A therapy that gained notoriety during the Covid pandemic and was even used to treat Donald Trump could help alleviate the deadly epidemic of opioid overdose in the US, scientists hope.
Monoclonal antibodies — or lab-made virus-fighting proteins — fight infection by stopping the virus from entering cells, and early clinical trials found that the risk of hospitalization fell by up to 71 percent.
Now, scientists are on track to use this treatment to relieve chronic pain, forcing patients, including arthritis and cancer patients, to take several pills a day for months – at the risk of addiction.
The research at the University of California, Davis is still in its early stages, with experts currently designing an antibody that could bind to nerve cells to prevent them from sending persistent pain signals to the brain. It will be years before it hits the shelves of hospitals or pharmacies.
But scientists hope they can develop a non-addictive monthly injection as an alternative to opioids like morphine, which are used as a last resort for patients with chronic pain, usually after surgery. It can also be used to help people taking non-steroidal anti-inflammatory drugs (NSAIDs), such as arthritis and cancer patients, who may have been taking several pills a day for months.
Overdose deaths in America rose to a record nearly 108,000 deaths last year, 85 percent of which involved an opioid such as fentanyl or a prescription opioid. As many as one in five Americans suffer from chronic pain, official estimates suggest, with some opioids prescribed to treat the condition.
Scientists at the University of California, Davis hope to develop an alternative pain reliever to opioids that would not be addictive. Above are the steps required to build the alternative. They have already completed the first and identified the channels they need to block on cells to stop pain signals. But they say it will take years to develop the treatment
Scientists hope to develop a non-opioid pain reliever using monoclonal antibody technology. Right: Trump pictured at Walter Reed Army Medical Center after testing positive for Covid in October 2020. He received experimental treatment with monoclonal antibodies to help fight his infection
The chart above shows the number of deaths from opioid overdoses, and is from the Centers for Disease Control and Prevention (CDC). This shows that the number of fatalities reached a record high in 2020, the last year for which figures are available. Opioid overdose deaths account for about 80 percent of all overdose deaths
dr. Vladimir Yarov-Yarovoy (above) is a chief scientist of research taking place at UC Davis.
People who prescribe opioids to treat chronic pain are at high risk of becoming dependent on the powerful drugs, scientists warn.
The researchers want to make antibodies that can bind to three specific channels on nerve cells that send pain signals to the brain.
This will make them stop functioning, the scientists say, relieving chronic pain for up to a month — roughly how long antibodies stay in the body.
The aim of the research is to create antibodies that will bind to those three specific sites on the nerve cells, inhibiting their activity and stopping the transmission of pain signals.
They are currently designing the antibodies, which are then tested on neural tissue before moving on to animal testing. It is still years away from reaching humans.
“Recent breakthroughs in structural and computational biology — the use of computers to understand and model biological systems — have paved the way for adopting novel approaches to create antibodies as superior therapeutic candidates for treating chronic pain,” Yarov said. -Yarovoy, the principal investigator.
How would the treatment go?
– Scientists use advanced computer programs to design complex virtual models of proteins.
– They analyze which proteins fit best with three specific ion channels in nerve cells, which are responsible for transmitting pain signals in the body.
– They create antibodies that will bind to those three specific channels on the nerve cells, inhibiting their activity and preventing them from sending pain signals.
– A patient with chronic pain receives a monthly infusion of the monoclonal antibodies.
Source: University of California, Davis
This will be the first attempt at targeting monoclonal antibody technology for pain relief. UC Davis researchers received $1.5 million in grants last April from the National Institutes of Health, the federal government’s primary agency for biomedical and public health research.
The goal, Yarov-Yarovoy said, is to make antibodies in the lab that fit into three specific voltage-gated sodium ions in nerve cells, like keys in locks. IV treatment with monoclonal antibody is expected to effectively block pain for about a month, eliminating the need to reach for pills.
“For patients with chronic pain, that’s exactly what you need,” Yarov-Yarovoy said. “They experience pain, not for days, but weeks and months.”
Researchers predict that this type of antibody treatment could be given intravenously on a monthly basis, as it typically takes a month for the antibodies to break down in the body.
Yarov-Yarovoy added, “The circulating antibodies are expected to provide long-term pain relief for weeks.”
After identifying the proteins that attach to the three nerve channels associated with pain, the scientists create antibodies that bind to those sites and block pain signals from traveling.
They then test the formulated antibodies on neural tissue in a lab, as the experiment is not yet ready for animal or human testing.
If successful, the experiment would play an important role in curbing the ongoing opioid addiction crisis fueled by many physicians who aggressively overprescribe and underestimate the risk of becoming dependent on the drugs.
In October 2020, Donald Trump was treated with an experimental antibody cocktail after testing positive for Covid. The treatment — made by Regeneron Pharmaceuticals in New York — works by binding to the virus’s spike protein it uses to invade cells, stopping an infection in its tracks.
The number of deaths from opioid overdoses has remained relatively stable since 2010. The number of opioid deaths that year was over 21,000. That percentage rose to 47,600 in 2017 and remained high at nearly 69,000 in 2020.
The number of fatal drug overdoses rose 15 percent to more than 107,000 by 2021, with 75 percent of those deaths involving an opioid, catching up with last year’s previous record, federal tracking shows.
The synthetic opioid fentanyl caused more overdoses than any other drug in 2021, leading to more than 71,000 deaths, a 23 percent increase from the previous year.
The Centers for Disease Control and Prevention reported a 30 percent increase in fatal overdoses in 2020, marking a record 93,000 deaths at the time. Opioids, most commonly fentanyl or other illegal synthetic drugs, were responsible for the most overdose deaths in 2019 and 2020, accounting for 72.9 percent of deaths in 2020, compared to 70.6 percent in 2019.