Targeting nicotine addiction: the possibility of a therapeutic vaccine

• Published in: Drug design, development and therapy Vol. 5; no. default; pp. 211 - 224
• Main Authors: Escobar-Chávez, José Juan, Domínguez-Delgado, Clara Luisa, Rodríguez-Cruz, Isabel Marlen
• Format: Journal Article
• Language: English
• Published: New Zealand Taylor & Francis Ltd 2011; Dove Press; Dove Medical Press
• Subjects: Addictions; Amine oxidase (flavin-containing); Animals; Brain; Bupropion; Cardiovascular diseases; Cigarette smoking; Clonidine; Dependence; Dopamine; Dopamine D3 receptors; Drug addiction; Drug dependence; Drug development; Drug interaction; Drugs; Health risks; Heart diseases; Humans; Lung cancer; Lung diseases; Mecamylamine; Nicotine; Nicotine - agonists; Nicotine - antagonists & inhibitors; Nicotine - immunology; Nicotine - pharmacology; nicotine addiction; nicotine vaccine; Organs; Quality of life; Receptors; Regulatory agencies; Reproductive disorders; Review; Side effects; Signs and symptoms; Smoking; Smoking cessation; Smoking Cessation - methods; Tobacco Use Disorder - immunology; Tobacco Use Disorder - therapy; Vaccines; Vaccines - immunology; Vaccines - therapeutic use; Withdrawal; Wound healing; nicotine vaccine; nicotine addiction; smoking cessation
• ISSN: 1177-8881; 1177-8881
• DOI: 10.2147/DDDT.S10033

Cigarette smoking is the primary cause of lung cancer, cardiovascular diseases, reproductive disorders, and delayed wound healing all over the world. The goals of smoking cessation are both to reduce health risks and to improve quality of life. The development of novel and more effective medications for smoking cessation is crucial in the treatment of nicotine dependence. Currently, first-line smoking cessation therapies include nicotine replacement products and bupropion. The partial nicotinic receptor agonist, varenicline, has recently been approved by the US Food and Drug Administration (FDA) for smoking cessation. Clonidine and nortriptyline have demonstrated some efficacy, but side effects may limit their use to second-line treatment products. Other therapeutic drugs that are under development include rimonabant, mecamylamine, monoamine oxidase inhibitors, and dopamine D3 receptor antagonists. Nicotine vaccines are among newer products seeking approval from the FDA. Antidrug vaccines are irreversible, provide protection over years and need booster injections far beyond the critical phase of acute withdrawal symptoms. Interacting with the drug in the blood rather than with a receptor in the brain, the vaccines are free of side effects due to central interaction. For drugs like nicotine, which interacts with different types of receptors in many organs, this is a further advantage. Three anti-nicotine vaccines are today in an advanced stage of clinical evaluation. Results show that the efficiency of the vaccines is directly related to the antibody levels, a fact which will help to optimize the vaccine effect. The vaccines are expected to appear on the market between 2011 and 2012.