Picibanil

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Picibanil , usually also referred to as OK-432 , is a sclerolosant and immune stimulant .

Composition and properties

OK-432 consists of a lyophilized and with benzylpenicillin (Penicillin G) and hydrogen peroxide treated special strain (Su) of Streptococcus pyogenes (group A type III 3). This strain is low in virulent . Picibanil has CAS number 39325-01-4. The LD 50 value is:

Application and effect

In the treatment of lymphangiomas with OK-432, positive results were achieved in children and adults. Use in first-line therapy for this indication is now being discussed.

OK-432 is injected directly into the tumor or lymphangioma ( intralesional ). It creates an immune response with local inflammation at the injection site . The proliferation of neutrophils , macrophages , NK cells and T lymphocytes is stimulated by increasing certain cytokine and interleukin levels. When Picibanil is injected into the cysts of a lymphatic disease, the inflammatory process causes the endothelia to become more permeable , which speeds up the outflow of the congested lymph . Afterwards, a shrinking process of the tissue leads to sclerosis and the regression of the cystic structures.

OK-432 was originally developed for cancer immunotherapy to induce non-specific active immunization. The results obtained in clinical studies are inconsistent.

Side effects

Transient fever , erythema , paresthesia and swelling around the injection site are described as side effects after the injection of OK-432 . Usually these side effects go away by the fourth day after the injection.

Development history

OK-432 was developed in 1967 by H. Okamoto and colleagues in Japan.

Individual evidence

  1. ↑ M. Hashimoto, K. Takashige et al. a .: Enhancement of antitumor activity of OK-432 (picibanil) by Triton X-114 phase partitioning. In: Int. Immunopharmacol. Volume 8, number 1, January 2008, pp. 12-19, doi : 10.1016 / j.intimp.2007.09.021 , PMID 18068095 .
  2. ↑ ChemCAS: Picibanil. Retrieved January 15, 2010.
  3. ^ SL Woolley et al.: Adult cystic hygroma: successful use of OK-432 (Picibanil). In: J Laryngol Otol 122, 2008, pp. 1260-1264. PMID 18430261 (Review).
  4. ↑ a b U. Waldschmidt: Therapy of lymphangiomas in childhood - special features and advantages of laser treatment. Dissertation, Charité - Universitätsmedizin Berlin, 2007.
  5. ↑ M. Katano and T. Morisaki: The past, the present and future of the OK-432 therapy for patients with malignant effusions. In: Anticancer Res 18, 1998, pp. 3917-3925. PMID 9854504 (Review).
  6. ↑ T. Taniguchi et al.: Clinical results of OK-432 injection therapy for ganglions. In: The Journal of Dermatology . 32, 2005, pp. 262-265, PMID 15863847 .
  7. ↑ a b D. Giese: Lymphatic malformations in childhood with special consideration of prognosis and late results. Dissertation, Medical Faculty of the Charité - Universitätsmedizin Berlin, 2005.
  8. ↑ B. Banieghbal and MRQ Davies: Guidelines for the successful treatment of lymphangioma with OK 432nd In: Eur J Pediatr Surg 13, 2003, pp. 103-107, PMID 12776241 .
  9. ↑ H. Okamoto, S. Shoin, S. Koshimura and R. Shimizu: Studies on the anticancer and streptolysin S-forming abilities of hemolytic streptococci. In: Jpn J Microbiol 11, 1967, pp. 323-336, PMID 4875331 (review).
  10. ↑ H. Okamoto, S. Shoin, M. Minami, S. Koshimura and R. Shimizu: Experimental anticancer studies. XXX. Factors influencing the streptolysin S-forming ability of streptococci having anticancer activity. In: Jpn J Exp Med 36, 1966, pp. 161-174, PMID 5297293 .

further reading

  • MT Poldervaart et al .: Treatment of lymphatic malformations with OK-432 (Picibanil): review of the literature. In: J Craniofac Surg 20, 2009, pp. 1159-1162. PMID 19553857 (Review)
  • MG Kim et al: The therapeutic effect of OK-432 (picibanil) sclerotherapy for benign neck cysts. In: Laryngoscope 118, 2008, pp. 2177-2181. PMID 19029851
  • S. Knipping et al: Sclerotherapy of cervical cysts with Picibanil (OK-432). In: Eur Arch Otorhinolaryngol 264, 2007, pp. 423-427. PMID 17082941
  • K. Kasahara et al .: Randomized phase II trial of OK-432 in patients with malignant pleural effusion due to non-small cell lung cancer. In: Anticancer Res 26, 2006, pp. 1495-1499. PMID 16619563
  • A. Fujino et al: A Role of Cytokines in OK-432 Injection Therapy for Cystic Lymphangioma. In: J Pediatr Surg 38, 2003, pp. 1806-1809. PMID 14666473
  • J. Laranne et al .: OK-432 (Picibanil) therapy for lymphangiomas in children. In: Eur Arch Otorhinolaryngol 259, 2002, pp. 274-278. PMID 12107533 (Review)
  • G. Claesson and R. Kuylenstierna: OK-432 therapy for lymphatic malformation in 32 patients (28 children). In: Int J Pediatr Otorhinolaryngol 1, 2002, pp. 1-6. PMID 12127216
  • C. Luzzato et al .: Sclerosing treatment of lymphangiomas with OK-432. In: Arch Dis Child 82, 2000, pp. 316-318. PMID 10735841
  • M. Mikhail et al .: Sclerosing of recurrent lymphangiomas using OK-432. In: J Pediatr Surg 30, 1997, pp. 1159-1160. PMID 7472972
  • S. Ogita et al .: OK-432 therapy for lymphangioma in children: Why and how does it work? In: J Pediatr Surg 31, 1996, pp. 477-480. PMID 8801295
  • S. Ogita et al .: OK-432 Therapy in 64 Patients with Lymphangioma. In: J Pediatr Surg 29, 1994, pp. 784-785. PMID 8078021
  • S. Ogita et al .: Treatment of cystic hygroma in children with special reference to OK-432 therapy. In: Z Kinderchir 42, 1987, pp. 279-281. PMID 2446443
  • S. Kai et al .: Studies on the immunopotentiating effects of a streptococcal preparation, OK-432. I. Enhancement of T cell-mediated immune responses of mice. In: Clin Exp Immunol 37, 1979, pp. 98-105. PMID 314874 ; PMC 1537677 (free full text)