Should You Get a Nicotine Vaccine for Your Child?

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A nicotine vaccine for children may be the most useful application of a novel nicotine vaccine in the works that might cause an unintended increase in smoking with people already addicted to smoking.

Research toward a nicotine vaccine that is reportedly designed to achieve smoking cessation in addicted cigarette smokers is in a Phase 1 clinical trial of which results are expected to be released this July. The vaccine is designed to work by preventing nicotine molecules from reaching the brain and thereby deprive a smoker from achieving the high that nicotine offers. The logic to this is that once a smoker cannot get satisfaction from smoking that he or she will then quit their smoking habit.

The creation of a nicotine vaccine is the work of researchers from Selecta Biosciences—a biotech company founded by Harvard Medical School immunologists Ulrich von Andrian and Omid Farokhzad, and MIT engineer Robert Langer. The researchers and their company are focused on the novel use of synthetic nanoparticles to illicit an immune response to attack a predetermined target similar to the way the human body’s immune system responds to an infection by a virus.

The nicotine vaccine is believed to work by using specially designed synthetic nanoparticles that will stimulate the immune system to produce specialized antibodies that will bind to nicotine molecules and essentially complex the brain-stimulating nicotine into supersized nicotine compounds that are too large to pass through the blood-brain barrier. If the nicotine cannot pass through the blood-brain barrier, then the smoker’s brain is prevented from the high that comes from smoking.

"This is the first time ever that a fully integrated synthetic, nanoparticle vaccine is being tested in human clinical trials and is a very important milestone in the translation of Selecta's SVP [Synthetic Vaccine Particle] technology," says Ulrich von Andrian, Ph.D., M.D., Edward Mallinckrodt Jr. Professor of Immunopathology at Harvard Medical School and Selecta co-founder. "Selecta has demonstrated its ability to rationally design immunotherapeutics and induce a robust targeted immune response. SVP technology will revolutionize the way vaccines will be designed, produced and applied."

Currently, the nicotine vaccine is in a Phase 1 clinical trial designed as a double-blind, placebo-controlled, ascending dose study in healthy, non-smoking and smoking volunteers. The trial’s goal is to determine the safety of the vaccine in human subjects and evaluate the vaccine's potency and efficacy through the measurement of concentrations of nicotine-specific antibodies that the researchers believe have the potential to bind to inhaled nicotine.

While the idea of a nicotine vaccine is intriguing and has potential, there are doubts as to whether if it does work as planned that it will actually lead to an addicted smoker to stop smoking. Smoking addiction is a complex process that is multifactorial. Removing the sense of pleasure derived from nicotine is no guarantee that it will also remove the other factors that make for addictive behavior. This is essentially a cold-turkey technique that in the past has often been found to be unsuccessful in combating addiction. The pleasure may be removed, but the craving will remain.

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Furthermore, the researchers report that the vaccine will not be able to completely block all of the nicotine from reaching the brain. Therefore, there is the likelihood that not unlike being addicted to pain medication, that the smoker will simply increase the number of cigarettes smoked per day to satisfy his or her nicotine cravings—which of course makes things worse than before for the smoker’s health.

According to a news article by MIT’s Technology Review, Selecta's vice president, Peter Keller, acknowledges that smoking several cigarettes in a row could overwhelm the immune system to render partial pleasure, since enough free-flowing nicotine molecules would still pass through uninhibited to the brain.

Since the nicotine vaccine has what may be some fatal flaws for its use on existing smokers as a smoking cessation tool, what about its use toward smoking prevention in people before they have that first cigarette and the subsequent addictive high? If a young person is tempted to try cigarette smoking for whatever reason only to discover that their pre-vaccination with a nicotine vaccine prevents them from experiencing that addictive high, then would that not that be a more effective and practical use of the vaccine? Maybe. But this too presents problems.

One of the problems is that it is becoming increasingly difficult to convince parents to have their child immunized for any new type of vaccine let alone the common ones many of us grew up with. The more recent vaccine against human papillomavirus, or HPV, which causes cervical cancer is one example. Another difficulty in getting parents to accept the need for immunizations today is the unsubstantiated concern that some immunizations may be the cause of the rise of autism in the U.S.

Another problem is that if the nicotine vaccine is leaky and still allows some nicotine to get to the brain, it may be just enough to still cause a new addiction in a young brain that doesn’t require a full dose in order to get an addiction started.

Clearly these and many other questions are in need of answer before we can state what the true value is to having a nicotine vaccine for either smoking cessation or prevention. Will it be safe? Will it be effective? Who will it benefit other than Selecta Biosciences and its investors? And, if it turns out that the nicotine vaccine meets all expectations (or more)—should you get a nicotine vaccine for your child along with those for mumps, measles, and chicken pox?

Image Source: Courtesy of MorgueFile

Reference: MIT Technology Review

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