466
9. Advanced Materials for the Future
effective and least expensive delivery of vac-
cines.
The potential of protein-based polymers
is to design a series of nanoparticle structures
for the delivery of a specific vaccine. Prelimi-
nary studies suggest that an appropriate series
of protein-based polymers could simultane-
ously function as adjuvant and constitute a
range of controlled release devices capable in a
single treatment of providing the primary, sec-
ondary, and as necessary even subsequent
immunizations. For example, vaccination
against anthrax is said to require six vaccina-
tions over a period of more than 1 year. The
composition would be one of nanoparticles that
would stimulate the immune response, contain
the anthrax vaccine, and be taken up through
an epitheUal fining. This would not require
hypodermic injection and in a single treatment
would provide a series of timed-release events
to fill the role of subsequent vaccinations.
9.1.6 Potential of Protein-based
Materials to Relieve Additional Major
Problems of Society
9.1.6.1 Drug Addiction Intervention
The magnitude of the worldwide drug addiction
problem requires fittle elaboration. In the
United States alone, the drug control budget for
1993 was about 12 bilUon doUars.^^ Although
periodic decreases in total number of illicit
drug users have been seen, the rise in "violent
crimes, homelessness, and drug-related emer-
gency room visits" suggests a basic limitation to
the progress possible by the education and pre-
vention focus.^^ Further progress would seem to
require an increased refiance on drug addiction
intervention rather than the current emphasis
on drug interdiction and education.
A useful narcotic antagonist is naltrexone,
which has a particularly benign side-effect
profile with a "wide range between the effec-
tive dose and the toxic dose."^^'^^ It has been
found effective in preventing re-use of heroin
after detoxification^"^^^ and even following
rapid detoxification.^^ Naltrexone (and related
cationic narcotic antagonists) are useful against
morphine, cocaine, codeine, and even alcohol
addiction^^"^^ as well as a spate of other afflic-
tions,
for example, bulimia nervosa,^^
self-
injurious behavior,^^ autism,^"^ Tourette's syn-
drome,^^ and Rett syndrome.^^ "Naltrexone is
non-addicting and has been reported to
produce few, if any, side effects. It is a unique
and important option for patients desiring a
nonaddicting treatment and total abstinence
from all mood-altering drugs."^^ Furthermore,
Sax and coworkers concluded, that "chronic
administration of naltrexone in doses up to
300mg/day for periods up to 36 months does
not significantly change hepatic function... ."^^
On the other hand, a naltrexone plasma con-
centration of 2ng/ml (approximately 1 million
times less) is sufficient "to block the effect of a
large heroin dose
(25
mg)."^^
The major limitation to the effective use of
naltrexone resides in patient compliance. As
stated by Fraser,^^ "The major limitation on the
use of naltrexone, however, is the lack of incen-
tive for the patient to keep taking the medica-
tion." As further stated by Littrel and Hyde,^^
"If patients comply with naltrexone treatment
after detoxification, opioid discontinuation is
usually maintained and craving is ablated.
However, the clinical usefulness of naltrexone
is limited by low patient acceptance "
Desirable at this point would be an
implantable naltrexone delivery system that
would not depend on patient compliance. It
could be a biodegradable controlled release
device, for example, injectable by hypodermic
syringe for relatively short-term release. Alter-
natively, it could be implanted by trocar or
by laparoscope for release for months as a
biocompatible and biodegradable yet remov-
able vehicle should patients' circumstances
warrant substantial pain control. As demon-
strated below (see Figure 9.39), properly
designed protein-based materials exhibit this
potential.
9.1.6.2 Improving the Environment
9.1.6.2.1 The Opportunity for Bioproduction
of Biodegradable Plastics
Global environmental concerns have resulted
in ever-mounting costs for disposal of soHd
waste. A particularly troubling solid waste is
nondegradable petroleum-based plastics, and