ARA-290
(Cibinetide)

The Discovery

The EPO Mystery

Erythropoietin, or EPO, is famous as the hormone that makes red blood cells.

Erythropoietin, or EPO, is famous as the hormone that makes red blood cells. Athletes have cheated with it. Kidney patients depend on it. But in the early 2000s, scientists noticed something puzzling: EPO seemed to protect nerve cells and reduce inflammation even at doses too low to affect red blood cell counts. Dr. Anthony Cerami, a renowned biomedical researcher, and Dr. Michael Brines at the Kenneth S. Warren Institute began investigating. They discovered that EPO activated a completely different receptor system in damaged tissues — one that had nothing to do with making blood. This was the tissue-protective receptor.

The Breakthrough

Extracting the Healer

Cerami and Brines faced a problem.

Cerami and Brines faced a problem. You couldn't give patients high-dose EPO just for tissue protection — it would dangerously thicken their blood. They needed a molecule that activated only the tissue-protective receptor without touching the blood-making machinery. After years of work, they designed ARA 290, a small peptide of just 11 amino acids. It was modeled on the part of EPO that connected to the tissue-protective receptor. In laboratory tests, ARA 290 protected nerve cells from damage, reduced inflammation, and promoted healing — all without making a single extra red blood cell. They had successfully separated EPO's healing power from its blood-thickening danger.

The Trials

The Neuropathy Patient's Hope

ARA 290 entered clinical trials for small fiber neuropathy, a painful condition where the tiny ne...

ARA 290 entered clinical trials for small fiber neuropathy, a painful condition where the tiny nerve fibers in your skin die off. Patients feel burning, tingling, and stabbing pain. There are very few effective treatments. In early trials, patients who received ARA 290 injections reported significant pain relief. Skin biopsies showed something remarkable: their nerve fibers were actually regenerating. New nerve endings were growing back. This was almost unheard of in neuropathy treatment — most drugs just mask the pain without fixing the underlying nerve damage. ARA 290 appeared to be genuinely healing the nerves.

The Crisis

The Sarcoidosis Breakthrough

Researchers also tested ARA 290 in patients with sarcoidosis, an inflammatory disease that causes...

Researchers also tested ARA 290 in patients with sarcoidosis, an inflammatory disease that causes lumps of immune cells to form in the lungs, skin, and other organs. Many sarcoidosis patients develop severe nerve pain. In a clinical trial, ARA 290 reduced pain scores and improved patients' quality of life. The results suggested that the peptide wasn't just treating symptoms — it was dampening the runaway inflammation that caused sarcoidosis in the first place. Published in scientific journals, these findings attracted attention from researchers studying other inflammatory conditions like diabetes, chronic kidney disease, and autoimmune disorders.

The Legacy

A Peptide That Teaches Healing

Today, ARA 290 (also called cibinetide) continues in clinical development.

Today, ARA 290 (also called cibinetide) continues in clinical development. Araim Pharmaceuticals, the company developing it, has conducted trials in diabetic neuropathy and chronic kidney disease. The peptide represents a new approach to medicine: instead of blocking a disease process, it activates the body's own repair systems. Scientists believe ARA 290 works by telling damaged tissues to stop dying and start healing. The journey from EPO's mysterious side effects to a purpose-built healing peptide shows how careful observation can lead to entirely new categories of medicine. ARA 290 may become one of the first drugs that genuinely regenerates damaged nerves.