Russian peptides: the history and the clinical literature

Soviet and then Russian neuroscience took a distinctive path with peptides. Rather than chasing large molecules, a number of Moscow and Leningrad groups worked on short, stabilised fragments of the body’s own regulatory peptides — sequences of four to seven amino acids that could be synthesised cheaply and given intranasally. Two of the best known came out of the Institute of Molecular Genetics of the Russian Academy of Sciences in Moscow, in work associated with the chemist Nikolai Myasoedov, whose name appears on the Semax and Selank clinical papers cited below[1][6].

Semax (Met-Glu-His-Phe-Pro-Gly-Pro) is built on the ACTH(4-10) fragment of adrenocorticotropic hormone — the part associated with attention and learning, without the hormonal action on the adrenal gland — capped with a Pro-Gly-Pro tail that slows its breakdown. It became a registered medicine in Russia, where its clinical literature focuses on ischaemic stroke and chronic cerebrovascular insufficiency. Selank(Thr-Lys-Pro-Arg-Pro-Gly-Pro) applies the same trick to tuftsin, a tetrapeptide from the immune system, and was developed with the Zakusov Institute of Pharmacology as an anxiolytic; it too is registered in Russia.

A second school grew up in Leningrad (now St Petersburg) around Vladimir Khavinson, first at the Military Medical Academy and later at the St Petersburg Institute of Bioregulation and Gerontology. Khavinson’s group began with peptide extracts of the pineal gland (Epithalamin) and thymus (Thymalin), then synthesised short sequences meant to reproduce them — Epitalon (Ala-Glu-Asp-Gly) for the pineal gland and Pinealon (Glu-Asp-Arg) for brain tissue. They called these "peptide bioregulators"; our bioregulator hub covers that concept in depth[18].

Cerebrolysin is the odd one out: a mixture of low-molecular-weight peptides and amino acids derived from porcine brain, made in Austria. The 2023 Cochrane review describes it as widely used in the treatment of acute ischaemic stroke in Russia, Eastern Europe, China, and other Asian and post-Soviet countries[17] — which is why so much of its trial literature, and its clinical culture, sits alongside the Russian peptides.

Semax — stroke and cerebrovascular disease

The earliest widely cited clinical paper treated 30 patients in the acute period of hemispheric ischaemic stroke with Semax on top of standard therapy and compared them with 80 conventionally treated patients of similar severity; the authors reported faster regression of general and focal — especially motor — deficits[1]. It was not a randomised placebo-controlled trial, and should be read that way. Later work extended it to chronic cerebrovascular insufficiency[2], and a 2018 study of 110 post-stroke patients reported that Semax raised plasma BDNF and was associated with better Barthel-index recovery, alongside the effect of starting rehabilitation early[3]. In rats, Semax regulates BDNF and its TrkB receptor in the hippocampus[4] and activates neurotrophin gene transcription after experimental ischaemia[5].

Selank — anxiety and neurasthenia

In 62 patients with generalised anxiety disorder or neurasthenia, Selank (30 patients) was compared with the benzodiazepine medazepam (32 patients). The anxiolytic effects were similar, and Selank additionally showed anti-asthenic and mildly stimulating effects; the authors also tracked serum enkephalin activity[6]. A companion study examined immune markers in patients with anxiety-asthenic disorders[7]. The laboratory literature links intranasal Selank to hippocampal BDNF expression in rats[8] and is summarised in a molecular review[9].

Epitalon and Epithalamin — the gerontology cohorts

The St Petersburg and Kyiv gerontology institutes followed 266 older people for six to eight years after courses of Thymalin and Epithalamin, reporting lower mortality in the treated groups than in controls[10]. A 12-year study of Epithalamin in elderly patients with coronary disease and accelerated ageing reported 28% fewer deaths than in the control group[11], and pineal peptides — including synthetic Epitalon — were reported to restore the night-time melatonin peak in older monkeys and people[12]. In cultured human cells, Epitalon induced telomerase activity and telomere elongation[13]. These are striking results from a small number of groups, largely unreplicated outside Russia and Ukraine — which is the honest caveat.

Pinealon — the brain bioregulator

Pinealon’s evidence is earlier-stage: cell-culture work on free-radical suppression[14], aged-rat studies under hypoxia[15], and a review of how the EDR tripeptide might regulate gene expression in neurons[16].

Three things are true at once. First, these are genuine human studies — patients with stroke, anxiety disorders and accelerated ageing — and our radar counts them as human evidence at full weight. Second, many are small, some are not randomised or blinded, and a large share come from the institutes that developed the compounds. Third, little of it has been independently replicated in Western trials, partly because the compounds were never taken through FDA or EMA approval.

Cerebrolysin shows what happens when Russian-used medicines meet large international trials: results become mixed. The Cochrane review of acute stroke found no benefit on all-cause death and a possible increase in non-fatal serious adverse events[17] — our Cerebrolysin and stroke review walks through it. That is the standard every compound on this page should eventually be held to.