Thymosin alpha 1 treatment for patients with sepsis

ABSTRACT

Introduction: Sepsis is a life-threatening organ dysfunction caused by host immune response to infection. In this regard, modifying host immune response may help to eliminate systemic infection and restore organ function. Thymosin alpha 1 (Tα1), acting as an immune modulator, exerts great biological influence in activating and restoring the dysregulated immune response for patients with sepsis.

Areas covered: In this review, we summarize the clinical studies of Tα1 treatment alone and in combination with anti-inflammatory for patients with sepsis or septic shock. Clinical studies were collected from available English and Chinese databases.

Expert opinion: In previous studies, single or combined treatment with Tα1 reduced the mortality rate of sepsis, improved the expression of HLA-DR on monocyte, and diminished the incidence of secondary infection. Based on the existing studies, Tα1 seems to be a promising alternative adjuvant therapy for sepsis. However, sepsis is a remarkably heterogeneous clinical syndrome, so much so that it is impossible to generalize the clinical results to all septic patients. Also, the present studies on Tα1 treatment are not able to focus on the immunosuppressive individuals. We believe that selecting septic patients with immunosuppression will be more likely to reveal the efficacy of Tα1 in future trials.

KEYWORDS:

• Thymosin alpha 1
• sepsis
• immunotherapy
• immunosuppression

Article highlights

• Sepsis is a life-threatening organ dysfunction caused by the immune response to infection.

• Tα1 exerts great biological influence in activating and regulating the immune system for patients with sepsis.

• Clinical data showed Tα1 reduced the mortality rate of sepsis, improved the expression of HLA-DR on monocyte, and diminished the incidence of secondary infection.

• Sepsis is a highly heterogeneous clinical syndrome, and trials that select the septic patients with immunosuppression will be more likely to verify the efficacy of Tα1.

• Tα1 treatment is a promising alternative adjuvant therapy for sepsis.

This box summarizes key points contained in the article.

Declaration of interest

J. F. Wu and X. D. Guan have received research support from SciClone Pharmaceuticals. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This work was supported by Program for Natural Science Foundation of Guangdong Province (2016A030313269), Science and Technology Planning Project of Guangdong Province (2014B090901049), and Fundamental Research Funds for the Central Universities (15YKPY14). This paper has been published as part of a supplement issue covering the proceedings of the Fifth International Symposium on Thymosins in Health and Disease and is funded by SciClone Pharmaceuticals.