A practical reference on nasal formulation: what it is, how it behaves, what the literature reports, and where the honest uncertainties sit.
Reviewed 2026-05-10. Anything still debated is marked as such rather than presented as settled.
Development took place during the 1980s at institutes of the Russian Academy of Sciences, where peptide fragments of ACTH were screened for cognitive and neuroprotective effects. The compound received regulatory approval in Russia as a nasal preparation, marketed for conditions such as ischemic stroke, transient ischemic attacks, and optic nerve disorders. Registration in other countries has not followed. Most published clinical reports originate from a small number of Russian research groups, and independent replication outside that setting remains limited. The regulatory status therefore differs sharply between Russia and the rest of the world.
Laboratory work points toward modulation of neurotrophic signaling, particularly expression of brain-derived neurotrophic factor and nerve growth factor in hippocampal tissue. Studies also describe effects on monoamine turnover, inflammatory mediators, and oxidative markers. These observations come mainly from animal models and cultured cells, so the causal chain in humans is not firmly established. Whether the reported molecular changes translate into measurable clinical benefit is an open question. Reviews generally present the mechanism as plausible rather than demonstrated.
Stability depends heavily on physical state. Lyophilized powder held dry, cold and dark retains its content over long periods, whereas dissolved peptide begins to change within days at room temperature. The most cited degradation route is oxidation of the methionine residue, which converts the peptide to a sulfoxide form that elutes differently on chromatography. Hydrolysis of amide bonds and adsorption onto container walls contribute smaller losses. Buffers that exclude oxygen from the headspace slow the oxidation pathway, but no single condition prevents all change indefinitely.
Practical handling follows from those properties. Bulk material is best divided into single-use portions soon after receipt, because each thaw exposes the whole container to moisture and temperature cycling. Vials should be allowed to reach room temperature before opening to prevent condensation on the powder. Low-binding plasticware reduces loss of dilute solutions, and sterile filtration is used when a preparation must remain free of microbial growth. Records of batch number, reconstitution date and storage history are what allow a later analytical result to be interpreted meaningfully.
| Property | Value | Notes |
|---|---|---|
| Sequence | Met-Glu-His-Phe-Pro-Gly-Pro | Heptapeptide; ACTH(4-10) analog extended at C-terminus |
| Molecular mass | ~813.9 Da | Free peptide, unmodified |
| Appearance | White to off-white powder | Typical lyophilized solid |
| Solubility | Soluble in water and saline | Also soluble in common aqueous buffers |
| Storage (solid) | -20 °C, desiccated | Protect from moisture and repeated thawing |
Regulatory status varies sharply by country. Semax is registered for medical use in Russia, where it appears in formularies as a nasal solution, and it also holds registration in a small number of neighbouring states. It has no approval from the United States Food and Drug Administration or the European Medicines Agency, and it is not a scheduled controlled substance in most jurisdictions. Elsewhere it circulates mainly as laboratory material, so purity documentation comes from suppliers rather than from a national pharmacopoeia.
Semax is a synthetic peptide created in the Soviet Union during the early 1980s by researchers working in Moscow. It was built from the short adrenocorticotropic hormone fragment known as ACTH(4-10), and the chain was then extended with three additional amino acids. The resulting molecule was named semax and entered clinical use in Russia in 1994. It is generally described as a nootropic and neuroprotective agent rather than as a hormone analogue.
The parent fragment ACTH(4-10) carries the sequence Met-Glu-His-Phe-Arg-Trp-Gly. Semax replaces the arginine and tryptophan positions with a proline-glycine-proline tail, giving Met-Glu-His-Phe-Pro-Gly-Pro. That change removes residues associated with adrenal stimulation, so the peptide does not drive cortisol release the way full ACTH does. This distinction shapes how the compound is grouped in the literature, where it sits with neuropeptides and peptide neuromodulators rather than with corticosteroids.
稳定性主要由水解与氧化两条路径支配。肽键在中性或弱酸性条件下相对稳定，遇到强碱或长时间高温则明显断裂；甲硫氨酸侧链容易被氧化成亚砜，使主峰前移并拉低实际含量。金属离子、光照和反复冻融会进一步促进降解或聚集。冻干粉在低温避光条件下可存放较长时间，配制后的水溶液通常需要冷藏并尽快用完。
纯度评估以反相高效液相色谱为主，通过主峰面积百分比给出粗略结果，再配合电喷雾质谱核对分子量。氨基酸分析可验证组成比例，手性色谱或毛细管电泳用于检查残基构型。常见杂质包括缺失序列的短肽、氧化产物与二聚体。由于多数市售品不附带完整检验报告，独立第三方检测常被用来核实标称值。
== Precautions == THF is a relatively acutely nontoxic solvent, with the median lethal dose (LD50) comparable to that for acetone. However, chronic exposure is suspected of causing cancer. Reflecting its remarkable solvent properties, it penetrates the skin, causing rapid dehydration. It is highly flammable. THF dissolves or penetrates most polymer glove materials in a very short period of time; only Linear low-density polyethylene (LLDPE) laminated gloves are capable of protecting against it for long time periods, similar to most ketones. Polyvinyl alcohol (PVA) coated gloves are capable of providing protection for nearly an hour, but because PVA is water soluble they are only effective in low humidity environments and when working with anhydrous solvents. Even very thick nitrile or nitrile-neoprene gloves degrade in under 10 minutes. One danger posed by THF is its tendency to form explosive peroxides upon reaction with air:
Directed by Michael Proudfoot, made by Uden Associates 1 December A Setting for St Paul's, about a proposed office block development at Petershill, south of St Paul's Cathedral; Prince Charles' speech in October 1987; in 1956 architect William Holford, Baron Holford designed nearby buildings, built in the 1960s; Norman St John-Stevas, chairman of the Royal Fine Art Commission; William Whitfield; Christopher Mitchell on the planning committee of the City of London Corporation; James Tuckey and Rollin Schlicht, project managers of MEPC (Mitsubishi Estate); architects Ted Cullinan and Robin Nicholson; Hugh Pearman of the Sunday Times; George Cassidy; the architects visit Philip Whitbourn, chief architect at English Heritage; David Jenkin and Frank Duffy of DEGW; Martin Stancliffe, Surveyor of the Fabric of St Paul's Cathedral; painter Roger de Grey. Narrated by Penelope Wilton, produced by Mike Tomlinson and David Sharp, directed by Cathy Denford, made by Orlando Television Productions 8 December The Business of Bottled Water, the £300m bottled water industry.
== Signaling pathways == Induction of FPR triggers multiple changes in eukaryotic cells including rearrangement of the cytoskeleton which in turn facilitates cell migration and the synthesis of chemokines. Important FPR regulated pathways include:
=== Pregnancy and lactation === Clomipramine use during pregnancy is associated with congenital heart defects in the newborn. It is also associated with reversible withdrawal effects in the newborn. Clomipramine is also distributed in breast milk and hence nursing while taking clomipramine is advised against.
Sources: en.wikipedia.org
A liver biopsy (tissue examination) is the only test widely accepted (gold standard) as definitively diagnosing and distinguishing MASLD and MASH from other forms of liver disease. It can be used to assess the severity of inflammation and resultant fibrosis. However, since most people affected by MASLD are likely to be asymptomatic, liver biopsy presents too high a risk for routine diagnosis, so other methods are preferred, such as liver ultrasonography or liver MRI. For young people, guidelines recommend liver ultrasonography, but biopsy remains the best evidence. Liver biopsy is also the gold standard to detect hepatic fibrosis and assess its progression. Routine liver function blood tests are not sensitive enough to detect MASLD, and biopsy is the only procedure that can reliably differentiate MASLD from MASH. There are several liver biopsy techniques available to obtain liver tissue. Percutaneous liver biopsy remains the most common practice. Biopsies can also be performed via the transvenous route, either during surgery or by laparoscopy, especially for people with contraindications to a percutaneous approach. The liver biopsy can also be image-guided, in real-time or not, which is recommended for some clinical situations, such as people with known liver lesions, previous intra-abdominal surgery who may have adhesions, a small liver that is difficult to percuss, people with obesity, and people with evident ascites.
=== Priapism === A relatively rare side effect associated with trazodone is priapism, likely due to its antagonism at α-adrenergic receptors. More than 200 cases have been reported, and the manufacturer estimated that the incidence of any abnormal erectile function is about one in 6,000 male patients treated with trazodone. The risk for this side effect appears to be greatest during the first month of treatment at low dosages (i.e. <150 mg/day). Early recognition of any abnormal erectile function is important, including prolonged or inappropriate erections, and should prompt discontinuation of trazodone treatment. Spontaneous orgasms have also been reported with trazodone in men. Clinical reports have described trazodone-associated psychosexual side effects in women as well, including increased libido, priapism of the clitoris, and spontaneous orgasms.
== Mechanism == Classified as a metalloexopeptidase, carboxypeptidase A consists of a single polypeptide chain bound to a zinc ion. This characteristic metal ion is located within the active site of the enzyme, along with five amino acid residues that are involved in substrate binding: Arg-71, Arg-127, Asn-144, Arg-145, Tyr-248, and Glu-270. X-ray crystallographic studies have revealed five subsites on the protein. These allosteric sites are involved in creating the ligand-enzyme specificity seen in most bioactive enzymes. One of these subsites induces a conformational change at Tyr-248 upon binding of a substrate molecule at the primary active site. The phenolic hydroxyl of tyrosine forms a hydrogen bond with the terminal carboxylate of the ligand. In addition, a second hydrogen bond is formed between the tyrosine and a peptide linkage of longer peptide substrates. These changes make the bond between the enzyme and ligand, whether it is substrate or inhibitor, much stronger. This property of carboxypeptidase A led to the first clause of Daniel E. Koshland, Jr.’s “induced fit” hypothesis. The S1 sub-site is where catalysis occurs in CPA, and the zinc ion is coordinated by Glu-72, His-69, and His-196 enzyme residues. A plane exists that bisects the active-site groove where residues Glu-270 and Arg-127 are on opposite sides of the zinc-water coupled complex. The zinc is electron rich due to glutamine ligands coordinating the zinc because before substrate binds, Glu-72 coordinates bidentate but shifts to monodentate after substrate binds.
Compounds eluting off the column are carried into a hydrogen fueled flame which excites specific elements in the molecules, and the excited elements (P,S, Halogens, Some Metals) emit light of specific characteristic wavelengths. The emitted light is filtered and detected by a photomultiplier tube. In particular, phosphorus emission is around 510–536 nm and sulfur emission is at 394 nm. With an atomic emission detector (AED), a sample eluting from a column enters a chamber which is energized by microwaves that induce a plasma. The plasma causes the analyte sample to decompose and certain elements generate an atomic emission spectra. The atomic emission spectra is diffracted by a diffraction grating and detected by a series of photomultiplier tubes or photo diodes. Electron capture detector (ECD) uses a radioactive beta particle (electron) source to measure the degree of electron capture. ECD are used for the detection of molecules containing electronegative / withdrawing elements and functional groups like halogens, carbonyl, nitriles, nitro groups, and organometalics. In this type of detector either nitrogen or 5% methane in argon is used as the mobile phase carrier gas. The carrier gas passes between two electrodes placed at the end of the column, and adjacent to the cathode (negative electrode) resides a radioactive foil such as 63Ni. The radioactive foil emits a beta particle (electron) which collides with and ionizes the carrier gas to generate more ions resulting in a current.
==== Migraine aura without headache ==== Aura may occur without a subsequent headache, which is called a migraine aura without headache. It may also be referred to as a "silent migraine", though this term is discouraged as it may downplay symptoms, and because there are more specific terms available. Symptoms such as visual disturbance, vision loss, alterations in color perception, and sensitivity to light, sound, and odors can still interfere with normal activity, even when there is no pain.
Sources: en.wikipedia.org
Semax is a synthetic seven-amino-acid peptide derived from a fragment of corticotropin. It is used in Russia as a nasal preparation, while elsewhere it is studied as a research compound. It is not approved as a medicine in most countries.
Its sequence corresponds to the 4-10 region of corticotropin extended by three residues. This fragment lacks the region responsible for adrenal steroid release, so it is explored for neural rather than hormonal effects. The relationship explains the compound's classification among ACTH-derived peptides.
It holds approval in Russia for several neurological indications as a nasal spray or drop formulation. Regulatory agencies in the United States and the European Union have not approved it. Products sold elsewhere are generally labeled for research use only.
Suppliers normally quote a percentage of total chromatographic peak area, most often from reversed-phase HPLC. That figure says nothing about what the remaining percentage contains, and it depends on the detection wavelength used. A mass spectrometry result is a separate and stronger check on identity.