Peripheral blood toll-like receptor 4 correlates response to candida immunotherapy of warts

Abstract

Human papilloma virus infection may be self-limiting; however, some cases may spread. There are no factors predicting the prognosis of such infections. The present study aimed to evaluate the significance of TLR4 expression in predicting the response of warts to candida immunotherapy. A total of 60 patients with different types of warts were included in the present study. A total volume of 2 ml venous blood was collected and real-time polymerase chain reaction was used to determine expression of TLR4. Patients were subjected to intralesional injection of Candida antigen into the largest wart at 2-week intervals until complete clearance or for a maximum of six sessions. Of the total 58 patients available for analysis of study results, 44 patients (75.9%) showed complete resolution with better response in younger ages. The TLR4 expression in patients with complete and partial response was significantly higher than that in patients who had no response (p = .006). Among our patients, 48.3% showed no side effects, 44.8% showed local reactions, and 6.9% showed systemic side effects. Only four patients showed recurrence after 6 months. Using receiver operating characteristic curve analysis, at cutoff of expression level >12 is accompanied by 100% specificity of TLR4 in predicting treatment response to candida immunotherapy. Candida immunotherapy is an effective warts treatment, especially in young patients. Higher PMBC TLR4 levels can predict response to candida immunotherapy.

Intralesional zinc sulfate 2% vs intralesional vitamin D in plantar warts: A clinicodermoscopic study

“…Our study showed absence of a significant correlation between age, sex, and the response to treatment in both group I and II, and this is consistent with Mohamed et al and Raghukumar et al In contrast, El‐Taweel et al and Sabry et al reported better response of younger patients for warts treatment as younger patients are more capable of mounting effective immune responses.…”

Cigarette smoking reduces the efficacy of intralesional vitamin D in the treatment of warts

“…This denotes that younger patients are more capable of mounting an effective immune responses. Sabry, Hamed, Salem, Marei, and El Sebaey () reported better response of younger patients to the intralesional injection of candida antigens for warts treatment.…”

Intralesional immunotherapy for non-genital warts: A systematic review and meta-analysis

“…A total of 54 studies of 3,446 enrolled patients was deemed finally eligible [Table 2]. Overall, 13 studies with 747 patients in the MMR group [10][11][12][13][14][15][16][17][18][19][20][21][22] ; 12 studies with 436 patients in the Candida group [23][24][25][26][27][28][29][30][31][32][33][34] ; nine studies with 311 patients in the Vitamin D group 25,[35][36][37][38][39][40][41][42] ; six studies with 235 patients in the PPD group 38,[43][44][45][46][47] ; six studies with 197 patients in the interferon-α group [48][49][50][51][52][53] ; four studies with 127 patients in the Mw group [54]…”

“…The overall complete response rate was 60.6% (95% confidence interval: 54.8-66.5%) among 53 studies with 2,548 patients [Figure 2a]. The complete response ratio of the Mw group was 73.1% (95% confidence interval: 55.6-90.6%) in four studies, [54][55][56][57]63 the Candida group was 62.6% (95% confidence interval: 53.3-71.9%) in 11 studies, 23,24,[26][27][28][29][30][31][32][33][34] MMR group was 63.2% (95% confidence interval: 53.1-73.4%) in 13 studies, [10][11][12][13][14][15][16][17][18][19][20][21][22] PPD group was 62.7% (95% confidence interval: 42.4-83.0%) in six studies, 38,[43][44][45][46][47] Vitamin D group was 54.2% (95% confidence interval: 32.7-76.0%) in eight studies, [35][36][37][38][39][40][41][42] interferon-α group was 51.9% (95% confidence interval: 27.0-76.9%) in six studies, [48]…”