Immunomodulating activity of cimetidine in Iraqi children and adolescents with common warts

Abstract EN

Back ground and objectives : Warts are epithelial proliferations on the skin and mucous membrane caused by various types of human papilloma viruses.

Wart lesions can decrease spontaneously or increase in number and size according to patient's immune status.

Many modalities of treatments have been used but none of them proved to be uniformly effective.

Cimetidine has important effects on the immune system and are used as immunomodulator in the treatment of various skin diseases.

This study was designed to evaluate the therapeutic effectiveness and immunomodulatory activity of cimetidine among children and adolescents with multiple recalcitrant common warts.

Materials and methods : Sixty eight patients (37 female and 31 male, 3-18 years old) diagnosed with multiple recalcitrant common warts were the subject of the study during the period from February 2013 to the end of December 2013.

All patients were treated with cimetidine (40mg \ kg \ day) in two divided doses for three months duration.

Monthly visits were conducted to observe size and number of the warts and side effects of the medication.

Serum levels of IL-12, y-INF, and TNF-a were measured by ELISA technique during each of the three months duration of cimetidine therapy.

Results : The therapeutic response to high dose regime of cimetidine among the 62 patients who completed the study revealed that, 48 patients (77.5 %) had either significant clinical improvement or complete resolution of their wart lesions after the third month of the study course.

While immunological study analysis demonstrated that there was a significant (P = 0.05) increment in serum levels of IL-12, TNF-a and y-IFN after three months regime of cimetidine therapy.

Conclusions : Through its immunomodulating activity, cimetidine can be proven to offer a safe and very effective treatment option against multiple recalcitrant common warts in children and adolscents.