Condition
Immune Function
Immune function is how well the body's white blood cells, tissues, and chemical signals recognize germs and damaged cells and respond to them. Thymosin alpha-1 and LL-37 have the most support, with moderate evidence: T-cell counts went up with thymosin alpha-1, and LL-37 was active against many bacteria, fungi, and viruses. Much of the cited work was in the lab, though, and the evidence for other options is limited.
Sources: PMID 23045967; PMID 31170191
- Updated
- How we grade
- 100 studies cited
- Supplements studied
- 3
- Medicines and peptides
- 3
- Graded outcomes
- 13
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Neutrophil Function Moderate Increase | Improves (the measure goes up) | Moderate effect | 200 people | |||
| Immune Cell Counts Small Increase | Improves (the measure goes up) | Small effect | 180 people |
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Inflammatory Markers Reduced inflammatory cytokines | Improves (the measure goes down) | Moderate effect | 150 people |
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| T Cell Function Expanded naive-like CD8+ cells and increased fatty acid oxidation capacity | Improves (the measure goes up) | Moderate effect | 50 people |
Prescription medicines and peptides studied, for context
Thymosin Alpha-1
- T-Cell Count: improves
- CD4/CD8 Ratio: improves
- NK Cell Activity: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| T-Cell Count Moderate Increase | Improves (the measure goes up) | Moderate effect | 13 studies | 580 people | ||
| CD4/CD8 Ratio Moderate Improvement | Improves (the measure goes up) | Moderate effect | 4 studies | 420 people | ||
| NK Cell Activity Moderate Increase | Improves (the measure goes up) | Moderate effect | 3 studies | 210 people |
LL-37
- Antimicrobial Activity: improves
- Biofilm Eradication: improves
- MRSA Killing: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Antimicrobial Activity Effective against 38+ bacteria, 16 fungi, 16 viruses | Improves (the measure goes up) | Large effect | 9 studies | 360 people | ||
| Biofilm Eradication >4 log reduction in S. aureus biofilms | Improves (the measure goes up) | Large effect | 5 studies | 180 people | ||
| MRSA Killing Effective at nanomolar concentrations | Improves (the measure goes up) | Large effect | 8 studies | 120 people | ||
| Immune Cell Activation Activates NK cells, dendritic cells, B cells | Improves (the measure goes up) | Moderate effect | 2 studies | 150 people |
Epitalon
- T-Cell Activity: improves
- Thymus Function: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| T-Cell Activity Small increase in T-cell function | Improves (the measure goes up) | Small effect | 55 people | |||
| Thymus Function Preliminary thymus support observed | Improves (the measure goes up) | Small effect | 28 people |
Key findings
- Neutrophil FunctionImproves (the measure goes up)
- Inflammatory MarkersImproves (the measure goes down)
- T Cell FunctionImproves (the measure goes up)
Shop the evidence-backed picks
Fullscript collectionImmune support: evidence-graded picksOpen on Fullscript
The collection holds the supplements we grade A or B for its theme, in third-party tested products where the catalog has them. It opens in our Fullscript store. You can look through it without signing in; Fullscript asks for a free account to order.
Or shop one supplement
The supplement graded A or B for Immune Function. Each opens third-party tested products for that supplement.
- Grade B
We earn from purchases made in our Fullscript store, and links to Fullscript, iHerb or Thorne carry our referral, so we may earn a commission at no extra cost to you. Grades come from the research and never change based on what we earn. Full disclosure
Studies cited
100 studies from PubMed
- Overview of Epitalon-Highly Bioactive Pineal Tetrapeptide with Promising Properties
- The Antioxidant Tetrapeptide Epitalon Enhances Delayed Wound Healing in an in Vitro Model of Diabetic Retinopathy.
- LL-37 Attenuates Sepsis-Induced Lung Injury by Alleviating Inflammatory Response and Epithelial Cell Oxidative Injury via ZBP1-Mediated Autophagy.
- Human cathelicidin peptide LL-37 induces endothelial-to-mesenchymal transition.
- Significance of the LL-37 Peptide Delivered from Human Cathelicidin in the Pathogenesis, Treatment, and Diagnosis of Sepsis.
- Cathelicidin regulates goblet cell mucus secretion and mucus-associated proteins in Citrobacter rodentium-induced colitis.
- Cathelicidin LL-37 in periodontitis: current research advances and future prospects - A review.
- Thymosin alpha 1 alleviates inflammation and prevents infection in patients with severe acute pancreatitis through immune regulation: a systematic review and meta-analysis.
- The efficacy and safety of thymosin α1 for sepsis (TESTS): multicentre, double blinded, randomised, placebo controlled, phase 3 trial.
- The efficacy and safety of thymosin alpha-1 combined with lenvatinib plus sintilimab in unresectable hepatocellular carcinoma: a retrospective study.
- Cathelicidin Antimicrobial Peptide Levels in Atherosclerosis and Myocardial Infarction in Mice and Human.
- Cathelicidin LL-37 promotes wound healing in diabetic mice by regulating TFEB-dependent autophagy.
- PD-1 inhibitor combined with SBRT, GM-CSF, and thymosin alpha-1 in metastatic breast cancer: A case report and literature review.
- Thymosin α1 reverses oncolytic adenovirus-induced M2 polarization of macrophages to improve antitumor immunity and therapeutic efficacy.
- Thymosin Alpha 1 Plus Routine Treatment for the Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.
- Comprehensive Review of the Safety and Efficacy of Thymosin Alpha 1 in Human Clinical Trials.
- Cathelicidin (LL-37) causes expression of inflammatory factors in coronary artery endothelial cells of Kawasaki disease by activating TLR4-NF-κB-NLRP3 signaling.
- Cathelicidin LL-37 promotes EMT, migration and metastasis of hepatocellular carcinoma cells in vitro and mouse model.
- Human cathelicidin LL-37 exerts amelioration effects against EHEC O157:H7 infection regarding inflammation, enteric dysbacteriosis, and impairment of gut barrier function.
- Antimicrobial peptide cathelicidin LL-37 preserves intestinal barrier and organ function in rats with heat stroke.
- Efficacy of LL-37 cream in enhancing healing of diabetic foot ulcer: a randomized double-blind controlled trial.
- Antibiofilm properties of cathelicidin LL-37: an in-depth review.
- Thymosin α-1 in cancer therapy: Immunoregulation and potential applications
- Thymosin alpha 1 - Reimagine its broader applications in the immuno-oncology era
- The efficacy of thymosin alpha-1 therapy in moderate to critical COVID-19 patients: a systematic review, meta-analysis, and meta-regression.
- Effects of an Optimized Aged Garlic Extract on Cardiovascular Disease Risk Factors in Moderate Hypercholesterolemic Subjects: A Randomized, Crossover, Double-Blind, Sustained and Controlled Study
- Peptides Regulating Proliferative Activity and Inflammatory Pathways in the Monocyte/Macrophage THP-1 Cell Line.
- Epitalon protects against post-ovulatory aging-related damage of mouse oocytes in vitro.
- Efficacy of antimicrobial peptide LL-37 against biofilm forming Staphylococcus aureus strains obtained from chronic wound infections
- Vitamin D-induced LL-37 modulates innate immune responses of human primary macrophages during DENV-2 infection.
- LL-37 transports immunoreactive cGAMP to activate STING signaling and enhance interferon-mediated host antiviral immunity.
- Human Cathelicidin Peptide LL-37 Induces Cell Death in Autophagy-Dysfunctional Endothelial Cells.
- Cathelicidin hCAP18/LL-37 promotes cell proliferation and suppresses antitumor activity of 1,25(OH)(2)D(3) in hepatocellular carcinoma.
- Sphingosine-1-Phosphate-Triggered Expression of Cathelicidin LL-37 Promotes the Growth of Human Bladder Cancer Cells.
- The human cathelicidin hCAP-18 in serum of children with haemato-oncological diseases.
- Anticancer Effect of Cathelicidin LL-37, Protegrin PG-1, Nerve Growth Factor NGF, and Temozolomide: Impact on the Mitochondrial Metabolism, Clonogenic Potential, and Migration of Human U251 Glioma Cells.
- LL-37 as a Powerful Molecular Tool for Boosting the Performance of Ex Vivo-Produced Human Dendritic Cells for Cancer Immunotherapy.
- Regulation of LL-37 in Bone and Periodontium Regeneration.
- Thymosin α-1 Reverses M2 Polarization of Tumor-Associated Macrophages during Efferocytosis.
- Thymosin alpha 1 as an adjuvant to hyperthermic intraperitoneal chemotherapy in an experimental model of peritoneal metastases from colonic carcinoma.
- Evaluation of LL-37 in healing of hard-to-heal venous leg ulcers: A multicentric prospective randomized placebo-controlled clinical trial
- Steroid hormone modulates the production of cathelicidin and human β-defensins in lung epithelial cells and macrophages promoting Mycobacterium tuberculosis killing.
- Antimicrobial Peptide LL-37 Drives Rosacea-Like Skin Inflammation in an NLRP3-Dependent Manner.
- LL-37-induced caspase-independent apoptosis is associated with plasma membrane permeabilization in human osteoblast-like cells.
- Colonic epithelial cathelicidin (LL-37) expression intensity is associated with progression of colorectal cancer and presence of CD8(+) T cell infiltrate.
- Interaction of LL-37 human cathelicidin peptide with a model microbial-like lipid membrane.
- Vitamin D and Cathelicidin (LL-37) Status in Patients with Type 2 Diabetes and Staphylococcus aureus Nasal Carriage.
- Thymosin alpha-1 therapy improves postoperative survival after curative resection for solitary hepatitis B virus-related hepatocellular carcinoma: A propensity score matching analysis.
- Combination of Gemcitabine and Thymosin alpha 1 exhibit a better anti-tumor effect on nasal natural killer/T-cell lymphoma.
- Thymosin alpha 1 exerts beneficial extrapulmonary effects in cystic fibrosis.
- The effect of aged garlic extract on the atherosclerotic process - a randomized double-blind placebo-controlled trial
- Garlic lowers blood pressure in hypertensive subjects, improves arterial stiffness and gut microbiota: A review and meta-analysis
- Aged garlic extract reduces left ventricular myocardial mass in patients with diabetes
- Aged garlic extract reduces low attenuation plaque in coronary arteries of patients with diabetes: A randomized, double-blind, placebo-controlled study
- Therapeutic Potential of Cathelicidin Peptide LL-37, an Antimicrobial Agent, in a Murine Sepsis Model
- Citrullination Alters the Antiviral and Immunomodulatory Activities of the Human Cathelicidin LL-37 During Rhinovirus Infection.
- Immunomodulatory Role of the Antimicrobial LL-37 Peptide in Autoimmune Diseases and Viral Infections.
- LL-37 restored glucocorticoid sensitivity impaired by virus dsRNA in lung.
- Synthetic cathelicidin LL-37 reduces Mycobacterium avium subsp. paratuberculosis internalization and pro-inflammatory cytokines in macrophages.
- Antimicrobial peptide LL-37 ameliorates a murine sepsis model via the induction of microvesicle release from neutrophils.
- Cathelicidin Mediates a Protective Role of Vitamin D in Ulcerative Colitis and Human Colonic Epithelial Cells.
- Salivary human beta-defensins and cathelicidin levels in relation to periodontitis and type 2 diabetes mellitus.
- Thymosin α1 therapy in critically ill patients with COVID-19: A multicenter retrospective cohort study
- Immunopotentiator thymosin alpha-1 attenuates inflammatory pain by modulating the Wnt3a/β-catenin pathway in spinal cord.
- Thymosin Alpha 1 Reduces the Mortality of Severe Coronavirus Disease 2019 by Restoration of Lymphocytopenia and Reversion of Exhausted T Cells.
- The clinical efficacy and adverse effects of Entecavir plus Thymosin alpha-1 combination therapy versus Entecavir Monotherapy in HBV-related cirrhosis: a systematic review and meta-analysis.
- Antimicrobial peptide LL-37 is bactericidal against Staphylococcus aureus biofilms
- LL-37 and its analog FF/CAP18 attenuate neutrophil migration in sepsis-induced acute lung injury.
- Myeloid cell-derived LL-37 promotes lung cancer growth by activating Wnt/β-catenin signaling.
- Cathelicidin LL-37 restoring glucocorticoid function in smoking and lipopolysaccharide-induced airway inflammation in rats.
- Human cathelicidin improves colonic epithelial defenses against Salmonella typhimurium by modulating bacterial invasion, TLR4 and pro-inflammatory cytokines.
- Cathelicidin-related antimicrobial peptide protects against myocardial ischemia/reperfusion injury.
- Thymosin alpha-1; a natural peptide inhibits cellular proliferation, cell migration, the level of reactive oxygen species and promotes the activity of antioxidant enzymes in human lung epithelial adenocarcinoma cell line (A549).
- Thymosin Alpha-1 Inhibits Complete Freund's Adjuvant-Induced Pain and Production of Microglia-Mediated Pro-inflammatory Cytokines in Spinal Cord.
- Antioxidant and angiotensin-converting enzyme (ACE) inhibitory activity of thymosin alpha-1 (Thα1) peptide.
- Randomized trial evaluating the effect of aged garlic extract with supplements versus placebo on adipose tissue surrogates for coronary atherosclerosis progression
- Copper and Cardiovascular Disease: A Systematic Review
- The Role of Copper in Bone Health: A Review
- Dietary Copper and Health: A Review of Evidence
- Copper and Angiogenesis: Implications for Wound Healing
- Tissue-specific Regulation of Innate Immune Responses by Human Cathelicidin LL-37.
- Roles and Mechanisms of Human Cathelicidin LL-37 in Cancer.
- Upregulated expression of human cathelicidin LL-37 in hypercholesterolemia and its relationship with serum lipid levels.
- Thymosin alpha 1 treatment for patients with sepsis
- Copper in Human Health: A Review of Essentiality and Toxicity
- Copper and Immunity: A Comprehensive Review
- Copper and Neurodegenerative Diseases: Evidence and Mechanisms
- Copper Status Assessment: Methods and Clinical Applications
- Circulating cathelicidin LL-37 in adult patients with pulmonary infectious diseases.
- Aged Garlic Extract Reduces Low Attenuation Plaque in Coronary Arteries of Patients with Metabolic Syndrome in a Prospective Randomized Double-Blind Study
- Copper Deficiency: Causes and Clinical Manifestations
- Recommended Dietary Allowances for Copper: Evidence Review
- Human cathelicidin, LL-37, inhibits respiratory syncytial virus infection in polarized airway epithelial cells
- The human cathelicidin LL-37--A pore-forming antibacterial peptide and host-cell modulator.
- The Roles of Cathelicidin LL-37 in Inflammatory Bowel Disease.
- The Role of Cathelicidin LL-37 in Cancer Development.
- Human Cathelicidin Compensates for the Role of Apolipoproteins in Hepatitis C Virus Infectious Particle Formation.
- Immune Modulation with Thymosin Alpha 1 Treatment
- Human-derived cathelicidin LL-37 directly activates mast cells to proinflammatory mediator synthesis and migratory response.
- The Human Cathelicidin Antimicrobial Peptide LL-37 and Mimics are Potential Anticancer Drugs.