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Pidotimod is a synthetic dipeptide and small molecule immunostimulant with established immunomodulatory properties. It is primarily used to stimulate both innate and adaptive immune responses in patients with documented cell-mediated immunosuppression or recurrent infections. Mechanistically, pidotimod induces maturation of dendritic cells and upregulates co-stimulatory molecules (such as HLA-DR, CD83, CD86), promotes T-cell differentiation toward the Th1 phenotype via pro-inflammatory cytokine release from dendritic cells, enhances natural killer cell activity and phagocytosis by neutrophils/macrophages, inhibits thymocyte apoptosis, increases salivary IgA levels and antigen-specific antibody titers. It also upregulates toll-like receptor signaling (notably TLR-2 and TLR-7) in respiratory epithelium. These effects collectively boost host defense against bacterial and viral pathogens[1][2][6][7]. Clinically it is indicated for prevention/treatment of recurrent upper/lower respiratory tract infections in children/adults—including asthma exacerbations—and has been studied for chronic bronchitis/COPD exacerbations as well as other infectious/inflammatory conditions[2][3][5].
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