Neuroprotection & Neurorecovery

Neuroprotective peptides are compounds investigated for their ability to protect neurons from damage, promote neural repair, and enhance recovery after neurological injury or in the context of neurodegenerative disease. This category overlaps with but is distinct from cognition-enhancing peptides, as the primary focus here is on structural and functional preservation of neural tissue.

Cerebrolysin, a mixture of porcine brain-derived neuropeptides, has been investigated in large Phase 3 trials for stroke, Alzheimer's disease, and traumatic brain injury, and is approved in over 50 countries. Cortexin is a related bovine brain-derived polypeptide complex approved in Russia for multiple neurological indications. Semax and selank, both synthetic heptapeptides developed at the Russian Academy of Sciences, are approved in Russia as neuroprotective and anxiolytic agents, respectively. Noopept is a synthetic dipeptide nootropic that upregulates BDNF and NGF. Dihexa, an angiotensin IV analog, potentiates HGF/c-Met signaling at picomolar concentrations but has faced controversy due to retracted foundational papers. Davunetide, an ADNP-derived octapeptide, showed promise in Phase 2 trials for mild cognitive impairment but failed its pivotal Phase 2/3 trial for progressive supranuclear palsy.

A recurring challenge in this category is that much of the clinical evidence originates from Russia or Eastern Europe, with limited independent Western replication. For cerebrolysin and davunetide, Western-standard randomized controlled trials have been conducted with mixed results.