title: [Treatment and prevention of tobacco addiction. Antinicotinic vaccine].
abstract: Tobacco addiction and its consequences are considered the leading avoidable cause of death, because of the great addictive power of nicotine, the main component in tobacco preparations. The addictive mechanism of nicotine is the stimulus of nicotinic cholinergic receptors at the mesolimbic areas of the brain, which in turn stimulate dopamine release in the brain centres of reward (mainly n. accumbens). Treatment of tobacco addiction includes nicotine replacement therapy (gums and dermal patches), pharmacological therapies (i.e. bupropion, varenicline) as well as behavioural and psychological support. Vaccination against nicotine addiction is a new approach, still in study (ongoing phase III clinical trial) as new treatment of tobacco addiction. The efficacy of such vaccines for smoking cessation is dependent upon their ability to increase concentration of nicotine antibodies. Nicotine vaccine stimulates immune system leading to the production of nicotine specific antibodies. These are linked to a larger carrier protein resulting complex too large to cross the blood-brain barrier, leading to a blockade of dopamine releasing mechanisms in the brain rewarding circuit. Several clinical trials currently carried out to assess the ability of nicotine vaccines in the prevention of tobacco dependence are reviewed here.
authors.forename: Pedro Lorenzo
authors.initials: PL
authors.lastname: Fernández
mesh_terms: D006801:Humans; D009538:Nicotine / Q000276:immunology*; D014029:Tobacco Use Disorder / Q000517:prevention & control / Q000628:therapy*; D014612:Vaccines
chemical_list: D014612:Vaccines; D009538:Nicotine