Division of Pharmacotherapies and Medical Consequences of Drug Abuse, National Institute on Drug Abuse, USA.
Adicciones. 2012;24(2):95-103.
Drug addictions are complex disorders that require multiple approaches, including the use of pharmacotherapies. Currently, these therapies are based on "small" molecules or chemicals that penetrate the blood-brain barrier, reach the brain, and produce their effects on neurotransmitter systems. Unfortunately, they often do not have the desired efficacy or may cause undesirable side effects, especially at the central nervous system (CNS) level. A novel approach is the use of biologics to treat drug addictions. Biologics are usually complex and "large" molecules, which do not cross the blood-brain barrier and, thus, have no CNS effects. In principle, it appears that the efficacy of biologics to treat drug addiction is by preventing the access of the drug of abuse to the brain, preventing the activation of brain reward systems, and eventually producing the extinction of addiction. Biologic therapeutics includes immunotherapies, such as vaccines or antibodies, as well as enzymes. New products as well as new and more efficient methods of production, are offering vast opportunities to advance the discovery and development of biologics to treat addictions as well as drug overdose. These products include new vaccines with greater specificity and ability to produce antibodies, new methods and techniques to produce vaccines and antibodies, as well as new enzymes with high efficiency to metabolize cocaine. The purpose of the article is to provide a general overview of the development of biologics for the treatment of drug addictions and overdose.
药物成瘾是一种复杂的疾病,需要采用多种方法进行治疗,包括使用药物疗法。目前,这些疗法基于能够穿透血脑屏障、到达大脑并对神经递质系统产生作用的“小分子”或化学物质。然而,这些疗法往往效果不尽如人意,或者可能会产生不良的副作用,尤其是在中枢神经系统(CNS)水平。一种新的方法是使用生物制剂来治疗药物成瘾。生物制剂通常是复杂的“大分子”,无法穿透血脑屏障,因此不会对 CNS 产生影响。从理论上讲,生物制剂治疗药物成瘾的疗效似乎是通过阻止滥用药物进入大脑、阻止大脑奖励系统的激活,最终导致成瘾的消除。生物治疗药物包括免疫疗法,如疫苗或抗体,以及酶。新产品以及新的、更有效的生产方法为推进生物制剂治疗成瘾和药物过量的发现和开发提供了巨大的机会。这些产品包括具有更高特异性和产生抗体能力的新型疫苗、生产疫苗和抗体的新方法和技术,以及具有高效可卡因代谢能力的新型酶。本文的目的是提供一个生物制剂治疗药物成瘾和药物过量的开发概况。