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Vaccine raises hope for cocaine addiction therapy

in.reuters.com

Vaccine raises hope for cocaine addiction therapy

A vaccine helped block the high felt by cocaine users in 38 percent of people who took it, U.S. researchers said on Monday, offering promise of a new approach to treating those addicted to the drug.

The aim is to prevent cocaine’s rewarding effects — the high — in order to reduce cravings that trigger drug relapses.

“The concept works,” Dr. Thomas Kosten of Baylor College of Medicine in Houston, Texas, whose study appears in the Archives of General Psychiatry, said in a statement.

Cocaine molecules on their own are too small to draw the attention of the immune system. To get the body to recognize cocaine, the researchers designed a vaccine that uses a harmless version of the cholera toxin with a few attached cocaine molecules.

When the immune system reacts to the toxin, it makes both cholera and cocaine antibodies.

“These antibodies bind to the cocaine, preventing it from leaving the bloodstream,” Kosten said. An enzyme called cholinesterase breaks down the cocaine and flushes it out of the body.

For the study, Kosten and colleagues studied 94 volunteers — mostly users of crack cocaine, which is a solid, smokable form of the drug — who were on methadone treatment at the Veterans Affairs Connecticut Healthcare System.

Over three months, the participants either got five shots of the vaccine or a placebo injection.

STUDY PLANS

Plans are under way to study the vaccine in many sites.

According to a 2007 National Survey on Drug Use and Health, 35.9 million Americans aged 12 and older reported having used cocaine, and 8.6 million reported having used crack. In 2006, cocaine accounted for about 14 percent of all admissions to drug abuse treatment programs.

Kosten said he plans to tinker with the vaccine to make it more effective. He has already tried a different carrier — a modified version of a meningitis bacterium — supplied by drug firm Merck & Co.

Animal studies showed it produced five times the antibody response as the cholera carrier.

He has used a similar approach on a nicotine vaccine called TA-NIC now being tested in Europe. Both the cocaine and nicotine vaccines are being developed through private equity firm Celtic Pharma.

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Scientists develop antidote for new class of drugs

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Scientists develop antidote for new class of drugs

A new compound can quickly counteract the action of an emerging class of drugs, offering a way to reverse the drugs’ actions if a patient develops serious side effects, U.S. researchers said on Sunday.

They designed the compound to work with a new blood-thinner being developed for heart patients undergoing angioplasty to clear out blocked arteries.

Such patients need to take blood thinners to prevent blood clots during surgery, but bleeding is a common side effect.

Having an antidote on hand would make the treatments safer, said Bruce Sullenger of Duke University Medical Center, whose study was published in the journal Nature Medicine.

But instead of just reversing the effects of the blood thinner, the antidote agent appears to work against a whole new class of drugs called aptamers.

“Most drugs target proteins. The type of drugs we’re talking about are ribonucleic acids (RNAs) that target proteins,” Sullenger said in a telephone interview.

“Normally in our body we don’t have these types of molecules outside of cells,” Sullenger said.

The antidote agent takes advantage of this, targeting only nucleic acid compounds circulating freely outside the cells.

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Over 65? Take lots of vitamin D to prevent a fall

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Over 65? Take lots of vitamin D to prevent a fall

Important news for seniors: A daily dose of vitamin D cuts your risk of falling substantially, researchers reported today.

But not just any dose will do. “It takes 700 to 1000 international units (IU) of vitamin D per day and nothing less will work,” Dr. Heike A. Bischoff-Ferrari, who directs the Center on Aging and Mobility at the University of Zurich, Switzerland, noted in an email to Reuters Health.

Those recommendations – which are higher than those by the U.S. Institute of Medicine — are based on the results of eight studies that looked at vitamin D supplements for fall prevention among more than 2,400 adults aged 65 and older. Falls were not notably reduced with daily doses of vitamin D lower than 700 IU.

An analysis of all eight studies, posted online today in the British Medical Journal, add weight to several others which have shown that vitamin D improves strength and balance, and bone health in the elderly, the researchers note.

Each year, 1 in 3 people aged 65 and older, and 1 in 2 aged 50 and older, fall at least once. Nine percent of these mishaps require a trip to the emergency room and around 6 percent result in a fracture. Many elderly people who fall end up in nursing homes.

“Falls are important events to prevent,” Bischoff-Ferrari said, “and 700 to 1000 IU of vitamin D per day is safe and inexpensive,” but it’s higher than the currently recommended by the Institute of Medicine for older adults. (The Institute recommends 400 IU per day for adults between age 51 and 70, and 600 IU per day for those aged 70 years and over.)

The current findings, Bischoff-Ferrari said, provide an argument to revise the recommendations. They looked at two forms of the vitamin: Vitamin D3, or cholecalciferol, which is more readily absorbed by the body and more potent than vitamin D2, or ergocalciferol, the form often found in multivitamins.

“At the higher dose of 700 to 1000 IU vitamin D, the benefit on fall prevention is significant — at least 19 percent, 26 percent with vitamin D3,” Bischoff-Ferrari said.

While vitamin D3 seemed more potent than D2, forms of vitamin D marketed as “active,” such as calcitriol, did not seem to be more effective than standard vitamin D supplements, the researchers found. Such active forms are more expensive and carry a higher risk of elevated calcium levels, which have been linked to hormone problems and cancer.

Moreover, the effect of 700 to 1000 IU vitamin D daily is kicks in “in a few months and is sustained over years, and the benefit is independent of age and present in those living at home and those living in nursing homes,” Bischoff-Ferrari noted.

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