, Viechtbauer W, van Schayck OC. Efficacy of the nicotine vaccine 3'-AmNic-rEPA (NicVAX) co-administered with varenicline and counselling for smoking cessation: a randomized placebo-controlled trial. Addiction. 2014 Aug;109(8):1252-9. doi: 10.1111/add.12573. Epub 2014 Jun 3. PMID: 24894625.
  24. Martell BA, Orson FM, Poling J, Mitchell E, Rossen RD, Gardner T, Kosten TR. Cocaine vaccine for the treatment of cocaine dependence in methadone-maintained patients: a randomized, double-blind, placebo-controlled efficacy trial. Arch Gen Psychiatry. 2009 Oct;66(10):1116-23. doi: 10.1001/archgenpsychiatry.2009.128. PMID: 19805702; PMCID: PMC2878137.
  25. Grimstein C, Bai JP. Individualizing therapy of monoclonal antibodies and fusion proteins: emerging potential in the age of personalized medicine. Ther Deliv. 2011 Mar;2(3):369-81. doi: 10.4155/tde.10.101. PMID: 22834007.
  26. Mirsadeghi S, Larijani B. Personalized Medicine: Pharmacogenomics and Drug Development. Acta Med Iran. 2017 Mar;55(3):150-165. PMID: 28282716.
  27. Han Y, Cao L, Yuan K, Shi J, Yan W, Lu L. Unique Pharmacology, Brain Dysfunction, and Therapeutic Advancements for Fentanyl Misuse and Abuse. Neurosci Bull. 2022 Nov;38(11):1365-1382. doi: 10.1007/s12264-022-00872-3. Epub 2022 May 15. PMID: 35570233; PMCID: PMC9107910.
  28. Pravetoni M, Pentel PR, Potter DN, Chartoff EH, Tally L, LeSage MG. Effects of an oxycodone conjugate vaccine on oxycodone self-administration and oxycodone-induced brain gene expression in rats. PLoS One. 2014 Jul 15;9(7):e101807. doi: 10.1371/journal.pone.0101807. PMID: 25025380; PMCID: PMC4099132.
  29. Pravetoni M, Le Naour M, Harmon TM, Tucker AM, Portoghese PS, Pentel PR. An oxycodone conjugate vaccine elicits drug-specific antibodies that reduce oxycodone distribution to brain and hot-plate analgesia. J Pharmacol Exp Ther. 2012 Apr;341(1):225-32. doi: 10.1124/jpet.111.189506. Epub 2012 Jan 18. PMID: 22262924; PMCID: PMC331069.
  30. Townsend EA, Blake S, Faunce KE, Hwang CS, Natori Y, Zhou B, Bremer PT, Janda KD, Banks ML. Conjugate vaccine produces long-lasting attenuation of fentanyl vs. food choice and blocks expression of opioid withdrawal-induced increases in fentanyl choice in rats. Neuropsychopharmacology. 2019 Sep;44(10):1681-1689. doi: 10.1038/s41386-019-0385-9. Epub 2019 May 2. PMID: 31043682; PMCID: PMC6784909.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) Eco-Vector

License URL: https://eco-vector.com/for_authors.php#07
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 77760 от 10.02.2020.