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T4 endonuclease V liposomal lotion is a topical formulation containing the DNA repair enzyme T4-bacteriophage endonuclease V, encapsulated within pH-sensitive liposomes. The enzyme specifically recognizes and repairs cyclobutane pyrimidine dimers (CPDs), a form of UV-induced DNA damage, by catalyzing glycosylase and AP lyase reactions that initiate base excision repair. Upon topical application, the liposomes are taken up by keratinocytes in the skin; in the acidic environment of lysosomes, they release the enzyme into cells where it diffuses to nuclei and facilitates DNA repair. This drug was developed primarily for patients with xeroderma pigmentosum—a rare genetic disorder characterized by defective DNA repair and high risk of skin cancer—and for prevention or reduction of actinic keratoses and nonmelanoma skin cancers such as basal cell carcinoma. Clinical studies showed significant reductions in new actinic keratoses and basal cell carcinomas among treated patients. Despite promising results, development was discontinued after phase 2/3 trials[1][2][3][6][8].
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