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Emerging Research

Ara 290

Tissue-Protective Peptide | Innate Repair Receptor Agonist

Ara 290 (Cibinetide) is an engineered 11-amino acid peptide derived from erythropoietin that activates the Innate Repair Receptor (IRR) to provide tissue-protective effects without stimulating red blood cell production. It has completed multiple Phase 2 clinical trials and holds FDA Orphan Drug status for several indications.

Daily dose

4 mg daily

Frequency

Once daily

Cycle length

28 days

Storage

2-8°C

Key benefits

Proven tissue protection, nerve regeneration, anti-inflammatory effects, excellent safety profile in clinical trials

How it works

Activates Innate Repair Receptor (IRR) through EPOR/β-common receptor complex, triggering tissue-protective signaling without erythropoietic effects

Dosage protocols

Goal

Neuropathy Treatment

Dose

4 mg daily · Once daily

Route

Subcutaneous

Goal

Tissue Protection

Dose

1-8 mg daily · Once daily

Route

Subcutaneous

Goal

Acute Intervention

Dose

2 mg · 3x weekly

Route

Intravenous

Goal

Research Protocol

Dose

4 mg daily · Once daily for 28 days

Route

Subcutaneous

Research indications

neuroprotection

Peripheral Nerve Regeneration23% increase in corneal nerve fiber area demonstrated in clinical trials, with sustained improvement in neuropathic pain
Diabetic Neuropathy TreatmentSignificant nerve regeneration and metabolic improvements in Type 2 diabetes patients with peripheral neuropathy
Central Nervous System ProtectionCrosses blood-brain barrier to provide neuroprotection in stroke and traumatic brain injury models

anti Inflammatory

Cytokine ReductionSignificantly reduces TNF-α, IL-6, and IL-12 production while maintaining tissue-protective signaling
Inflammatory Bowel DiseaseReduces colitis severity in animal models through broad anti-inflammatory mechanisms
Transplant ProtectionImproves islet graft survival and reduces rejection through immunomodulatory effects

tissue Repair

Wound Healing EnhancementImproves re-epithelialization and angiogenesis in diabetic wound models through VEGF upregulation
Cardiovascular ProtectionReduces infarct size and improves survival in myocardial infarction models with sustained cardioprotective effects
Anti-Aging Tissue EffectsMaintains cardiac function and reduces inflammation in aging heart models through IRR activation

autoimmune

Rheumatoid Arthritis TreatmentPhase II trial showed significant pain reduction (VAS pain decreased 27-29mm, p=0.03) in patients with active RA, with good EULAR responses observed
Autoimmune ModulationReduces inflammatory cytokines and modulates immune response through IRR activation without immunosuppression

Administration

injectable

Interactions

Synergistic
BPC-157Both peptides promote tissue repair through complementary pathways - Ara 290 via IRR activation and BPC-157 via growth factor signaling, potentially enhancing wound healing and neuroprotection
Synergistic
TB-500Combined tissue repair mechanisms may enhance recovery from injury - Ara 290 provides anti-inflammatory effects while TB-500 promotes cellular migration and angiogenesis
Compatible
Thymosin Beta-4No known interactions between IRR activation and thymosin pathways, both work through different mechanisms for tissue protection and repair
Avoid Combination
EPO (Erythropoietin)Clinical trials exclude recent EPO use within 2 months due to potential receptor interference and unclear combined effects on hematopoiesis
Monitor Combination
NAD+Both affect cellular metabolism and stress response - monitor for additive anti-inflammatory effects and potential enhanced tissue protection
Compatible
SemaglutideClinical trials included patients on antidiabetic medications including GLP-1 agonists with no adverse interactions, may provide complementary metabolic benefits
Use Caution
Growth HormoneBoth affect tissue repair and growth pathways - combination may enhance effects but requires monitoring for potential excessive growth factor activity
Requires Timing
Anti-TNF BiologicsClinical protocols require 6-month washout from anti-TNF therapy before Ara 290 to avoid potential immune system interactions

Safety notes

Excellent safety profile in clinical trials with no serious drug-related adverse events

No anti-drug antibodies detected in human studies

No hematopoietic effects or risk of polycythemia unlike erythropoietin

Contraindicated with recent anti-TNF therapy (within 6 months) or EPO use (within 2 months)

Monitor for injection site reactions and rotate injection sites

Not recommended during pregnancy or in patients with BMI >34 kg/m²

Research studies

Pancreatic Islet Protection Study (2021)

Human islets | 100 nM | 48 hours | Improved viability and function

In vitro study of human pancreatic islets showing Ara 290 protection against inflammatory damage, supporting its potential in diabetes treatment and transplantation.

View study →

Diabetic Macular Edema Pilot Study (2020)

Human | 4 mg SC daily | 12 weeks | Improved quality of life, variable visual outcomes

Open-label pilot study in 9 patients examining Ara 290 effects on diabetic macular edema, showing good safety profile and improved patient-reported outcomes.

View study →

Sarcoidosis Neuropathy Phase 2b Trial (2017)

Human | 1-8 mg SC daily | 28 days | 23% increase in corneal nerve fiber area at 4 mg dose

Double-blind, placebo-controlled trial in 64 patients with sarcoidosis-associated small fiber neuropathy. The 4 mg dose showed significant nerve regeneration and pain reduction in moderate-severe cases.

View study →

Type 2 Diabetes Neuropathy Phase 2 (2015)

Human | 4 mg SC daily | 28 days | Sustained HbA1c improvement and nerve regeneration

Randomized controlled trial in 48 patients with diabetic peripheral neuropathy demonstrating sustained metabolic improvements and comparable nerve regeneration to sarcoidosis studies.

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Rheumatoid Arthritis Phase II Trial (2013)

Human | 2mg IV | 1-3x/week for 4 weeks | 15 patients with active RA

Open-label Phase II trial in patients with active rheumatoid arthritis showed significant pain reduction (VAS pain decreased 27-29mm, p=0.03) and good safety profile. One patient achieved good EULAR response, one moderate response. Presented at EULAR 2013.

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Myocardial Infarction Protection Study (2012)

Mouse | 24 μg/kg IV | Single dose | Reduced infarct size and improved survival

Preclinical study demonstrating cardioprotective effects of Ara 290 in acute myocardial infarction model with significant reduction in cardiac damage.

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Stroke Neuroprotection Research (2011)

Rat | 300 μg/kg IV | Single dose | Reduced stroke volume and improved outcomes

Comprehensive study showing Ara 290 crosses blood-brain barrier and provides significant neuroprotection in stroke models through IRR activation.

View study →