Cytokine induction and modifying the immune response to human papilloma virus with imiquimod

Eur J Dermatol. Oct-Nov 1998;8(7 Suppl):13-6; discussion 20-2.


Imiquimod is the newest in a class of drugs known as immune response modifiers. In preclinical studies, imiquimod induced the production of cytokines - the principal cytokine for antiviral activity being interferon alpha. Imiquimod does not inhibit viruses directly, nor does it cause direct, non-specific cytolytic destruction [1]. Preclinical studies suggest that its antiviral action results from in vivo cytokine-induced activation of the immune system. This paper reviews a recent double blind, placebo-controlled study designed to evaluate this hypothesis. The results of this study showed that wart regression following treatment with imiquimod strongly correlated with a decrease in viral DNA and gene transcripts; a decrease in mRNA expression for proteins associated with cellular proliferation, and an increase in keratinocyte markers. These results support the hypothesis that stimulation of local cytokines by imiquimod leads to a reduction in human papilloma virus (HPV) load; to wart regression and to the normalisation of keratinocyte proliferation without evidence of scarring.

MeSH terms

  • Adjuvants, Immunologic / pharmacology
  • Adjuvants, Immunologic / therapeutic use*
  • Aminoquinolines / pharmacology
  • Aminoquinolines / therapeutic use*
  • Animals
  • Clinical Trials, Phase I as Topic
  • Condylomata Acuminata / drug therapy
  • Condylomata Acuminata / immunology
  • Cytokines / biosynthesis*
  • Cytokines / drug effects
  • DNA, Viral / analysis
  • DNA, Viral / drug effects
  • Humans
  • Imiquimod
  • Interferon Inducers / pharmacology
  • Interferon Inducers / therapeutic use*
  • Papillomaviridae / genetics
  • Papillomaviridae / immunology*
  • Papillomavirus Infections / drug therapy*
  • Papillomavirus Infections / immunology
  • Randomized Controlled Trials as Topic
  • Tumor Virus Infections / drug therapy*
  • Tumor Virus Infections / immunology


  • Adjuvants, Immunologic
  • Aminoquinolines
  • Cytokines
  • DNA, Viral
  • Interferon Inducers
  • Imiquimod