Phase 1 Clinical Trial of Intralesional Injection of Candida Antigen for the Treatment of Warts

Kim, Kevin H.; Horn, Thomas; Pharis, Joni; Kincannon, Jay; Jones, Robert; O’Bryan, Kevin; Myers, John M.; Nakagawa, Mayumi

doi:10.1001/archdermatol.2010.350

Cited by 62 publications

(81 citation statements)

References 5 publications

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“…The role of immunity is documented by the appearance and persistence of warts in immunosuppressed individuals. 7 Immunotherapy agents that have been tried include cimetidine, imiquimod, interferons, Candida albicans antigens, measles, mumps, rubella (MMR) vaccine, tuberculin (purified protein derivative) and intralesional vitamin D. [8][9][10][11][12] Intralesional tuberculin purified protein derivative (PPD) is effective for the warts over injected as well as distinct site and also prevents reoccurrence. Similarly vitamin D is an effective and a very recent modality used in treatment.…”

Section: Introductionmentioning

confidence: 99%

A comparative study between intralesional PPD and vitamin D3 in treatment of viral warts

et al. 2018

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Background: Viral warts are caused by human papillomavirus. There are innumerable treatment modalities but they may result in partial clearance or recurrence. Some newer and effective treatments include intralesional immunotherapy. We undertook a study to evaluate the safety and efficacy of two such immunotherapy namely tuberculin purified protein derivative (PPD) versus intralesional vitamin D3 for the treatment of viral warts.Methods: A total of 80 patients were included in the study. Group 1 patient were injected with 10 TU of tuberculin PPD (0.1 ml) intralesional while in group 2 patients were injected (0.5 ml) vitamin D3. The clinical assessment was done by photographic measurements at baseline, before each treatment session, and after the completion of treatment.Results: In group 1 A total of 80% (32 patients) showed complete clearance and 20% (8 patients) showed partial response while in group 2 72.5% (29 patients) showed complete clearance while 27.5% (11 patients) showed partial response. No significant side effects were observed except for pain at the site of injection.Conclusions: Intralesional vitamin D and intralesional Tuberculin PPD immunotherapy shows significant results in treatment of viral warts.

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Section: Introductionmentioning

confidence: 99%

A comparative study between intralesional PPD and vitamin D3 in treatment of viral warts

et al. 2018

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“…Candida antigen, applied via intradermal injection into an affected lesion, activates a cell-mediated immune response against the HPV via enhancement of anti-HPV T cell responses [2]. This hypothesis is further supported by multiple reports of Candida-treated patients clearing untreated warts [2][3][4].…”

Section: Candida Antigenmentioning

confidence: 80%

Management of Cutaneous Human Papillomavirus Infection: Pharmacotherapies

Ramírez-Fort

Au²,

Javed³

et al. 2014

Human Papillomavirus

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A plethora of different treatment modalities for treating human papillomavirus (HPV) are available, offering a range of efficacies and balancing several patient needs. Here we discuss pharmacotherapies for HPV, focusing in particular on the mechanism of action and treatment efficacy. Immunomodulators such as Candida antigen, imiquimod and squaric acid stimulate cell-mediated immunity and induce production of antiviral cytokines. Proapoptotic and antiviral treatments such as podophyllin resin, podophyllotoxin gel, bleomycin, 5-fluorouracil, cidofovir and interferon α interfere with the viral reproduction cycle. Other therapies include trichloroacetic acid, acitretin, cantharidin and sinecatechins, some of which operate by epidermal destruction, effects on cellular proliferation and other mechanisms of which are poorly understood. Overall, given the high HPV recurrence rates, adjunctive use of antiviral agents should be considered in treatment, especially when managing severe or complicated presentations.

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“…It was also found that 7 of 8 immuno-compromised patients showed a partial or complete response to the antigen [19]. Another study, which used higher doses of Candida antigen, reported complete response rates as high as 82% [20]. MMR vaccine has shown complete response rates as high as 75% in one study and 81% in another study.…”

Section: Efficacy Of Intralesional Immunotherapies and Intralesional mentioning

confidence: 94%

Wart Immunotherapies: A Short Review

Sefcik¹,

Burkhart²

2017

TODJ

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Objective:To review the efficacy and costs of various contact immunotherapies, contact allergens, intralesional immunotherapies, and intralesional cytotoxic agents for the treatment of recalcitrant warts. Background:Cutaneous warts are common viral skin lesions caused by human papillomavirus that can be challenging to treat and frustrating for physicians and patients. Although several treatment options exist, there is no single treatment that can ensure a complete response with lack of lesion recurrence. Immunotherapies for recalcitrant warts present as a cost-effective, efficient therapy option for patients. Intralesional approaches have the added benefit of affecting warts at locations distant to the target location by inducing a systemic Tcell mediated response in the body. Results:Various contact immunotherapies, contact allergens, intralesional immunotherapies, and intralesional cytotoxic agents have shown to be effective in treating warts. The costs of each treatment varies drastically from around $10 US to over $1000 US to achieve a complete response. Several antigens were found to be both efficacious and cost effective. Conclusion:Although efficacy of several antigens has been confirmed by randomized studies, more randomized comparative studies will need to be performed in order to determine the best antigen and correct standardized doses for the treatment of warts in individual patients. It is important to note that individual response to antigen type and dose may vary among patients. Therefore, further studies may play an important role in the use of immunotherapies in a clinical setting.

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Phase 1 Clinical Trial of Intralesional Injection of Candida Antigen for the Treatment of Warts

Cited by 62 publications

References 5 publications

A comparative study between intralesional PPD and vitamin D3 in treatment of viral warts

A comparative study between intralesional PPD and vitamin D3 in treatment of viral warts

Management of Cutaneous Human Papillomavirus Infection: Pharmacotherapies

Wart Immunotherapies: A Short Review

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