Thymosin-β4: A key modifier of renal disease

Introduction: There is an urgent need for new treatments for chronic kidney disease (CKD). Thymosin-4 is a peptide that reduces inflammation and fibrosis and has the potential to restore endothelial and epithelial cell injury, biological processes involved in the pathophysiology of CKD. Therefore, thymosin-4 could be a novel therapeutic direction for CKD.Areas covered: Here, we review the current evidence on the actions of thymosin-4 in the kidney in health and disease. Using transgenic mice, two recent studies have demonstrated that endogenous thymosin-4 is dispensable for healthy kidneys. In contrast, lack of endogenous thymosin-4 exacerbates mouse models of glomerular disease and angiotensin-II-induced renal injury. Administration of exogenous thymosin-4, or its metabolite, Ac-SDKP, has shown therapeutic benefits in a range of experimental models of kidney disease.Expert opinion: The studies conducted so far reveal a protective role for thymosin-4 in the kidney and have shown promising results for the therapeutic potential of exogenous thymosin-4 in CKD. Further studies should explore the mechanisms by which thymosin-4 modulates kidney function in different types of CKD. Ac-SDKP treatment has beneficial effects in many experimental models of kidney disease, thus supporting its potential use as a new treatment strategy.