Cerebrolysin: Neuroprotection and Neuroplasticity with Peptides

EXOMA Scientific Team · Publicado el 13 de abril de 2026 · Actualizado el 28 de agosto de 2026

Cerebrolysin: neurotrophic mixture of brain peptides. Mechanisms of action, clinical evidence in neurodegeneration, comparison with Semax y Selank.

What is Cerebrolysin?

Cerebrolysine (also known as Cerebrolysin) is a preparation of neurotrophic peptides of low molecular weight derived from porcine brain by standardized enzymatic hydrolysis. It contains a mixture of bioactive peptides that mimic the activity of endogenous neurotrophic factors.

Composition

• Low-molecular-weight peptides (<10 kDa): ~75%
• Free amino acids: ~25%
• Identified neurotrophic peptides: Fragments that mimic BDNF, NGF, CNTF, and GDNF
• Original manufacturer: EVER Pharma (Austria)
• Registration: Approved in more than 40 countries (not FDA)

Mechanisms of Action

Cerebrolysin exerts neuroprotective effects through multiple pathways:

1. Neurotrophic Activity

• BDNF mimicry: Peptides that activate TrkB receptors
• NGF mimicry: Activation of TrkA in cholinergic neurons
• Trk signaling: Activation of PI3K/Akt and MAPK/ERK pathways
• Neuronal survival: Inhibition of the intrinsic apoptotic pathway

2. Neuroplasticity

• Synaptogenesis: Increase in dendritic spine density
• LTP (Long-Term Potentiation): Facilitation of synaptic plasticity
• Expression of synaptophysin: Marker of functional synapses
• Neurogenesis: Stimulation of the proliferation of neural progenitors in the dentate gyrus

3. Neuroprotection

• Anti-excitotoxicity: Modulation of NMDA receptors
• Antioxidant: Reduction of ROS in neurons
• Anti-apoptotic: Regulation of Bcl-2/Bax
• Anti-inflammatory: Reduction of activated microglia

4. Regulation of APP/Aβ Metabolism

• Reduction of Aβ: Modulation of APP processing toward the non-amyloidogenic pathway
• Tau phosphorylation: Reduction of tau protein hyperphosphorylation
• GSK-3β: Inhibition of this key kinase in Alzheimer's pathology

Clinical Evidence

Alzheimer's disease

Cochrane meta-analysis (2015):

• 6 randomized clinical trials
• Total N: 784 patients
• Results: Significant improvement in global cognitive function (ADAS-cog)
• Improvement in global clinical assessment (CIBIC+)
• Quality of evidence: Moderate

E-ADL Study (2011):

• 819 patients with mild to moderate Alzheimer's
• 24 weeks of IV treatment
• Significant improvement in ADAS-cog (-3.2 points vs placebo)
• Benefit maintained up to 6 months post-treatment

Cerebrovascular Accident

CASTA Study (2012):

• 1,070 patients with acute ischemic stroke
• Trend toward better functional recovery
• Significant improvement in the moderate-to-severe stroke subgroup (NIHSS >12)

Traumatic Brain Injury

• Studies in patients with moderate-to-severe TBI
• Improvement on the Glasgow Outcome Scale
• Reduction of inflammatory markers in CSF

Comparison with Nootropic Peptides

Semax (ACTH 4-10 + Pro-Gly-Pro)

Semax is a synthetic heptapeptide analog of ACTH(4-10):

• Mechanism: Modulation of BDNF, activation of TrkB, regulation of serotonin and dopamine
• Administration: Intranasal
• Advantages: Defined peptide, non-invasive administration
• Evidence: Approved in Russia for stroke and cognitive impairment
• Profile: More stimulating and focused on acute cognition

Selank (ACTH 4-7 + Thr-Pro-Arg)

Selank is a synthetic analog of tuftsin (Thr-Lys-Pro-Arg):

• Mechanism: GABAergic modulation, IL-6 regulation, anxiolytic effect
• Administration: Intranasal
• Advantages: Anxiolytic effect without sedation
• Evidence: Approved in Russia for anxiety disorders
• Profile: More anxiolytic and emotionally stabilizing

Direct Comparison

Neuroprotective Synergies

Research suggests synergistic potential between:

• Cerebrolysin + Semax: Neurotrophy + cognitive stimulation
• Semax + Selank: Cognition + emotional regulation
• Cerebrolysine + NAD+: Neurotrophy + mitochondrial energy support

Pharmacokinetics

• Administration: IV or IM (peptides cross the BBB)
• Volume: 5-30 mL per dose in clinical studies
• Treatment duration: Typically 10-30 days
• Onset of effect: 1-2 weeks
• Persistence: Effects sustained weeks after discontinuation

Conclusion

Cerebrolysin represents a pleiotropic approach to neuroprotection, acting simultaneously on multiple mechanisms of neuronal damage. Together with Semax and Selank, it forms a group of peptides with applications in neuroscience that address distinct aspects of brain function.

Available at Exoma Peptides with certified quality and COA included.

References

Material for research use only. The following primary sources support the scientific claims of this article:

1. Ziganshina LE, Abakumova T, Hoyle CH. Cerebrolysin for acute ischaemic stroke. Cochrane Database Syst Rev. 2020;(7):CD007026. PMID 32662068. (revisión sistemática: sin beneficio significativo y con señal de posible daño en ictus isquémico agudo)

Products available at EXOMA

• Cerebrolysin