Thymus and thymic peptides: stages of the long road from experimental research to implementation in clinical practice (review)

Peptides isolated from the thymus and synthesized thymomimetics, due to their rich spectrum of multivariate effects, are unique structures that implement mutual feedback between the nervous, immune and endocrine systems through intercellular interactions and intracellular signaling pathways. This review not only focuses on the clinical effectiveness of using these substances to reconstruct the immune system, but also attempts to summarize the current knowledge about the mechanisms of thymic factors. Thus, the search for immunomodulators as an alternative therapeutic strategy for balancing the body’s response to excessive inflammation at the immune depression led to the discovery of previously unknown mechanisms of action of the thymic synthetic pentapeptide TP5. Our experience with synthetic thymomimetics in vitro experiments and clinical practice for various secondary immunodeficiency (SID) conditions is presented. We have proven the fact of restoration of the immune system in infectious and inflammatory diseases against the background of restoration of the functional capacity of neutrophilic granulocytes when using synthetic thymic hexapeptide (HP), which is an analogue of the active center of thymopoietin. A personalized approach to patient management with the identification of the pathological immunophenotype of SID justifies the use of synthetic thymomimetics and makes their use promising. There is no doubt that understanding the subtle mechanisms of the multi-vector action of thymic immunomodulators, demonstrated in the article, can become a point of support in determining the optimal treatment strategy for various pathologies, especially in immunosenescence, as well as immune-dependent diseases associated with atypical infectious and inflammatory processes.