Vaccine promises to cure alcoholism, but without mental health treatment, could society swap one addiction for another?
Splitting headaches and waves of nausea – a drinker’s worst enemy – may soon provide alcoholics with an unlikely rescue from a crippling addiction. A preclinical trial for the Universidad de Chile’s alcoholism vaccine, set to break ground in February, will use mice to determine dosing. Researchers will apply the findings to a human trial in November this year.
Dr. Juan Asenjo, director of the Institute for Cell Dynamics and Biotechnology at Universidad de Chile, thinks that although the vaccine is not a cure-all, it could provide an important first step.
“People who end up alcoholic have a social problem; a personality problem because they’re shy, whatever, and then they are depressed, so it’s not so simple,” Asenjo said. “But if we can solve the chemical, the basic part of the problem, I think it could help quite a bit.”
The preclinical trial precludes the phase one clinical trial in India, when doctors will inject people with the vaccine for the first time. If all goes well, the vaccination could be available as soon as two years from now, according to Asenjo.
The vaccine could affect hundreds of millions of alcoholics worldwide. In Chile, one in 15 men have an alcohol use disorder, according to the most recent 2011 study from the World Health Organization (WHO).
“If it works, it’s going to have a worldwide impact, but with many vaccines one has to test them carefully. I think the chances that this one will work are quite high,” said Asenjo.
Normally, the liver turns alcohol into the compound acetaldehyde, which can be thanked for the vicious hangovers that often follow heavy drinking. An alcohol-metabolizing enzyme then breaks the compound down.
The vaccine would work for six months to one year through RNA, which can control gene expression. The so-called anti-aldh2 antisense RNA acts as a messenger to tell the liver not to express genes that metabolize alcohol. In other words, the vaccine ups the ante on hangovers in order to discourage consumption.
Asenjo said his research team in Chile is heading up the only trial of alcohol vaccines in the world, but the concept isn’t new.
Nearly a century ago, a drug called Disul?ram hit the shelves. Disulfiram blocks the enzyme from breaking down alcohol, thus intensifying the body’s negative response to alcohol.
The drug doesn’t ease intense cravings and has a high toxicity level. Coping with harsher hangovers is apparently a tough pill to swallow as patients often don’t continue taking the medicine as directed.
The vaccine, once injected, can’t be reversed until completion.
Inspiration for the vaccine struck from the far East, said Asenjo. Some hangover-prone individuals have a gene mutation that, like Disulfiram, inhibits the breakdown of alcohol and subsequently slashes alcoholism rates among those with the gene.
“People who are Japanese, Chinese or Korean and have this mutation – Let’s say 15 to 20 percent of the population – they don’t touch alcohol, and that’s because they feel bad with the vomit and the nausea,” Asenjo said.
Chile’s National Commission for Scientific and Technological Research’s (CONICYT) Fondef program, which gives money to develop science and technology, financed researchers at Universidad de Chile to look into this phenomenon. They found a way to alter a person’s gene expression to mimic this gene mutation, thus providing a long-term treatment.
The only lasting treatment currently available demands an iron will, according to the director of general services at Alcoholics Anonymous (AA) Chile. He said hasn't picked up a drink in the past 36 of his 75 years.
The recovering alcoholic, who asked to remain anonymous, agreed that a vaccine alone can’t solve addiction.
“Personally, I hope it works, but it’s not so easy for the person who already has alcoholism,” said the director. “Once you have this problem. You don’t have a solution. You pick up a drink, think you can handle a few, but it’s not possible.”
He leafed through a long list of AA’s sister organizations from Neurotics Anonymous, Smokers Anonymous to Compulsive Shoppers Anonymous. A vaccine, he said, can’t cure all. It won’t fix the mental challenges that plague addicts. They might latch onto an even more lethal substance with alcohol out of the picture.
“I had a friend. He quit drinking. Then he became a terrible smoker. He was connected to an oxygen tank for two months to keep him alive,” said the director.
“A person needs to confront themselves,” he added.
source: http://www.santiagotimes.cl
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