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BCG polysaccharide + nucleic acid (BCG-PSN) is an immunomodulatory biologic derived from a lipopolysaccharide fraction extracted from the Bacillus Calmette–Guérin (BCG) vaccine. It consists of bacterial polysaccharides and nucleic acids. Unlike live BCG vaccine, BCG-PSN does not contain viable mycobacteria but retains strong immunomodulatory properties. Its mechanism involves modulation of immune responses—downregulating Th17 lymphocyte subsets and associated cytokines (such as IL-17 and IL-23), reducing IgE levels, and influencing inflammatory pathways including interleukin 4, interleukin 13, and interleukin 31. Clinically, it has been used for the treatment of warts (verrucae), chronic urticaria, atopic dermatitis, lichen planus, asthma, vitiligo (often in combination with other therapies), and has shown higher efficacy with fewer side effects compared to live BCG vaccine in some indications[1][3][4][5][6][7]. Administration is typically by intralesional or intramuscular injection.
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