ARA-290
Cibinetide Β· Helix B Surface Peptide Β· HBSP
11-amino acid peptide derived from the helix B surface of erythropoietin (EPO) that retains EPO's tissue-protective properties without haematopoietic activity. Phase 2 trials demonstrated efficacy in sarcoidosis-related small-fibre neuropathy and metabolic syndrome.
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Mechanism of Action
Binds the innate repair receptor (IRR/EPOR-Ξ²cR heterodimer) on non-haematopoietic cells β distinct from the classic EPO receptor on red blood cell precursors. Activates PI3K/Akt and JAK2/STAT3 signalling for cell survival, downregulates NF-ΞΊB inflammatory cascade, promotes peripheral nerve repair and metabolic insulin sensitisation.
Clinical Applications
- βPeripheral neuropathy (diabetic, chemotherapy-induced, sarcoidosis-related)
- βChronic inflammatory conditions with neuropathic component
- βInsulin resistance and metabolic syndrome support
- βPost-COVID neuropathy and small-fibre symptoms
- βNeuroprotection in chronic inflammatory disease
Dosing Protocol
Recommended Dosing
SC injection. 4 mcg/kg/day (clinical trial dose for sarcoidosis) or fixed 300β400 mcg/day. Duration: 4β12 weeks. No standard consensus dosing exists outside trials β use conservative approach and monitor.Safety & Contraindications
Possible Side Effects
- β Injection-site reactions (mild, transient)
- β No haematopoietic effects (does not raise haematocrit)
- β Generally well-tolerated in Phase 2 trials
Contraindications
- βPolycythaemia or active EPO therapy (theoretical receptor interaction)
- βPregnancy (insufficient safety data)
- βActive malignancy (tissue-protective signalling may theoretically support tumour cells)