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Thymosin Alpha-1

Thymosin Alpha-1 (thymalfasin) is a 28-amino-acid immunomodulatory peptide, approved in some countries and studied in trials for sepsis and hepatitis.

Evidence: Moderate

Reading time:2 min
Citations:3
Updated:July 5, 2026

Type

Peptide

INCI Name

Synthetic 28-amino-acid, N-terminally acetylated peptide identical to thymosin alpha 1 (thymalfasin)

Direct Answer

Thymosin Alpha-1 (thymalfasin) is a 28-amino-acid immunomodulatory peptide, approved in some countries and studied in trials for sepsis and hepatitis.

Summary Table

Evidence Level

Moderate

AI Summary

Thymosin Alpha-1 (thymalfasin) is a synthetic 28-amino-acid immunomodulatory peptide. Evidence is moderate: it is approved in a number of countries (as Zadaxin) for indications including chronic hepatitis B and immune support, and it has been evaluated in randomized controlled trials for severe sepsis (for example the ETASS trial and the larger phase 3 TESTS trial). It is not FDA-approved in the United States. Reported tolerability is generally favorable, but results across sepsis trials have been mixed, and effects are indication-specific.

Key Information

Classification

1 Mechanisms

Key Takeaways

  • Thymosin Alpha-1 (thymalfasin) is an immunomodulatory 28-amino-acid peptide approved in some countries (not the US)
  • Randomized trials in severe sepsis (ETASS, TESTS) have produced mixed results
  • Benefit is indication-specific; regulatory status varies by country

Scientific Overview

In Plain English

Thymosin Alpha-1 (also called thymalfasin) is a peptide that influences the immune system. It is an approved medicine in some countries for conditions like chronic hepatitis B and has been tested in randomized trials for severe sepsis. It is not approved in the US. Trial results in sepsis have been mixed.

Scientific Details

Thymosin Alpha-1 (thymalfasin) is a synthetic, N-terminally acetylated 28-amino-acid peptide with immunomodulatory activity, including effects on T-cell function and innate immune signaling. It is approved in several countries for chronic hepatitis B and as an immune adjunct. In severe sepsis it has been evaluated in randomized controlled trials, including the single-blind ETASS trial and the multicenter, double-blind phase 3 TESTS trial; results across trials have been mixed, and it is not FDA-approved in the United States.

How It Works

Thymosin Alpha-1 is described as an immunomodulator associated with enhancement of T-cell and dendritic-cell function and modulation of innate immune signaling (including Toll-like receptor pathways). These mechanisms are characterized in laboratory studies and supported by clinical trials in specific indications.

Mechanism of Action

Immunomodulation

human

Thymosin Alpha-1 is associated with enhanced T-cell and dendritic-cell function and modulation of innate immune signaling.

Evidence Level

Human Evidence

Approved in several countries for chronic hepatitis B and immune support. Randomized controlled trials in severe sepsis (ETASS; the phase 3 TESTS trial) have evaluated immunomodulatory use, with mixed results across trials.

Animal Evidence

Preclinical work characterized immunomodulatory pharmacology.

Limitations

Not FDA-approved in the US; efficacy is indication-specific and, in sepsis, results across randomized trials have been inconsistent. Approval and evidence vary by country.

Why This Grade

Graded moderate: supported by approvals in some countries and multiple randomized controlled trials in sepsis and hepatitis, but with mixed trial results, indication-specific benefit, and no US FDA approval.

References

  1. The efficacy and safety of thymosin alpha1 for sepsis (TESTS): multicentre, double blinded, randomised, placebo controlled, phase 3 trial. BMJ.Human Studydoi:10.1136/bmj-2024-082583
  2. The efficacy of thymosin alpha 1 for severe sepsis (ETASS): a multicenter, single-blind, randomized and controlled trial. Critical Care.Human Studydoi:10.1186/cc11932
  3. Thymosin alpha-1. American Journal of Health-System Pharmacy.Reviewdoi:10.1093/ajhp/58.10.886

Alternative Names

  • Thymalfasin
  • Zadaxin
  • Tα1
  • TA1

Risks & Safety

  • Not FDA-approved in the United States; regulatory status and quality assurance vary by country
  • Injection-site reactions have been reported; tolerability is generally described as favorable in trials
  • Efficacy in sepsis is not consistently established across randomized trials
  • Material sold by research-chemical vendors is not the regulated product and is not quality-controlled

Claim Boundaries

ION BLUE is an educational research aggregator. This content summarizes published scientific literature. It is not medically reviewed, is not medical advice, and is not a recommendation to use any substance. Some peptides discussed are approved in certain countries; others are research chemicals not approved for human use. Consult a licensed healthcare provider. This entry summarizes research and approvals that vary by country and is not medical advice or a recommendation to obtain or use thymosin alpha-1.

This page summarizes published research and is for informational purposes only; it is not medical advice.