# Thymosin Alpha-1 References: The Cited Literature

> Thymosin Alpha-1 references: the full cited literature behind this digest — PubMed and journal sources with DOIs for every quantitative claim on the site.

Every numbered citation used across this site, with DOIs and PubMed links.

## About these sources

The Thymosin Alpha-1 references below are the published sources behind every quantitative claim on this site — peer-reviewed trials, meta-analyses, mechanism studies, and regulatory documents, drawn from PubMed and primary journals. Each is numbered to match the inline `[N]` markers used throughout. Where a source is paywalled, the PubMed record and DOI are still listed so any reader can locate the original.

## 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] 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. https://pubmed.ncbi.nlm.nih.gov/36527881/
[9] Mao HY, Shi TD. [Treatment with interferon and thymosin alpha-1 versus interferon monotherapy for HBeAg positive chronic hepatitis B: a meta-analysis]. Zhonghua Gan Zang Bing Za Zhi. 2011;19(1):29-33. https://pubmed.ncbi.nlm.nih.gov/21272455/
[10] Wolf E, Milazzo S, Boehm K, Zwahlen M, Horneber M. Thymic peptides for treatment of cancer patients. Cochrane Database Syst Rev. 2011;(2):CD003993. https://pubmed.ncbi.nlm.nih.gov/21328265/
[11] Peng D, Xing HY, Li C, Wang XF, Hou M, Li B, Chen JH. The clinical efficacy and adverse effects of Entecavir plus Thymosin alpha-1 combination therapy versus Entecavir Monotherapy in HBV-related cirrhosis: a systematic review and meta-analysis. BMC Gastroenterol. 2020;20(1):348. https://pubmed.ncbi.nlm.nih.gov/33076834/
[12] Yang YF, Zhao W, Xia HM, et al. Comparison of the efficacy of thymosin alpha-1 and interferon alpha in the treatment of chronic hepatitis B: a meta-analysis. Antiviral Res. 2008;77(2):136-141. https://pubmed.ncbi.nlm.nih.gov/18078676/
[13] 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/
[14] Pica F, Chimenti MS, Gaziano R, Buè 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. https://pubmed.ncbi.nlm.nih.gov/27350088/
[15] Dinetz E, Lee E. Comprehensive Review of the Safety and Efficacy of Thymosin Alpha 1 in Human Clinical Trials. Altern Ther Health Med. 2024. https://pubmed.ncbi.nlm.nih.gov/38308608/
[16] U.S. Food and Drug Administration. Thymosin alpha-1 (Tα1)-related bulk drug substances: FDA review for the 503A Bulk Drug Substances List. FDA briefing / Pharmacy Compounding Advisory Committee. 2024. https://www.fda.gov/media/183892/download
[17] Vitek M, Zvonar Pobirk A, Roškar R, Matjaž MG. Exploiting the potential of in situ forming liquid crystals: development and in vitro performance of long-acting depots for peptide drug thymosin alpha 1 subcutaneous administration. Drug Deliv. 2025;32(1):2460708. https://pubmed.ncbi.nlm.nih.gov/40066714/

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A forward but evidence-graded reading of the Thymosin Alpha-1 record — the four-decade hepatitis and immune-restoration signal read first, the null phase-3 sepsis trial held in plain view, the molecule kept distinct from thymosin beta-4, and the community reports fenced off as unverified; an open reading desk, not a clinic, and nothing here dosed, sourced, prescribed, or sold.