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Minneapolis Medical Research Foundation, Minneapolis, Minnesota (D.E.K., S.A.R., E.B., M.G.L., P.R.P.); University of Minnesota College of Pharmacy, Minneapolis, Minnesota (D.E.K., J.V.S.P.); University of Minnesota Medical School and Hennepin County Medical Center, Minneapolis, Minnesota (P.R.P.); Nabi Biopharmaceuticals, Rockville, Maryland (S.S., S.F.); and Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota (C.T.L.)
Vaccination against nicotine is being studied as a potential treatment for nicotine dependence. Some of the limitations of vaccination, such as variability in antibody titer and affinity, might be overcome by instead using passive immunization with nicotine-specific monoclonal antibodies. The effects of antibodies on nicotine distribution to brain were studied using nicotine-specific monoclonal antibodies (NICmAbs) with Kd values ranging from 60 to 250 nM and a high-affinity polyclonal rabbit antiserum (Kd = 1.6 nM). Pretreatment with NICmAbs substantially increased the binding of nicotine in serum after a single nicotine dose, reduced the unbound nicotine concentration in serum, and reduced the distribution of nicotine to brain. Efficacy was directly related to antibody affinity for nicotine. Efficacy of the highest affinity NICmAb, NICmAb311, was dose-related, with the highest dose reducing nicotine distribution to brain by 78%. NICmAb311 decreased nicotine clearance by 90% and prolonged the terminal half-life of nicotine by 120%. At equivalent doses, NICmAb311 was less effective than the higher affinity rabbit antiserum but comparable efficacy could be achieved by increasing the NICmAb311 dose. These data suggest that passive immunization with nicotine-specific monoclonal antibodies substantially alters nicotine pharmacokinetics in a manner similar to that previously reported for vaccination against nicotine. Antibody efficacy is a function of both dose and affinity for nicotine.
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