# Thymosin Alpha-1 References: Cited Studies & Sources

> Thymosin Alpha-1 references: the full citation list — PubMed, BMJ, Blood, Cochrane and more — with DOIs and links for every study summarized on this site.

Every study summarized on this site, with DOIs and PubMed links so you can read the primary source yourself.

## About these sources

Every quantitative claim in this Thymosin Alpha-1 digest maps to one of the numbered sources below — peer-reviewed journals (BMJ, Blood, Critical Care, Clinical Infectious Diseases, Frontiers in Oncology, Vaccine, and others), PubMed-indexed trials and reviews, and Cochrane systematic-review work. Where a setting carries conflicting evidence (sepsis, COVID-19), the conflicting sources are cited together so the reader can weigh them. Sort by year or setting and follow the DOI or PubMed link to the primary record.

## References

[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. https://pubmed.ncbi.nlm.nih.gov/265536/
[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. https://pubmed.ncbi.nlm.nih.gov/23327199/
[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. https://pubmed.ncbi.nlm.nih.gov/39814420/
[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. https://pubmed.ncbi.nlm.nih.gov/33362999/
[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. https://pubmed.ncbi.nlm.nih.gov/16741252/
[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. https://pubmed.ncbi.nlm.nih.gov/32442287/
[7] Costantini C, Bellet MM, Pariano M, et al. A Reappraisal of Thymosin Alpha1 in Cancer Therapy. Front Oncol. 2019;9:873. https://pubmed.ncbi.nlm.nih.gov/31555601/
[8] Garaci E, Perno CF, et al. A pilot study of the safety and efficacy of thymosin alpha 1 in augmenting immune reconstitution in HIV-infected patients with low CD4 counts taking highly active antiretroviral therapy. Clin Infect Dis. 2004;38 Suppl 2:S141-S143. https://pubmed.ncbi.nlm.nih.gov/14632754/
[9] Perruccio K, Bonifazi P, Topini F, et al. Thymosin alpha1 to harness immunity to pathogens after haploidentical hematopoietic transplantation. Ann N Y Acad Sci. 2010;1194:153-161. https://pubmed.ncbi.nlm.nih.gov/20536464/
[10] Garaci E, Rocchi G, Perroni L, et al. Combination treatment with zidovudine, thymosin alpha 1 and interferon-alpha in human immunodeficiency virus infection. Int J Clin Lab Res. 1994;24(1):23-28. https://pubmed.ncbi.nlm.nih.gov/7910053/
[11] Carraro G, Naso A, Montomoli E, et al. Thymosin-alpha 1 (Zadaxin) enhances the immunogenicity of an adjuvated pandemic H1N1v influenza vaccine (Focetria) in hemodialyzed patients: a pilot study. Vaccine. 2012;30(6):1170-1180. https://pubmed.ncbi.nlm.nih.gov/22178096/
[12] Yang YF, Zhao W, Zhong YD, et al. Treatment with lamivudine versus lamivudine and thymosin alpha-1 for e antigen-positive chronic hepatitis B patients: a meta-analysis. Virol J. 2009;6:63. https://pubmed.ncbi.nlm.nih.gov/19467157/
[13] Htet NH, Naing C, Vongpunsawad S, Win TT, Poovorawan Y. Thymosin-alpha-1 for people with chronic hepatitis B. Cochrane Database Syst Rev. 2022;(3):CD014610. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8929401/
[14] Ricci D, Etna MP, Severa M, et al. Novel evidence of Thymosin α1 immunomodulatory properties in SARS-CoV-2 infection: Effect on innate inflammatory response in a peripheral blood mononuclear cell-based in vitro model. Int Immunopharmacol. 2023;117:109996. https://pubmed.ncbi.nlm.nih.gov/36933449/
[15] Chen C, Wang J, Xun J, et al. Role of thymosin alpha1 in restoring immune response in immunological nonresponders living with HIV. BMC Infect Dis. 2024;24(1):78. https://pubmed.ncbi.nlm.nih.gov/38233816/
[16] Pica F, Chimenti MS, Gaziano R, et al. Serum thymosin α1 levels in patients with chronic inflammatory autoimmune diseases. Clin Exp Immunol. 2016;186(1):39-45. https://pubmed.ncbi.nlm.nih.gov/27350088/
[17] Dinetz E, Lee R. Comprehensive Review of the Safety and Efficacy of Thymosin Alpha 1 in Human Clinical Trials. Altern Ther Health Med. 2024;30(1):6-12. https://pubmed.ncbi.nlm.nih.gov/38308608/

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A titration reading of the Thymosin Alpha-1 (thymalfasin) record — the thymic immunomodulator's strongest hepatitis-B signal logged first, the null phase-3 sepsis trial and the US non-approval held in plain sight, and the molecule kept ruled apart from thymosin beta-4, thymulin, and thymopentin; no clinic behind the rail and nothing here dosed, dispensed, or sold.