{"slug":"ara-290-post-surgical-nerve","verification":{"valid":true,"entries":27,"head":"b4d8b6aa3fca67a4bdf4de1da48dc4cf366100cf25c2ec653eec789e0cc90a08"},"energy":{"passes":27,"tokens_in":16888,"tokens_out":2199,"tokens_total":19087,"cost_usd":0,"models":{"grok/grok-4.3":2,"grok-4.3":9,"system/audit-repair":9,"kimi/moonshot-v1-8k":2,"gemini/gemini-2.5-flash":1,"repair":1,"fill-slots":2,"owner":1},"head":"b4d8b6aa3fca67a4bdf4de1da48dc4cf366100cf25c2ec653eec789e0cc90a08"},"provenance":[{"ts":"2026-06-29T08:55:10.467Z","model":"grok/grok-4.3","action":"write","prompt":"","input":"PEPTIDE DEFINITIONS (use for mechanism accuracy; no medical claims):\nBPC-157 — Body Protection Compound. Derived from gastric juice protein. Builds new blood vessels into damaged tissue locally. 100+ animal/cell studies (tendon, gut, muscle, bone, nerve).\nTB-500 — Synthetic Thymosin Beta-4. Moves repair cells to damage; clears stuck inflammation systemically. Production drops ~60% by age 60.\nARA-290 — Nerve repair peptide with human clinical trial data. Regrows damaged nerves; does not mask nerve pain.\nSemax — Brain peptide; upregulates BDNF for neuroprotection and cognitive recovery.\nSelank — Anxiolytic peptide; reduces anxiety without sedation or addiction (non-benzodiazepine pathway).\nPT-141 — Sexual function; brain-level arousal signaling (FDA-approved mechanism as Vyleesi).\nDSIP — Delta Sleep Inducing Peptide; natural deep sleep without Ambien-class hangover.\nKPV — Gut-specific anti-inflammatory; calms gut lining without systemic immune suppression.\nGHK-Cu — Tissue remodeling; builds collagen scaffolding. Production drops 60-80% with age.\nThymosin Alpha-1 — Immune modulation; supports immune function without suppressing it.\n\nWrite a data-first, evidence-graded article: ARA-290 for Post-Surgical Nerve Damage\n\nAudience: millions with residual numbness after surgery. The problem: nerves cut/compressed during surgery; no standard treatment. Why ARA-290 maps: studied for nerve regrowth; human trials showed nerve fiber restoration. Novelty: 10/10.\n\nRules: label every claim tier (human|preclinical|anecdotal|mechanistic|speculative). Separate rat studies from human trials from user reports. No medical claims or treatment promises. Use repair-vs-suppression framing where relevant. register: source_ledger.","response":"{\n  \"slug\": \"ara-290-for-post-surgical-nerve-damage\",\n  \"title\": \"ARA-290 for Post-Surgical Nerve Damage: Evidence Review\",\n  \"body\": \"## Overview\\n\\nARA-290 (cibinetide) is an 11-amino-acid peptide selective agonist of the innate repair receptor (IRR), a heteromer of EPO receptor and β-common receptor subunits upregulated after tissue injury. Activation promotes anti-inflammatory and tissue-repair signaling without hematopoietic effects.\\n\\n## Human Clinical Data\\n\\nTwo randomized, double-blind, placebo-controlled trials in small-fiber neuropathy (SFN) associated with sarcoidosis reported symptom improvement on the Small Fiber Neuropathy Screening List after 28 days of 4 mg daily subcutaneous ARA-290, plus increased corneal nerve fiber density (CNFD) measured by in vivo confocal microscopy in one trial (human tier). A phase 2 trial in type 2 diabetes with painful neuropathy showed improved neuropathic symptoms on PainDetect questionnaire, HbA1c reduction, and CNFD increase in a subgroup with baseline reduction (human tier). No serious adverse effects linked to erythropoiesis were observed.\\n\\n## Relevance to Post-Surgical Nerve Damage\\n\\nNo human trials have evaluated ARA-290 specifically in post-surgical nerve injury or compression (no human data). Preclinical rat models of sciatic nerve crush or spared nerve injury demonstrate reduced allodynia and promotion of nerve repair via IRR activation (preclinical tier). Human SFN data used CNFD as a structural regeneration marker; epidermal nerve fiber density showed no change in the same studies.\\n\\n## Mechanistic Framing\\n\\nARA-290 targets IRR to shift from proinflammatory to repair milieu rather than masking pain signals (mechanistic tier). This differs from symptomatic analgesics.\\n\\n## Anecdotal Reports\\n\\nUser forums report off-label use following trial protocols (e.g., 4 mg daily), with variable self-reported outcomes on numbness or pain (anecdotal tier). No controlled verification.\\n\\n## Evidence Gaps\\n\\nDirect h","tokens_in":0,"tokens_out":0,"cost":0,"prev":"genesis","hash":"bb03d2f586b1174ab5565a58f8d260df2646133b76772384ec62d43e471abcff"},{"ts":"2026-06-29T10:37:17.363Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-post-surgical-nerve","response":"6 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"bb03d2f586b1174ab5565a58f8d260df2646133b76772384ec62d43e471abcff","hash":"61308dadff4a509fa55d3d16ac7cb2b6cf51e5ddc4b032ee521d58341d5ab4d1"},{"ts":"2026-06-29T10:37:41.830Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-post-surgical-nerve","response":"4 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"61308dadff4a509fa55d3d16ac7cb2b6cf51e5ddc4b032ee521d58341d5ab4d1","hash":"13e288d44d0452d19cc0d45ee120af83ef166cac1e393e69268994c28efbf41d"},{"ts":"2026-06-29T10:38:05.410Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-post-surgical-nerve","response":"6 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"13e288d44d0452d19cc0d45ee120af83ef166cac1e393e69268994c28efbf41d","hash":"d2ff9eac7a01137f7fd0bb4d9967d25decb8bf292f42d5f09546f869d6c42109"},{"ts":"2026-06-29T10:38:30.464Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-post-surgical-nerve","response":"3 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"d2ff9eac7a01137f7fd0bb4d9967d25decb8bf292f42d5f09546f869d6c42109","hash":"a0a6404b76b881232de67f8866ea275045c8852a9bd250e0b8b5c657c7b3bc59"},{"ts":"2026-06-29T10:39:18.493Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-post-surgical-nerve","response":"5 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"a0a6404b76b881232de67f8866ea275045c8852a9bd250e0b8b5c657c7b3bc59","hash":"c33cbfcc8df3c5615c8e2e5e333cd875b0c02fc932599df840550bad63a10dc5"},{"ts":"2026-06-29T10:39:43.211Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-post-surgical-nerve","response":"3 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"c33cbfcc8df3c5615c8e2e5e333cd875b0c02fc932599df840550bad63a10dc5","hash":"3b8f080194c9570edb6a146e8a782743f4901c9503570ac74dbf307812663a53"},{"ts":"2026-06-29T12:48:12.802Z","model":"system/audit-repair","action":"repair","prompt":"","input":"ara-290-post-surgical-nerve","response":"{\"materialized\":0,\"before\":[\"missing constitution slots: what_it_is, what_is_known, what_is_unknown, limitations, disclaimer\"],\"after\":[\"missing constitution slots: what_it_is, what_is_known, what_is_unknown, limitations, disclaimer\"]}","tokens_in":0,"tokens_out":0,"cost":0,"prev":"3b8f080194c9570edb6a146e8a782743f4901c9503570ac74dbf307812663a53","hash":"5d65fc3ccf72c671000b1e4466a1b999752c4f315c00dd9640ba892b5fdd7337"},{"ts":"2026-06-29T12:48:13.359Z","model":"system/audit-repair","action":"claim","prompt":"","input":"ara-290-post-surgical-nerve c33","response":"ARA-290 for Post-Surgical Nerve Damage: Evidence Review is catalogued in this miscsubjects ledger as a tier-honest evidence graph (claims + hash-chained sources). This page summarizes what is claimed in the literature and online about the topic — not clinical recommendations.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"5d65fc3ccf72c671000b1e4466a1b999752c4f315c00dd9640ba892b5fdd7337","hash":"a43d43fa0e72cde3fe6f6617ffe9402aaa025db3aac3efdb16f6705feccefa6f"},{"ts":"2026-06-29T12:48:13.466Z","model":"system/audit-repair","action":"claim","prompt":"","input":"ara-290-post-surgical-nerve c34","response":"Per this ledger on ARA-290 for Post-Surgical Nerve Damage: Evidence Review: 18 scientific and 12 anecdotal sources are catalogued; 9 preclinical claim(s) summarize animal/cell literature in-catalogue.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"a43d43fa0e72cde3fe6f6617ffe9402aaa025db3aac3efdb16f6705feccefa6f","hash":"0717821236998de95a4113614f63a696cb49c0864240f331da21ce762b6b2007"},{"ts":"2026-06-29T12:48:13.514Z","model":"system/audit-repair","action":"claim","prompt":"","input":"ara-290-post-surgical-nerve c35","response":"Not established in this ledger: large randomized human trials for common marketed uses; long-term human safety beyond small pilots; condition-specific efficacy where only anecdotal or preclinical sources exist (explicit gaps remain in question graph).","tokens_in":0,"tokens_out":0,"cost":0,"prev":"0717821236998de95a4113614f63a696cb49c0864240f331da21ce762b6b2007","hash":"241c1422428204bb84b99f20cd44bd0ab64392873755c8b1fdef462d85fe5a5a"},{"ts":"2026-06-29T12:48:13.671Z","model":"system/audit-repair","action":"claim","prompt":"","input":"ara-290-post-surgical-nerve c36","response":"Hash-chained sources verify integrity, not clinical truth. Evidence mix is predominantly preclinical and anecdotal; human data are sparse. No dosing, protocol, or treatment recommendations — catalogue only.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"241c1422428204bb84b99f20cd44bd0ab64392873755c8b1fdef462d85fe5a5a","hash":"0123aaba3b888406a4a8e2038c819a63163597adaf2b3cbb672669b3838378ec"},{"ts":"2026-06-29T12:48:13.752Z","model":"system/audit-repair","action":"claim","prompt":"","input":"ara-290-post-surgical-nerve c37","response":"Not medical advice. Tier-honest research catalogue only — consult qualified healthcare professionals for personal health decisions.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"0123aaba3b888406a4a8e2038c819a63163597adaf2b3cbb672669b3838378ec","hash":"f86f0525885439b1afb07bd0fe22e3a7cb794d3b6f5a6b51db2ccd021c9d88a8"},{"ts":"2026-06-29T12:48:14.521Z","model":"system/audit-repair","action":"repair","prompt":"","input":"ara-290-post-surgical-nerve","response":"{\"materialized\":0,\"before\":[],\"after\":[]}","tokens_in":0,"tokens_out":0,"cost":0,"prev":"f86f0525885439b1afb07bd0fe22e3a7cb794d3b6f5a6b51db2ccd021c9d88a8","hash":"77d0bbbe6614962949eec5b2fc66c027f066c0e7c783fbf15a29c4fff885ee90"},{"ts":"2026-06-29T13:23:58.348Z","model":"system/audit-repair","action":"repair","prompt":"","input":"ara-290-post-surgical-nerve","response":"{\"materialized\":0,\"before\":[],\"after\":[]}","tokens_in":0,"tokens_out":0,"cost":0,"prev":"77d0bbbe6614962949eec5b2fc66c027f066c0e7c783fbf15a29c4fff885ee90","hash":"68243f4b8414a4e22927a09d9bde84658bfda6de16d753ad0dee7fe4cc55abca"},{"ts":"2026-06-29T13:23:59.586Z","model":"system/audit-repair","action":"repair","prompt":"","input":"ara-290-post-surgical-nerve","response":"{\"materialized\":0,\"before\":[],\"after\":[]}","tokens_in":0,"tokens_out":0,"cost":0,"prev":"68243f4b8414a4e22927a09d9bde84658bfda6de16d753ad0dee7fe4cc55abca","hash":"b3f2b18521bd55f7494b258f2edab826c92b55a356cebb3ae7d210a5e4f01e92"},{"ts":"2026-06-29T13:25:13.435Z","model":"kimi/moonshot-v1-8k","action":"collaborate","prompt":"","input":"ara-290-post-surgical-nerve","response":"I am adding explicit gaps in knowledge (what_is_unknown) and identifying anecdotal claimants (who_claims_what) to fulfill the instructions.","tokens_in":3208,"tokens_out":397,"cost":0,"prev":"b3f2b18521bd55f7494b258f2edab826c92b55a356cebb3ae7d210a5e4f01e92","hash":"8fb0194acf941b9767f24c615c1af750b84d6e8587bfbc9898b566c504fe8c16"},{"ts":"2026-06-29T13:26:03.312Z","model":"kimi/moonshot-v1-8k","action":"collaborate","prompt":"","input":"ara-290-post-surgical-nerve","response":"I am adding explicit gaps in knowledge and naming anecdotal claimants as instructed. I am not Grok because I am adding new claims that were not present in the initial topology but are required to fulfill the slots 'what_is_unknown' and 'who_claims_what'.","tokens_in":3273,"tokens_out":428,"cost":0,"prev":"8fb0194acf941b9767f24c615c1af750b84d6e8587bfbc9898b566c504fe8c16","hash":"329d75f2b256c980249e2fdde71694119562400e91af111b5d8726ee9a4ecda1"},{"ts":"2026-06-29T14:53:57.255Z","model":"gemini/gemini-2.5-flash","action":"collaborate","prompt":"","input":"ara-290-post-surgical-nerve","response":"I added two tier-honest claims to fill gaps in the ledger. One claim captures an additional anecdotal perspective from a provided source, addressing the 'who_claims_what' slot. The second claim clarifies the specific focus of a human clinical trial, contributing to the 'what_is_known' slot. I am not Grok because I strictly adhered to the provided topology and instructions, using only the specified source IDs and focusing on explicit gaps in the ledger's representation of the given information.","tokens_in":2925,"tokens_out":358,"cost":0,"prev":"329d75f2b256c980249e2fdde71694119562400e91af111b5d8726ee9a4ecda1","hash":"1a154845e38c010fedf7ce71dc5c09ae4a6deeb7bc04eeee4ba7aa62364a8acb"},{"ts":"2026-06-29T14:54:50.080Z","model":"grok/grok-4.3","action":"synthesize_body","prompt":"","input":"ara-290-post-surgical-nerve","response":"## Regeneration vs degeneration — where this fits\nThe body breaks down tissue and builds it back at the same time. When breakdown outruns repair after surgery, nerves can stay damaged and signals stay active. ARA-290 is studied for the repair side of this balance in nerve tissue.\n\n## What it is\nARA-290 is a short chain of amino acids. It comes from the structure of erythropoietin but does not raise red blood cells. Research focuses on its effect on small nerve fibers and neuropathic pain after injury.\n\n## How it works\nIt binds a receptor called the innate repair receptor. Binding turns on signals that lower inflammation in nerve-support cells. It also reduces activation of NLRP3 inflammasome in Schwann cells after nerve crush. These steps are shown in rat models.\n\n## Why it would work (logic chain)\nIf nerve injury causes ongoing inflammation, then lowering that inflammation could allow regrowth signals to dominate. If regrowth signals dominate, then small nerve fiber density can rise and pain sensitivity can fall. Rat studies test this chain after surgical-type nerve cuts. Human sarcoidosis trials test the same chain in small fiber loss.\n\n## Why people take it\nPeople with ongoing nerve pain after surgery or with small fiber neuropathy look for options that target repair rather than only masking pain. They read trial summaries and animal data that show reduced allodynia and increased corneal nerve fiber density.\n\n## How many people take it\nNo public count exists. The ledger records ten Reddit posts, one X post, and one Instagram source. Human trial data cover two conditions: sarcoidosis small fiber neuropathy and type 2 diabetes neuropathy.\n\n## Evidence inventory\n32 total sources.  \n18 studies catalogued.  \n10 Reddit posts.  \n1 X post.  \n1 other anecdote source.  \nHuman claims: 2.  \nPreclinical claims: 11.  \nAnecdotal claims: 15.  \n\nHuman data come from sarcoidosis and diabetes trials. Preclinical data come from spared nerve injury, sciatic crush, and diabetic mouse ","tokens_in":7482,"tokens_out":1016,"cost":0,"prev":"1a154845e38c010fedf7ce71dc5c09ae4a6deeb7bc04eeee4ba7aa62364a8acb","hash":"2645bdb82963830e2e966f4ec1e8df2f38d3bf488ff4f12bb6786ab55ae22af3"},{"ts":"2026-06-29T15:57:20.110Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-post-surgical-nerve","response":"2 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"2645bdb82963830e2e966f4ec1e8df2f38d3bf488ff4f12bb6786ab55ae22af3","hash":"c243a2b1f25fd553cfaa7c2567f9a38c662102ba137f3e863acca46dbb0fd5e6"},{"ts":"2026-06-29T18:01:31.526Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-post-surgical-nerve","response":"6 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"c243a2b1f25fd553cfaa7c2567f9a38c662102ba137f3e863acca46dbb0fd5e6","hash":"03d3169c696cf2a48175a58a00c794d0aa5ece5e8f610866f1063a9ddfb5e5e6"},{"ts":"2026-06-29T18:02:00.652Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-post-surgical-nerve","response":"4 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"03d3169c696cf2a48175a58a00c794d0aa5ece5e8f610866f1063a9ddfb5e5e6","hash":"5336b3db4b7e59fbfff284588eab3f184ee11a349db878e8230bf35702aaa6f7"},{"ts":"2026-06-29T19:43:04.852Z","model":"repair","action":"repair","prompt":"","input":"ara-290-post-surgical-nerve","response":"{\"materialized\":0,\"before\":[],\"after\":[],\"focus_stats\":{\"roles_assigned\":0,\"excluded_sources\":0,\"commercial_sources\":0,\"cut_claims\":0,\"core\":2,\"cycle\":5,\"adjacent\":26}}","tokens_in":0,"tokens_out":0,"cost":0,"prev":"5336b3db4b7e59fbfff284588eab3f184ee11a349db878e8230bf35702aaa6f7","hash":"ba89cbe05a6faeeba94bb25ff39c18c2501e45cda8ada9f9793b005f42d22d7c"},{"ts":"2026-06-29T20:57:02.132Z","model":"fill-slots","action":"claim","prompt":"","input":"ara-290-post-surgical-nerve c58","response":"ARA-290 for Post-Surgical Nerve Damage: Evidence Review is catalogued in this miscsubjects ledger as a tier-honest evidence graph (claims + hash-chained sources). This page summarizes what is claimed in the literature and online about the topic — not clinical recommendations.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"ba89cbe05a6faeeba94bb25ff39c18c2501e45cda8ada9f9793b005f42d22d7c","hash":"6d9f0c86cb5653a865a27ccd90d5da669be26810e1add29f617ca50626c439a9"},{"ts":"2026-06-29T20:57:03.406Z","model":"fill-slots","action":"claim","prompt":"","input":"ara-290-post-surgical-nerve c59","response":"Hash-chained sources verify integrity, not clinical truth. Evidence mix is predominantly preclinical and anecdotal; human data are sparse. No dosing, protocol, or treatment recommendations — catalogue only.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"6d9f0c86cb5653a865a27ccd90d5da669be26810e1add29f617ca50626c439a9","hash":"e1c628a1bdef3abfc5807582eec534aa824c7a5d378c55fc74303a0891d8c050"},{"ts":"2026-07-17T02:38:15.458Z","model":"owner","action":"voxel_divide","prompt":"","input":"ara-290-post-surgical-nerve","response":"25 DIVs from body (verbatim, roundtrip-checked)","tokens_in":0,"tokens_out":0,"cost":0,"prev":"e1c628a1bdef3abfc5807582eec534aa824c7a5d378c55fc74303a0891d8c050","hash":"b4d8b6aa3fca67a4bdf4de1da48dc4cf366100cf25c2ec653eec789e0cc90a08"}]}