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RxTA1

What the peptide adds to care already underway.

Thymosin Alpha-1 references

The clinical comparisons and the cell experiments, with the source list in full.

Starting with a clinical question

The postoperative question brings me to the postoperative liver-cancer analysis and the oncology review. The former reports a survival association after surgery; the latter explains why an immune-active addition to cancer care has been pursued.

For sepsis, the ETASS trial and TESTS trial deserve to be considered together. The COVID-19 meta-analysis is a useful companion to the conflicting cohorts.

The comprehensive review supplies the broader clinical history. For laboratory biology, there is the dendritic-cell and tryptophan study; its cell and mouse experiments ask different questions from the clinical trials. The complete list follows.

  1. Goldstein AL, Low TL, McAdoo M, et al. Thymosin alpha1: isolation and sequence analysis of an immunologically active thymic polypeptide. Proc Natl Acad Sci U S A. 1977;74(2):725-729. ↗
  2. Wu J, Zhou L, Liu J, et al. The efficacy of thymosin alpha 1 for severe sepsis (ETASS): a multicenter, single-blind, randomized and controlled trial. Crit Care. 2013;17(1):R8. ↗
  3. Wu J, Pei F, Zhou L, et al. The efficacy and safety of thymosin alpha1 for sepsis (TESTS): multicentre, double blinded, randomised, placebo controlled, phase 3 trial. BMJ. 2025;388:e082583. ↗
  4. Dominari A, Hathaway III D, Pandav K, et al. Thymosin alpha 1: A comprehensive review of the literature. World J Virol. 2020;9(5):67-78. ↗
  5. Romani L, Bistoni F, Montagnoli C, et al. Thymosin alpha1 activates dendritic cell tryptophan catabolism and establishes a regulatory environment for balance of inflammation and tolerance. Blood. 2006;108(7):2265-2274. ↗
  6. Liu Y, Pan Y, Hu Z, et al. Thymosin Alpha 1 Reduces the Mortality of Severe Coronavirus Disease 2019 by Restoration of Lymphocytopenia and Reversion of Exhausted T Cells. Clin Infect Dis. 2020;71(16):2150-2157. ↗
  7. Costantini C, Bellet MM, Pariano M, et al. A Reappraisal of Thymosin Alpha1 in Cancer Therapy. Front Oncol. 2019;9:873. ↗
  8. Bozza S, Gaziano R, Bonifazi P, et al. Thymosin alpha1 activates the TLR9/MyD88/IRF7-dependent murine cytomegalovirus sensing for induction of anti-viral responses in vivo. Int Immunol. 2007;19(11):1261-1270. ↗
  9. Tao N, Xu X, Ying Y, Hu S, Sun Q, Lv G, Gao J. Thymosin alpha1 and Its Role in Viral Infectious Diseases: The Mechanism and Clinical Application. Molecules. 2023;28(8):3539. ↗
  10. Dinetz E, Lee E. Comprehensive Review of the Safety and Efficacy of Thymosin Alpha 1 in Human Clinical Trials. Altern Ther Health Med. 2024. ↗
  11. Pica F, Chimenti MS, Gaziano R, Bue C, Casalinuovo IA, Triggianese P, et al. Serum thymosin alpha1 levels in patients with chronic inflammatory autoimmune diseases. Clin Exp Immunol. 2016;186(1):39-45. ↗
  12. Shang W, Zhang B, Ren Y, Wang W, Zhou D, Li Y. Thymosin alpha1 use in adult COVID-19 patients: A systematic review and meta-analysis on clinical outcomes. Int Immunopharmacol. 2022;113(Pt A):109584. ↗
  13. Linye H, Zijing X, Wei P, Chao H, Chuan L, Tianfu W. Thymosin alpha-1 therapy improves postoperative survival after curative resection for solitary hepatitis B virus-related hepatocellular carcinoma: A propensity score matching analysis. Medicine (Baltimore). 2021;100(20):e25749. ↗
  14. Wang Z, Chen J, Zhu C, Liu L, Qi T, Shen Y, Zhang Y, Xu L, et al. Thymosin Alpha-1 Has no Beneficial Effect on Restoring CD4+ and CD8+ T Lymphocyte Counts in COVID-19 Patients. Front Immunol. 2021;12:568789. ↗
  15. Liu J, Shen Y, Wen Z, Xu Q, Wu Z, Feng H, Li Z, Dong X, et al. Efficacy of Thymosin Alpha 1 in the Treatment of COVID-19: A Multicenter Cohort Study. Front Immunol. 2021;12:673693. ↗
  16. Sun Q, Xie J, Zheng R, et al. The effect of thymosin α1 on mortality of critical COVID-19 patients: A multicenter retrospective study. Int Immunopharmacol. 2021;90:107143. ↗
  17. Matteucci C, Minutolo A, Balestrieri E, et al. Thymosin Alpha 1 Mitigates Cytokine Storm in Blood Cells From Coronavirus Disease 2019 Patients. Open Forum Infect Dis. 2021;8(1):ofaa588. ↗