Thymosin Alpha-1

Thymosin Alpha-1

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Thymus-derived immunomodulatory peptide; dual-action Th1 stimulator and Treg inducer approved in 35+ countries as ZADAXIN for hepatitis B

Quick Facts

Property Value
Also Known As Tα1, ZADAXIN, Thymalfasin
Category Immune Modulation / Anti-Aging
Sequence 28-amino acid polypeptide (N-acetylated)
Molecular Weight 3108 Da
Molecular Formula C₁₂₉H₂₁₅N₃₃O₅₅
PubChem CID 16129620
Administration SubQ
Typical Dose Range 1.6 mg SubQ 2x/week (standard); up to 1.6 mg 2x/day (critical care)
Half-Life ~2 hours
Storage Lyophilized: -20°C, 2 years; Reconstituted: 2–8°C, use within 1–2 weeks
FDA Status Not FDA-approved in USA; approved in 35+ countries as ZADAXIN for chronic HBV
WADA Status Prohibited under S0 (Non-Approved Substances)

Mechanism of Action

Thymosin Alpha-1 is an endogenous 28-amino acid peptide naturally secreted by the thymus gland. Its unique therapeutic value lies in its dual immunomodulatory action: it simultaneously stimulates Th1 immune responses against pathogens while inducing regulatory T-cells (Tregs) to prevent autoimmunity (PMID-27450734).

Th1 stimulation occurs via upregulation of IL-2, IFN-γ, and TNF-α, enhancing NK cell cytotoxicity, CD8+ T-cell activity, and dendritic cell maturation for improved antigen presentation. Tα1 also acts as a TLR9 agonist, activating innate immune pathogen sensing (PMID-11381492).

The Treg induction arm operates through the IDO (indoleamine 2,3-dioxygenase) pathway — activating tryptophan catabolism that drives Treg differentiation and immune tolerance. This prevents excessive immune activation while maintaining pathogen clearance. In clinical use, this balance enables Tα1 to fight infections and enhance anti-tumor immunity while calming autoimmune overactivity (PMID-36812669).

Tα1 also supports thymopoiesis (thymic T-cell production), which is particularly relevant in aging and immunocompromised states where thymic involution reduces adaptive immune capacity (PMID-41373628).

Key Research Areas

  1. Hepatitis B (ZADAXIN Indication) — Two meta-analyses demonstrate superiority of combination therapy (Tα1 + antiviral) over antiviral monotherapy. IFN + Tα1 achieved higher HBV-DNA negativity and HBeAg loss in 535 patients across 7 RCTs (PMID-21272455). Entecavir + Tα1 improved clinical response in 1,144 patients across 7 RCTs (PMID-33076834).

  2. Sepsis and Critical Care — The definitive 2025 TESTS Phase 3 RCT (n=1,089, BMJ) found Tα1 did NOT reduce 28-day mortality in sepsis vs. placebo (23.4% vs. 24.1%), contradicting earlier positive meta-analyses (PMID-39814420). An earlier meta-analysis (2016) had shown mortality benefit for Tα1 alone (28-day) and Tα1 + ulinastatin combination (28+90-day) (PMID-26517783).

  3. COVID-19 — Systematic review of 8 studies showed Tα1 significantly reduced mortality in moderate-to-critical COVID-19 patients (PMID-37845598). A pilot RCT (n=49) demonstrated accelerated CD4+ T-cell recovery by day 5 (PMID-36056913).

  4. Cancer Immunotherapy Adjunct — Review of Tα1 as immunotherapy adjunct covers melanoma, lung, and hepatocellular carcinoma applications, enhancing ADCC and tumor antigen recognition (PMID-36812669).

  5. Aging and Immune Senescence — Tα1 restores thymic output in aged individuals and supports adaptive immune function during immunosenescence (PMID-41373628).

Evidence Level Summary

Evidence Type Count Notes
Phase 3 RCT 1 TESTS sepsis trial (n=1,089) — negative primary endpoint
Systematic reviews / meta-analyses 4 2 HBV, 1 COVID-19, 1 sepsis — all Level I
Phase 2 RCT 1 COVID-19 pilot (n=49)
Narrative reviews 5 Immune modulation, cancer, aging, HBV
Total vault studies 11

The evidence base for Thymosin Alpha-1 is the strongest of any research peptide in the vault, with 5 Level I studies and 2 human RCTs. It is approved in 35+ countries (ZADAXIN) for chronic HBV, providing real-world clinical validation. However, the 2025 TESTS Phase 3 RCT (BMJ) was negative for sepsis mortality, requiring honest qualification of the sepsis evidence. The HBV and COVID-19 data remain positive. Tα1 has an excellent established clinical safety profile from millions of patients globally.

Clinical Applications

Protocols Using This Peptide

Ageless Peps Products

  • AP-TA1-Vial — Thymosin Alpha-1 Vial, $72-$86 retail
  • AP-TA1-500MCG-Capsules — Thymosin Alpha-1 Capsules, 500mcg x 60 caps, $184 retail

Dosing Reference

Research Dosing Ranges

Route Dose Range Frequency Duration Source
SubQ 1.6 mg 2x/week 6–12 months (chronic); 4–8 weeks (acute) ZADAXIN label; PMID-28422855); OS HR 0.308 in propensity-matched analysis (PMID-34011034). Synergizes with checkpoint inhibitors by turning "cold" tumors "hot" (PMID-31555601). Safety confirmed across 11,000+ subjects (PMID-38308608). Action: Consider as immunotherapy adjunct under oncologist supervision.

Synergistic Combinations

Related Research

PMID Title Year Study Type
PMID-11381492 Thymosin alpha-1 2001 Narrative Review
PMID-21272455 IFN + Tα1 for HBV: Meta-analysis (7 RCTs) 2011 Meta-analysis
PMID-25640173 Tα1 treatment in chronic hepatitis B 2015 Narrative Review
PMID-26517783 Tα1 for severe sepsis: Meta-analysis 2016 Meta-analysis
PMID-27450734 Immune Modulation with Tα1 Treatment 2016 Narrative Review
PMID-33076834 Entecavir + Tα1 for HBV Cirrhosis (7 RCTs) 2020 Meta-analysis
PMID-36056913 Thymalfasin pilot RCT for COVID-19 (n=49) 2023 RCT
PMID-36812669 Tα1 in cancer therapy: immunoregulation 2023 Narrative Review
PMID-37845598 Tα1 in COVID-19: Systematic Review & Meta-Analysis 2023 Systematic Review
PMID-39814420 TESTS Phase 3 RCT: Tα1 for Sepsis (n=1,089) — NEGATIVE 2025 RCT
PMID-41373628 Aging and Thymosin Alpha-1 2025 Narrative Review

Related

#peptide #immune #anti-aging #subq