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Thymosin Alpha-1 Rx

An independent digest of the Thymosin Alpha-1 (thymalfasin) literature — a thymic immune-modulating peptide, what four decades of trials actually measured, and where the evidence stops.

The sources // Open the papers

Thymosin Alpha-1: Where You Can Check Each Claim

This protein helps guide immune cells. You'll find the full source for every study named here, with a link that opens the paper.

What the source list lets you check

Thymosin Alpha-1 helps immune cells work together; this page lets you check each numbered claim. Goldstein's 1977 paper starts the list, which runs through the phase 3 TESTS sepsis study from 2025, a large late test meant to confirm benefit in very sick adults. The list includes lab work, cancer work, human studies, and studies that found no help. Each link opens a paper; if the paper has its own number, that number helps you find the same paper if the link moves.

  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. Garaci E. Thymosin alpha1: a historical overview. Ann N Y Acad Sci. 2007;1112:14-20. ↗
  9. Badamchian M, Goldstein AL, Sztein MB. Immune and neuroendocrine modulation with thymosins: current status of recent clinical trials in the United States. Int J Neurosci. 1990;51(3-4):365-367. ↗
  10. Billich A. Thymosin alpha1. SciClone Pharmaceuticals. Curr Opin Investig Drugs. 2002;3(5):698-707. ↗
  11. Liu B, Gong X, Chang S, Sun P, Wu J. Generation of mature Nα-terminal acetylated thymosin α 1 by cleavage of recombinant prothymosin α. ScientificWorldJournal. 2013;2013:387282. ↗
  12. Hoch K, Volk DE. Structures of Thymosin Proteins. Vitam Horm. 2016;102:1-24. ↗
  13. Binsfeld M, Hannon M, Otjacques E, et al. Impact of the immunomodulating peptide thymosin alpha 1 on multiple myeloma and immune recovery after hematopoietic stem cell transplantation. Cancer Immunol Immunother. 2015;64(8):989-998. ↗
  14. Garaci E, Pica F, Matteucci C, et al. Historical review on thymosin α1 in oncology: preclinical and clinical experiences. Expert Opin Biol Ther. 2015;15 Suppl 1:S31-S39. ↗
  15. Mandaliti W, Nepravishta R, Sinibaldi Vallebona P, Pica F, Garaci E, Paci M. Thymosin α1 Interacts with Exposed Phosphatidylserine in Membrane Models and in Cells and Uses Serum Albumin as a Carrier. Biochemistry. 2016;55(10):1462-1472. ↗
  16. Pica F, Chimenti MS, Gaziano R, et al. Serum thymosin alpha1 levels in patients with chronic inflammatory autoimmune diseases. Clin Exp Immunol. 2016;186(1):39-45. ↗
  17. Dinetz E, Lee E. Comprehensive Review of the Safety and Efficacy of Thymosin Alpha 1 in Human Clinical Trials. Altern Ther Health Med. 2024;30(2):8-15. ↗