Thymosin α 1: a novel therapeutic option for patients with refractory chronic purulent rhinosinusitis.

Chronic purulent rhinosinusitis (CPR) is an inflammatory condition of unknown origin. Although various medical and surgical treatment modalities are available, 5-10% of patients remain refractory. Immune deficiency is one of the underlying risk factors for this disease. Earlier studies demonstrated disturbances in cell-mediated immunity and defects in monocyte chemotaxis in CPR. Treatment with the thymic hormone preparation thymostimulin led to significant clinical improvement in patients and in vitro restoration of monocyte chemotaxis. Unfortunately, thymostimulin became unavailable, which has led to recent interest in the immunomodulatory effects of the thymic peptide thymosin α1, which has demonstrated some benefit for CPR. Our current in vitro work focuses on the potential effects of thymosin α1 on monocyte function and gene expression profiles in order to understand its effects and mechanisms of action. Future clinical studies will evaluate the potential significance of thymosin α1 in treatment of CPR patients.