Ara 290 (Cibinetide)
Tissue-Protective Peptide | Innate Repair Receptor Agonist
Community Research
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Ara 290 is an engineered 11-amino acid peptide activating the Innate Repair Receptor (IRR) to provide tissue-protective effects without red blood cell stimulation. Has FDA Orphan Drug status.
Activates IRR through EPOR/β-common receptor complex, triggering tissue-protective signaling without erythropoietic effects.
Molecular Data
?ELERALNSSpGlu
Position 1
Glutamic Acid
Position 2
Leucine
Position 3
Glutamic Acid
Position 4
Arginine
Position 5
Alanine
Position 6
Leucine
Position 7
Asparagine
Position 8
Serine
Position 9
Serine
Position 10
Research Indications
23% increase in corneal nerve fiber area with sustained pain improvement.
Nerve regeneration and metabolic improvements in Type 2 diabetes patients.
Crosses blood-brain barrier for stroke and TBI neuroprotection.
Improves epithelialization and angiogenesis via VEGF upregulation.
Reduces infarct size in myocardial infarction models.
Maintains cardiac function in aging models.
Reduces TNF-α, IL-6, and IL-12 production.
Reduces colitis severity in animal models.
Improves graft survival and reduces rejection.
Dosing Protocols
Primary clinical administration route with proven efficacy.
| Goal | Dose | Frequency | Route |
|---|---|---|---|
| Neuropathy Treatment | 4 mg daily | Once daily | SubQ |
| Tissue Protection | 1-8 mg daily | Once daily | SubQ |
| Acute Intervention | 2 mg | 3x weekly | IV |
Reconstitution Instructions
- Ara 290 lyophilized powder (4 mg vial)
- Sterile water for injection
- Sterile syringes and needles
- Alcohol swabs
- Light protection
- 1 Allow vial to reach room temperature (15-20 minutes)
- 2 Clean vial top with alcohol swab
- 3 Slowly inject 1 mL sterile water
- 4 Gently swirl to dissolve (no vigorous shaking)
- 5 Slight cloudiness is normal
- 6 Use immediately or refrigerate up to 24 hours
- 7 Protect from light
- 8 Rotate injection sites
Interactions
What to Expect
Side Effects & Safety
Common Side Effects
- Excellent safety profile in clinical trials with no serious drug-related adverse events
Stop Signs - Discontinue if:
- Severe injection site reactions
- Unexpected blood count changes
- Allergic reaction signs
- Worsening of underlying condition
- New neurological symptoms
- Any serious adverse events
Contraindications
- Recent anti-TNF therapy (within 6 months)
- EPO use (within 2 months)
- Pregnancy
- BMI > 34 kg/m²
Quality Checklist
Good Signs
- Pharmaceutical grade manufacturing with GMP conditions
- Proper peptide sequence verification - correct 11-amino acid sequence with N-terminal pyroglutamate
- Sterile lyophilized powder with proper freeze-drying
- Clinical batch documentation - Purity >95%, endotoxin <1 EU/mg, sterility verified
Warning Signs
- Light-sensitive formulation - requires protection during storage and use
Bad Signs
- Cloudy or discolored solution indicates degradation; should be clear to slightly cloudy
References
- Cibinetide Improves Corneal Nerve Fiber Abundance in Patients With Sarcoidosis-Associated Small Nerve Fiber Loss and Neuropathic PainDahan A, Brines M, Niesters M, Cerami A, van Velzen MInvestigative Ophthalmology & Visual Science (2017)
Phase 2b trial, 64 subjects with sarcoid neuropathy, 1-8mg SC daily for 28 days. Cibinetide significantly increased corneal and skin small nerve fiber abundance, consistent with disease-modifying effect. 23% increase in corneal nerve fiber area at 4mg dose.
- ARA 290, a Nonerythropoietic Peptide Engineered from Erythropoietin, Improves Metabolic Control and Neuropathic Symptoms in Patients with Type 2 DiabetesBrines M, Dunne AN, van Velzen M, et al.Molecular Medicine (2015)
Phase 2 trial, 4mg SC daily for 28 days in T2DM patients. Improvement in HbA1c and lipid profiles sustained 4 weeks post-dosing. Neuropathic symptoms significantly improved. Corneal nerve fiber density increased.
- A Phase 2 Clinical Trial on the Use of Cibinetide for the Treatment of Diabetic Macular EdemaLois N, Gardner E, McFarland M, et al.Translational Vision Science & Technology (2020)
9 patients, 4mg SC daily for 12 weeks. No serious adverse events. Improvement in NEI VFQ-25 composite quality of life scores. Some participants showed improvements in CRT, tear production, diabetic control, and albuminuria.
- A Small Nonerythropoietic Helix B Surface Peptide Based Upon Erythropoietin Structure Is Cardioprotective Against Ischemic Myocardial DamageBrines M, Patel NSA, Villa P, et al.Proceedings of the National Academy of Sciences (2008)
Engineered helix B surface peptide (pHBSP/ARA-290) from EPO structure. Increased reactive oxygen species threshold for mitochondrial permeability transition by 40%. Reduced ischemic myocardial infarct size equivalent to EPO without erythropoietic effects.
- Neuroprotection with an Erythropoietin Mimetic Peptide (pHBSP) in a Model of Mild Traumatic Brain Injury Complicated by Hemorrhagic ShockRobertson CS, Garcia R, Gaddam SSK, et al.Journal of Neurotrauma (2013)
pHBSP reduced contusion volume from 20.8mm3 (control) to 5.9mm3. Improved cerebral blood flow recovery and beam-walking performance. Neuroprotective effects similar to EPO without thrombotic risk.
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Disclaimer
This information is for educational and research purposes only. Consult a healthcare professional before use.