Calcipotriol and 5 Fluorouracil (5-FU)
Cytokines are cell signalling molecules that aid cell to cell communication in immune responses and stimulate cells to move toward sites of inflammation.
Thymic stromal lymphopoeitin (TSLP) is an epithelium-derived cytokine that induces a robust anti-tumour immunity in barrier-defective skin. Calcipotriol (Daivonex), an ointment most commonly used in psoriasis, is a topical TSLP inducer.
5-FU cream (Efudix) is an anti-metabolite that blocks the growth of abnormal cells and is frequently used to treat pre-cancerous solar keratoses. But there are major disadvantages including the long treatment/healing duration (1-2 months) and the severity of the side effects – pain, irritation, burning, crusting, photosensitivity.
Calcipotriol ointment and Efudix cream used together twice daily for a 4-day treatment of solar keratoses has been shown to be more effective than using Efudix alone! The short treatment duration and minimal side-effect profile in a trial conducted at Washington University and Massachusetts General Hospital highlight the advantages of this combined therapy which resulted in a specific induction of CD4+ ’T helper cell’ immune response against solar keratoses. These are considered helper cells because they do not neutralise but trigger the body’s immune responses.