# Thymosin Alpha-1 References: The Cited Literature, in Full

> Thymosin Alpha-1 references: the full cited literature behind this digest — Goldstein's 1977 sequence, the ETASS and TESTS sepsis trials, COVID-19 and hepatitis B studies, with DOIs and PubMed links.

Every quantitative claim on this site traces to a numbered entry below, with its DOI or PubMed identifier.

## How to read this list

The numbered markers throughout this Thymosin Alpha-1 digest — [1], [2], and so on — correspond to the entries below. Each carries the authors, journal, year, and a DOI or PubMed identifier so any claim can be checked at source. Where a paper sits behind a paywall, the PubMed link still resolves the citation. This is editorial commentary on publicly available science, not a substitute for the primary literature.

## 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] Sugahara S, Ichida T, Yamagiwa S, et al. Thymosin-alpha1 increases intrahepatic NKT cells and CTLs in patients with chronic hepatitis B. Hepatol Res. 2002;24(4):346-354. https://pubmed.ncbi.nlm.nih.gov/12479932/
[9] Bozza S, Gaziano R, Bonifazi P, et al. Thymosin alpha1 activates the TLR9/MyD88/IRF7-dependent murine cytomegalovirus sensing for induction of anti-viral responses in vivo. Int Immunol. 2007;19(11):1261-1270. https://pubmed.ncbi.nlm.nih.gov/17804687/
[10] Huang Y, Chen Z, Zhou C, et al. The modulation of thymosin alpha 1 in the maturation, differentiation and function of murine bone marrow-derived dendritic cells in the absence or presence of tumor necrosis factor-alpha. Int Immunopharmacol. 2004;4(4):539-546. https://pubmed.ncbi.nlm.nih.gov/15099531/
[11] Romani L, Bistoni F, Gaziano R, et al. Thymosin alpha1 activates dendritic cells for antifungal Th1 resistance through Toll-like receptor signaling. Blood. 2004;103(11):4232-4239. https://pubmed.ncbi.nlm.nih.gov/15010376/
[12] Serafino A, Pica F, et al. Thymosin alpha1 Activates Complement Receptor-Mediated Phagocytosis in Human Monocyte-Derived Macrophages. J Innate Immun. 2014;6(1):72-88. https://pubmed.ncbi.nlm.nih.gov/23797159/
[13] 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/
[14] 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. https://pubmed.ncbi.nlm.nih.gov/2279903/
[15] Baxevanis CN, Reclos GJ, Perez S, Kokkinopoulos D, Papamichail M. Immunoregulatory effects of fraction 5 thymus peptides. I. Thymosin alpha 1 enhances while thymosin beta 4 suppresses the human autologous and allogeneic mixed lymphocyte reaction. Immunopharmacology. 1987;13(2):133-141. https://pubmed.ncbi.nlm.nih.gov/2954929/
[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. https://pubmed.ncbi.nlm.nih.gov/27350088/
[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(1):8-15. https://pubmed.ncbi.nlm.nih.gov/38308608/

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A register of record on the thymic immune peptide thymosin alpha-1 — every claim logged to its study, the largest sepsis trial's null result kept in plain view, and not one thing here a clinic, a prescription, or for sale.