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Omiganan + imiquimod is a topical combination under investigation for the treatment of viral skin diseases such as human papillomavirus (HPV)-induced anogenital warts and high-grade squamous intraepithelial lesions. Omiganan is a synthetic cationic peptide derived from indolicidin (a cathelicidin isolated from bovine neutrophils) with broad-spectrum antimicrobial activity against bacteria and fungi. Imiquimod is an immune response modifier that acts as a toll-like receptor 7 (TLR7) agonist to stimulate innate and adaptive immune responses. The combination has shown synergistic effects in enhancing interferon responses and inflammatory cell infiltration in preclinical and early clinical studies. Omiganan enhances the interferon regulatory factor-driven and NFκB-driven responses induced by TLR7 stimulation with imiquimod, leading to increased production of cytokines such as IL-6, IL-10, MXA, IFNγ, and greater immune cell infiltration (CD4+, CD8+, CD14+ cells). This supports its evaluation for HPV-induced skin diseases[2][3][5].
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