Azoximer Bromide: Mystery, Serendipity, and Promise

Abstract

Azoximer bromide (AZB) was identified as an immunomodulator, and was initially developed and currently successfully indicated as one of several natural polyelectrolytes, a vaccine adjuvant, and an effective agent for the treatment of infectious and inflammatory diseases of viral, bacterial, and fungal origin. AZB has the potential to increase an individual’s resistance to local and general infection and is indicated for the treatment of viral infections, and has also demonstrated clinical efficacy in the treatment of a variety of secondary immunodeficiencies. However, AZB may offer long-term promise beyond use against infection. Multiple clinical trials and research studies in cancer patients have reported favourable outcomes with AZB as well as an optimal safety and tolerability profile. The findings raise the possibility of direct antitumor properties. This literature review analyses the novel mechanisms that mediate the AZB direct anticancer effects. Overall, the evidence suggests that AZB has the hallmark of an agent that could be used to support existing cancer treatments at different stages of disease.

Azoximer bromide and hydroxyapatite: promising immune adjuvants in cancer

“…AZB is synthesized by partial oxidation of the parent polymer with hydrogen peroxide to introduce N-oxide groups, followed by the quaternization of non-oxidized amino groups with bromoacetic acid. AZB is licensed and authorized in Russia, the Commonwealth of Independent States, and Slovakia, for infectious and inflammatory diseases 50 . In 2008 the World Health Organization (WHO) assigned the international non-proprietary name (INN) to the drug, Polyoxidonium ® -AZB 51 .…”

“…In 2008 the World Health Organization (WHO) assigned the international non-proprietary name (INN) to the drug, Polyoxidonium ® -AZB 51 . The biological activity is mainly observed in the bridging of inflammatory responses to immune responses, the activation of phagocytic cells, T- and NK-cells, the maturation of DCs, the modulation of the synthesis of cytokines, such as IF-alpha and -gamma, antitoxic activities, and membrane stabilizing effect 50 , 52 . AZB binding has been shown to occur more rapidly with monocytes and neutrophils than lymphocytes.…”

Analysis of the safety and immunogenicity profile of an azoximer bromide polymer-adjuvanted subunit influenza vaccine.

“…The addition of AZB to influenza SU vaccine enhances antibody production, even in immunosuppressed mice. 19,21,22 In the Grippol formulations, AZB allows a reduction in the amount of HA antigen required per dose. 23 This antigen-sparing strategy raises two questions:…”

“…mean fold increase (MFI) (post-vaccination GMT: pre-vaccination GMT ratio). For annual re-licensing of inactivated influenza vaccines in the European Union, age-defined criteria for SPR, SCR and MFI in groups of at least 50 vaccinees, had been set by the CPMP in 1992, 19 but were withdrawn in 2016. These variables are regarded here for the purpose of completeness.…”

Analysis of the safety and immunogenicity profile of an azoximer bromide polymer-adjuvanted subunit influenza vaccine.

“…The addition of AZB to influenza SU vaccine enhances antibody production, even in immunosuppressed mice. 20 – 22 In the Grippol formulations, AZB allows a reduction in the amount of HA antigen required per dose. 23 This antigen-sparing strategy raises two questions: Does AZB itself increase vaccine reactogenicity compared with non-adjuvant vaccines, i.e.…”