Имиквимод

Описание

Aldara was launched in the US for the topical treatment of genital warts caused by human papillomavirus (HPV). It can be prepared in a six step approach beginning with the nucleophilic substitution of 4-chloro-3-nitroquinolone with isobutylamine or via a thermal electrocyclic ring closure of 1 - and 2-azahexatriene systems. Aldara has antiviral and antitumor properties, with the former activity arising from the induction of cytokines, in particular, INF-α. Aldara also induces TNF-γ, IL-1α, IL-1β, IL-1ra, IL-6, IL-8, IL-10, GM-CSF, G-CSF and MID-la formation 1-4 hr after stimuli. The exact cells responsible for the response have not been determined, however, it is not activating T lymphocytes, NK cells, B lymphocytes, or dendritic stem cells but monocytes (CD14⁺, CD36⁺, HLA-DR⁺, HLA-DQ^±, CD19^-, CD16^- and CD23^-) are partly responsible. The speculation is that Aldara may interact with a kinase modulating the transduction pathway leading to cytokine genes. There is no direct antiviral activity (induction of IFN does not follow true dose response) and it is not mutagenic. The hydroxylated metabolite also induces IFN-α.

Химические свойства

White to off white crystalline powder

Использование

Imiquimod is a caspase 3 activator which acts as an immunomodulator and displays antiviral and anti-tumor activity. It is a patient-applied cream used for the treatment of genital warts and basal cell carcinoma. It is also used to cure actinic keratosis on the face and scalp. It belongs to a group of drugs called immune response modifiers, which work by activating the immune system to fight abnormal skin growth.

Показания

Imiquimod (Aldara) is a topical immune response modifier approved for the treatment of anogenital warts (condylomata acuminata). The exact mechanism of action is unknown; it has no direct antiviral activity in vitro. It is thought to work in vivo by inducing the production of tumor necrosis factor (TNF α ), interferons (IFN)α and γ , and other cytokines with antiviral activity. It may also be useful for treatment of other types of warts, molluscum contagiosum, and certain forms of skin cancer. Local irritant reactions related to the frequency of application are common.

Фармацевтические приложения

An imidazoquinoline used for the treatment of genital and perianal warts. While the mechanism of action is not precisely known, it is thought to induce interferon. It has no direct antiviral activity. The 5% cream applied three times a week for up to 16 weeks resulted in total wart clearance in 50% of patients, with a better response in women than in men. Local reactions are common and include erythema, erosion, excoriation and edema.

Биологическая активность

Immunomodulator that displays antiviral and antitumor activity. Acts as a Toll-like receptor 7 (TLR-7) agonist; stimulates proinflammatory cytokine production and activates NF- κ B.

Механизм действия

Imiquimod (Aldara) is an imidazoquinolone amine that is an immune responsemodifier. Its exact mechanism is unknown in the topical treatment of HPV and molluscum contagiosum but may be related to the immunomodulating effect of the drug. It is also effective in the treatment of actinic keratoses and superficial basal cell carcinoma.
It induces production of a variety of cytokines and can enhance cell-mediated cytolytic antiviral activity. It is a rapid and potent inducer of interferon-α, interleukin?1 α and β, interleukin 6, interleukin 8, tumor necrosis factor-α, granulocyte-macrophage colony-stimulating factor, and granulocyte colonystimulating factor. Systemic absorption is minimal. It is generally well tolerated. Adverse local reactions include erythema, erosion, excoriation, flaking, and edema of the treatment sites.