Latest Scripps Florida Collaboration Aims to Reshape Addiction Therapy

By Eric Sauter

A Scripps Florida scientist, working with the Hanley Center, a non-profit addiction recovery facility in West Palm Beach and the Florida Department of Health, is closing in on a novel blood test that could accurately predict the risk of a relapse in patients with addictions.

"We are attempting to identify reliable biomarkers for addiction that may accurately predict propensity for relapse with some temporal resolution," said Paul Kenny, a Scripps Research scientist and associate professor in molecular therapeutics at Scripps Florida. "The new collaboration with the Hanley Center is exciting because it may yield commercial and clinical human applications."

The collaboration, which Kenny described as just getting under way, is part of a larger five-year project at the Hanley Center. In the umbrella project, Barbara Krantz, CEO of Hanley Center, and Karen Dodge, professor with the University of Miami Miller School of Medicine, Department of Epidemiology and Public Health, and an epidemiologist with the Palm Beach County branch of the Florida Department of Health, have set out to determine and, to a certain degree, define what it means to recover from addiction.

"One key question is how you can determine the degree to which someone has recovered from addiction," Kenny says. "Our work at Scripps Florida adds a new element to the Hanley Center study—the distinct probability that there is something biological we can use to make an objective determination of the status of a patient's recovery."

The next major step in the collaboration involves testing blood samples from human patients at the Hanley Center for specific biomarkers. That analysis should get under way sometime in the fall or early winter, Kenny said.

"At this stage, it's not that difficult in terms of development," Kenny said. "This type of clinical trial that we're about to embark on is for a diagnostic, which is less complex than for a for potential therapeutic agent. If the test works, then we will be able to estimate the status of an individual's recovery and perhaps predict the risk of relapse. Ideally, this information could identify those most at risk of relapse, and help prevent it."

A Shared Vision

Krantz and Dodge offered their comments about the advantages of combining the science of neurobiology with clinical expertise at a meeting of The National Association of Addiction Treatment Providers in Jupiter last May. The current collaboration—Krantz calls it a consortium—brings something new and vital to the field of addiction treatment, something that she feels has been missing.

"This [work] brings the clinical and hard bench research together, which is absolutely needed in our field," she said, "Working with Paul I believe we can develop a biomarker for relapse—and eventually, that will help produce better outcomes for patients."

Krantz sees addiction as a priority public health issue, because current trends are moving in the wrong direction—for example, she said, the not well known fact that some Baby Boomers are starting to return to illicit drugs. And, she said, because addiction systems in the brain share so much common machinery with other neurological diseases, the current collaboration may turn out to be valuable beyond the confines of addiction therapy.

Karen Dodge agrees on the importance of the work.

"If we find in humans the same ability to predict relapse as in animal studies, it would give us the ability to save lives," Dodge said. "You could create a whole cottage industry based on a readily administered test for recovery. A kit would be wonderful, like a pregnancy test. With it, you could provide better services, enhance treatment protocols, and introduce more aggressive case management and peer advocacy when needed."

Searching for a Better Diagnosis

In his research to date, Kenny has found similar brain systems and chemistry are involved in the process of addiction, no matter what the substance—cocaine, heroin, tobacco, or alcohol. 

In the new study, the group will analyze the recovering addicts' blood samples for molecules they've discovered in the lab, including neuropeptides and nucleic acids.

In a paper published last year in the journal Proceedings of the National Academy of Sciences (December 9, 2008, vol. 105, no. 49), Kenny and his colleagues demonstrated in animal studies that hypocretin plays a key role in the motivational properties of nicotine, and may be a key neurobiological factor in maintaining tobacco addiction in human smokers. Thus, one candidate for further investigation as a viable biomarker for addiction and recovery is blood levels of hypocretin.

Having access to Hanley Center volunteer data is a chance to move these findings closer to a potential clinical application.

"Ultimately, these things could be connected—developing biomarkers and developing treatments for addiction," he said.  

Send comments to: mikaono[at]scripps.edu

"If the test works, then we will be able to estimate the status of an individual's recovery and perhaps predict the risk of relapse," says Associate Professor Paul Kenny.