Anti-nicotine vaccination: where are we?

Nicotine is the main substance responsible for dependence on tobacco-containing, products, which have a heavy impact on the public health of developed as well as non-developed countries by being a main etiologic factor for the induction of cardiovascular diseases and tobacco-related cancer. A vaccine against nicotine induces antibodies against the molecule, intercepting the nicotine on its way to its specific receptors. The binding of the antibody to nicotine in turn significantly diminishes the nicotine concentration in the brain shortly after smoking. This approach therefore interrupts the vicious circle between smoking and nicotine-related gratification. The preclinical data of our animal experiments are briefly summarized. At the end of 2003, three companies were in early clinical development of an anti-nicotine vaccine: Xenova (TA-NIC), Nabi (NicVAX) and Cytos (Nicotine-Qbeta). The carrier molecules are recombinant cholera toxin B (TA-NIC), an especially selected carrier protein (Nabi) and a virus-like particle VLP (Cytos). Another carrier is additionally used by Chilka in an advanced preclinical model, which showed superiority to cholera toxin B carrier. Cytos has successfully completed a phase I study with 40 healthy non-smoking volunteers. So far, results of a phase I trial by Cytos have shown no unexpected toxicities and phase II trials have now started in Switzerland (Cytos).