Immune response modification: imiquimod.
Imiquimod is 1-(2-methylpropyl)-1H-imidazo[4,5-c]quinolin-4-amine and has a molecular formula of C14H16N4. It was discovered by researchers at 3M Pharmaceuticals (St Paul, MN, USA) and is the newest in a class of drugs known as immune response modifiers. Imiquimod 5% cream has been formulated for the treatment of external genital and perianal warts (condylomata acuminata) in male and female patients. Each gram of 5% cream contains 50 mg of imiquimod. In preclinical studies, imiquimod induced the production of cytokines, the principal one for antiviral activity being interferon-alpha. Imiquimod does not induce direct antiviral activity, nor does it cause direct, non-specific cytolytic destruction. Preclinical studies suggest that its antiviral action results from in vivo cytokine-induced activation of the immune system. A double-blind, placebo-controlled study designed to evaluate this hypothesis has been previously presented. The results of the study showed that wart regression after treatment with imiquimod is strongly correlated with a decrease in virally infected cells and with increases in the expression of a spectrum of cytokines. This supports the hypothesis that stimulation of local cytokines by imiquimod leads to a reduction of human papillomavirus load and wart regression, without evidence of scarring.
Tyring
S
S
University of Texas Medical Branch, Galveston 77555, USA.
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000634:Aminoquinolines / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003218:Condylomata Acuminata / Q000628:therapy / Q000821:virology; D016207:Cytokines / Q000096:biosynthesis; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D000077271:Imiquimod; D007155:Immunologic Factors / Q000627:therapeutic use; D007369:Interferon Inducers / Q000627:therapeutic use*; D016898:Interferon-alpha / Q000096:biosynthesis; D008297:Male; D027383:Papillomaviridae / Q000302:isolation & purification; D010919:Placebos; D012074:Remission Induction; D019562:Viral Load
D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D016207:Cytokines; D007155:Immunologic Factors; D007369:Interferon Inducers; D016898:Interferon-alpha; D010919:Placebos; D000077271:Imiquimod