Abstract

Anti-nicotine vaccines may aid smoking cessation via the induction of anti-nicotine antibodies (Ab) which reduce nicotine entering the brain, and hence the associated reward. Ab function depends on both the quantity (titer) and the quality (affinity) of the Ab. Anti-nicotine vaccines tested previously in clinical studies had poor efficacy despite high Ab titer, and this may be due to inadequate function if Ab of low affinity were induced. In this study, we designed and synthesized a series of novel nicotine-like haptens which were all linked to diphtheria toxoid (DT) as carrier, but which differed in the site of attachment of linker to nicotine, the nature of linker used, and the handle used to attach the hapten to DT. The resulting hapten conjugates were evaluated in a mouse model, using CpG (a TLR9 agonist) and aluminum hydroxide (Al(OH)3) as adjuvants, whereby Ab titers, affinity and function were evaluated using a radiolabeled nicotine challenge model. A series of additional linkers varying in length, rigidity and polarity were used with a single hapten to generate additional DT-conjugates, which were also tested in mice. Conjugates made with different haptens resulted in various titers of anti-nicotine Ab. Several haptens gave similarly high Ab titers, but among these, Ab affinity and hence function varied considerably. Linker also influenced Ab titer, affinity and function. These results demonstrate that immune responses induced in mice by nicotine-conjugate antigens are greatly influenced by hapten design including site of attachment of linker to nicotine, the nature of linker used, and the handle used to attach the hapten to DT. While both Ab titer and affinity contributed to function, affinity was more sensitive to antigen differences.

Highlights

  • Tobacco use is responsible for approximately six million deaths annually and poses a substantial burden on public health worldwide [1]

  • There was a lack of efficacy in the intent to treat (ITT) population, subgroup analyses showed enhanced long-term abstinence rate compared to placebo in smokers with the highest antibody levels [6,7]

  • The highest levels of nicotine-specific IgG were obtained with Hapten 11-diphtheria toxoid (DT) (p

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Summary

Introduction

Tobacco use is responsible for approximately six million deaths annually and poses a substantial burden on public health worldwide [1]. Pharmacological treatments currently used for smoking cessation are most often nicotine replacement therapies (e.g., gums, patches) or prescription drugs that act within the central nervous systems to reduce nicotine reward and/or symptoms of withdrawal These treatments are beneficial for promoting short-term abstinence but are only modestly effective over the long-term, with fewer than one-quarter of treated subjects remaining abstinent at the end of one year [3,4]. Two vaccines have undergone phase 2 clinical testing as monotherapies, namely NicQβ (Cytos Biotechnology), which uses a virus-like particle as carrier [6] and NicVax (Nabi Biopharmaceuticals) which uses a bacterial exoprotein as carrier [7] In both studies, there was a lack of efficacy in the intent to treat (ITT) population, subgroup analyses showed enhanced long-term abstinence rate compared to placebo in smokers with the highest antibody levels [6,7]. This indicated that better overall vaccine efficacy might be achievable if high antibody levels could be generated in a greater proportion of subjects

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