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Rusalatide is a synthetic 23–amino acid peptide corresponding to the receptor‑binding domain of human thrombin (prothrombin 508–530) that functions as a thrombin receptor–activating, regenerative signaling peptide for tissue repair and vascular protection.[3][5][12] It mimics specific non‑coagulant signaling functions of thrombin at protease‑activated receptors on endothelial and other cells to stimulate angiogenesis, enhance osteogenesis, modulate cytokine responses, increase nitric oxide production, inhibit apoptosis, and activate progenitor and stem cells, thereby promoting repair of injured vasculature and tissues after ischemia, radiation, trauma, or chronic wounding.[3][5] Initially discovered at the University of Texas Medical Branch, it has been developed by Chrysalis BioTherapeutics and collaborators for indications including acute radiation syndrome, adult respiratory distress syndrome/acute respiratory distress syndrome, myocardial ischemia, diabetic foot ulcers, fractures, and other vascular and tissue injury settings, with orphan-drug designation for radiation injuries.[3][5][12]
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