Pidotimod (Polimod ®) is a synthetic dipeptide molecule with biological and immunological activity on both the adaptive and the innate immune responses. In vitro studies, both from animal and human specimens, have documented a good activity on innate and adaptive immune responses and have been confirmed by in vivo studies. These activities have been applied in clinical studies demonstrating the efficacy of pidotimod in reducing the rate of recurrent infections of the upper respiratory and urinary tracts in children. The same results were obtained in recurrent respiratory tract infections in adults. Interestingly, these effects are more evident in the setting of immune defects such as senescence, Down's syndrome, and cancer.Pidotimod (Polimod ®) is a synthetic dipeptide molecule with biological and immunological activity on both the adaptive and the innate immune responses (Fig. 1). In comparison with biological response modifiers of extractive origin, the synthetic process ensures a high purity product with a high reproducibility among batches. Pidotimod is rapidly absorbed by the gastrointestinal tract with a bioavailability of 45%. The plasma half life is 4 h with poor metabolism and renal elimination of the unmodified molecule.In vitro studies from both animal and human specimens have documented a good activity on innate and adaptive immune responses and have been confirmed by in vivo studies. These activities have been applied in clinical studies demonstrating the efficacy of pidotimod in reducing the rate of recurrent infections of the upper respiratory and urinary tract in children. The same results were obtained in recurrent respiratory tract infections in adults. More importantly, these effects are more evident in the setting of immune defects such as senescence, Down's syndrome, and cancer. The aim of this review is to analyze the effects of pidotimod on the innate and adaptive immunity and the studies of clinical efficacy.
Animal studiesThe first experiments were designed to demonstrate a protective effect of pidotimod in experimental infections in mice. Mice injected intraperitoneally (i.p.) with P. mirabilis, P. vulgaris, S. aureus, K. pneumoniae or P. aeruginosa are protected from death when treated concomitantly with repeated injections ofpidotimod. The protective effect reached a 100% survival with Proteus strains, 90% with S. aureus and 40% with more aggressive bacteria such as Pseudomonas and Klebsiella strains. This effect is dose-dependent and can be strengthened by a synergistic activity with beta-lactam antibiotics