Ara 290 (Cibinetide)

Tissue-Protective Peptide | Innate Repair Receptor Agonist

Weight: 1,257 Da
Half-life: ~20 minutes (SubQ), ~2 minutes (IV)
Chain: 11 amino acids
5 studies
2020 latest
2 recent
Extensively Studied
Dose 4 mg daily
Frequency Once daily
Cycle 28 days
Storage Lyophilized: 2-8°C refrigerated, protect from light. Reconstituted: use immediately or refrigerate up to 24 hours

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.

Mechanism of Action

Activates IRR through EPOR/β-common receptor complex, triggering tissue-protective signaling without erythropoietic effects.

01 Proven tissue protection
02 Nerve regeneration
03 Anti-inflammatory effects
04 Excellent safety profile in clinical trials

Molecular Data

Molecular Weight
1,257 Da
Chain Length
11 amino acids
Type
Engineered peptide
Amino Acid Sequence
One-letter: ?ELERALNSS
H₂N
H
? 1
O C
N
E 2
O C
N
L 3
O C
N
E 4
O C
N
R 5
O C
N
A 6
O C
N
L 7
O C
N
N 8
O C
N
S 9
O C
N
S 10
COOH
pGl
1

pGlu

Position 1

Glu
2

Glutamic Acid

Position 2

Leu
3

Leucine

Position 3

Glu
4

Glutamic Acid

Position 4

Arg
5

Arginine

Position 5

Ala
6

Alanine

Position 6

Leu
7

Leucine

Position 7

Asn
8

Asparagine

Position 8

Ser
9

Serine

Position 9

Ser
10

Serine

Position 10

N-terminus C-terminus
Hydrophobic
Polar
Positive (+)
Negative (-)
Modified
Peak 0.0 mcg
Trough 0.0 mcg
SS Peak 0.0 mcg
SS Trough 0.0 mcg

Research Indications

Neuroprotection
Peripheral Nerve Regeneration most effective

23% increase in corneal nerve fiber area with sustained pain improvement.

Diabetic Neuropathy Treatment most effective

Nerve regeneration and metabolic improvements in Type 2 diabetes patients.

CNS Protection most effective

Crosses blood-brain barrier for stroke and TBI neuroprotection.

Tissue Repair
Wound Healing effective

Improves epithelialization and angiogenesis via VEGF upregulation.

Cardiovascular Protection effective

Reduces infarct size in myocardial infarction models.

Anti-Aging Effects effective

Maintains cardiac function in aging models.

Anti-Inflammatory
Cytokine Reduction moderate

Reduces TNF-α, IL-6, and IL-12 production.

IBD Support moderate

Reduces colitis severity in animal models.

Transplant Protection moderate

Improves graft survival and reduces rejection.

Dosing Protocols

Primary clinical administration route with proven efficacy.

GoalDoseFrequencyRoute
Neuropathy Treatment4 mg dailyOnce dailySubQ
Tissue Protection1-8 mg dailyOnce dailySubQ
Acute Intervention2 mg3x weeklyIV

Reconstitution Instructions

Materials Needed:
  • Ara 290 lyophilized powder (4 mg vial)
  • Sterile water for injection
  • Sterile syringes and needles
  • Alcohol swabs
  • Light protection
  1. 1 Allow vial to reach room temperature (15-20 minutes)
  2. 2 Clean vial top with alcohol swab
  3. 3 Slowly inject 1 mL sterile water
  4. 4 Gently swirl to dissolve (no vigorous shaking)
  5. 5 Slight cloudiness is normal
  6. 6 Use immediately or refrigerate up to 24 hours
  7. 7 Protect from light
  8. 8 Rotate injection sites

Interactions

++
BPC-157
Complementary tissue repair pathways may enhance wound healing.
synergistic
++
TB-500
Combined mechanisms enhance recovery from injury.
synergistic
+
Thymosin Beta-4
No known interactions; different mechanisms for tissue protection.
compatible
!
EPO
Clinical trials exclude EPO use within 2 months due to receptor interference.
avoid
~
NAD+
Both affect cellular metabolism; monitor for additive effects.
monitor
+
Semaglutide
No adverse interactions in clinical trials with GLP-1 agonists.
compatible
~
Growth Hormone
Both affect tissue repair; requires monitoring for excessive growth factor activity.
monitor
!
Anti-TNF Biologics
6-month washout required before Ara 290 to avoid immune interactions.
avoid

What to Expect

Week 1-2
Initial anti-inflammatory effects and mild pain symptom improvement
Week 2-4
Progressive nerve regeneration, improved tissue healing markers
Week 4-6
Peak therapeutic effects, maximum nerve fiber density improvements
Month 2-6
Long-lasting benefits via molecular switch effect

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 Pain
    Dahan A, Brines M, Niesters M, Cerami A, van Velzen M
    Investigative 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 Diabetes
    Brines 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 Edema
    Lois 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 Damage
    Brines 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 Shock
    Robertson 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.

Disclaimer

This information is for educational and research purposes only. Consult a healthcare professional before use.