streptococcus pyogenes preparation

Picibanil, also known as OK-432, is a lyophilized biological preparation made from the Su strain of *Streptococcus pyogenes*, which has been attenuated with penicillin and heat treatment. [2, 17] It functions as a potent immunomodulator or biological response modifier. [18] Its primary mechanism involves stimulating a robust local inflammatory and immune response, mediated in part through Toll-like receptor 4 (TLR4). [6, 12] This leads to the production and release of various cytokines, including interferons, interleukins (IL-1, IL-2, IL-6, IL-12), and tumor necrosis factor-alpha (TNF-α), and the activation of innate and adaptive immune cells such as macrophages, natural killer (NK) cells, and cytotoxic T-lymphocytes. [4, 5] In the treatment of lymphatic malformations, this induced inflammation leads to sclerosis and fibrosis, causing the collapse and resolution of the cysts. [1, 3] In oncology, it is used to enhance the host's anti-tumor immune response. [14] Developed by Chugai Pharmaceutical, Picibanil is approved in Japan, Taiwan, and South Korea for several indications, including certain cancers and lymphatic malformations. [6, 14]

Brand names

PicibanilSapylin

Other names

lyophilized streptococcal preparationheat-treated Su strain of Streptococcus