Research shows that some people produce antibodies to opioid drugs

This week’s preliminary study found that patients taking opioids because of chronic pain may develop antibodies to the drug. This helps explain some of the side effects of long-term opioid use. These antibodies may also impede efforts to create opioid vaccines, and scientists hope to treat opioid use disorders better than existing drug therapies.

Researchers at the University of Wisconsin-Madison and the Scripps Institute in California have taken blood samples from 19 volunteers who were taking opioid analgesics for chronic back pain. These samples were then screened for antibodies to opioids by exposing the blood to proteins that bind the commonly used opioids hydrocodone and oxycodone. In 10 of these patients, they discovered opioid-specific antibodies. Patients with high doses of opioid therapy had higher levels of these antibodies, but the three control patients who were not taking opioids for pain had no or very low levels. ..

The survey results are Presented This week’s American Chemistry Society Fall 2020 Virtual Conference. That is, the results are based on preliminary data that has not yet undergone peer review. These conclusions are far from the established science, as the sample size of 19 patients is also very small.

But in the real case, they say, these antibodies may be part of the reason why people taking opioids develop symptoms such as hyperalgesia. One theory that researchers are exploring is that the metabolic by-products resulting from taking opioid drugs can bind to carbohydrates in the body, creating what is known as advanced glycation end products (AGE). is. These AGEs are linked Chronic inflammatory condition It is also involved in the immune system, such as diabetes and clogged arteries.

“We believe that antibodies are produced in response to opioids that modify some proteins that are normally part of the body, so antibodies can recognize opioids, but in some cases It also recognizes the “self” factor and can cause inflammation and further pain. “The researcher author UW Madison College of Pharmacy Cody Wenthur said in an email. “We are very interested in following up on this notion through direct identification and structure determination of modified proteins.”

The authors also found that these innate immune responses Potential vaccine Opioid use disorder. Some scientists, including the authors of the study, want to create a vaccine that can provoke a transient antibody response to opioids from prescription and illegal drugs. Antibodies cling to molecules from these drugs as they enter the system, blocking them from entering the brain and causing effects associated with opioid abuse, such as addictive euphoria. These vaccines are theorized and can prevent craving symptoms more than other currently available drugs, but they can also be used in combination with current medication support therapies.

In this study, volunteers made IgM antibodies against opioids. This is a short-term antibody that usually lasts several weeks. However, the vaccines these and other researchers want to develop are usually trying to produce IgG antibodies that outlast IgM antibodies. Concern is that this weak native response will make the body less responsive to vaccines and will produce a more effective antibody army.

Opioid vaccines are not Universally seen As a good idea, some harm reduction advocates are struggling with drug use, including the resources needed to develop them, providing affordable housing and more access to existing treatments. Insists that it should be used to support other means of helping people. But if the authors are correct, it will be harder than expected to reach the point where vaccines for opioid abuse are effective. Previous attempts to create a vaccine against nicotine and cocaine addiction have also failed for a variety of reasons.

Wenther and his team do not believe these findings subside the idea of ​​an opioid vaccine. And by studying these antibodies more closely, researchers hope to better understand the effects of long-term opioid use and how to develop successful vaccines.

“The possibility of producing an effective opioid vaccine is still very much alive. These results highlight possible challenges and future opportunities. Anti-opioid antibodies in the bloodstream of pre-vaccinated humans. “The levels of to help predict the relative susceptibility of the vaccine to efficacy, and perhaps also to inform them of the dose of vaccine they will receive,” he said.

Wentur said that research papers related to this research It is a peer-reviewed journal and must be published In just a few weeks.. They also plan to continue to study more people, including those who have never used opioids, to validate their findings.

This article was updated with comments from one of the study authors.