BPC 157

What is BPC 157?

BPC 157 NZ health Education

Also known as PL 14736, BPC (Body Protection Compound) 157 is a peptide, which is a smaller form of protein made up of multiple amino acids bonded together. More specifically, it is a pentadecapeptide with amino acid sequence Gly-Glu-Pro-Pro-Pro-Gly-Lys-Pro-Ala-Asp-Asp-Ala-Gly-Leu-Val.

BPC 157 is a naturally occurring peptide found in human stomach juices, and in trace amounts in stomach fluids of other mammals. It “protects stomach cells”, “maintains gastric integrity against various noxious agents” and “is continuously present in the gastric mucosa and gastric juice” (1).

It has been found to be protective against adverse effects of alcohol and non-steroidal anti-inflammatories on the gastric epithelium and other epithelia, leading researchers to explore its use outside of the stomach. There are some early research into its use in central nervous system disorders (2) and irritable bowel disease (3).

Popular Use in Injuries

Along with another peptide TB 500, it is one of the two primary physical injury-healing peptides gaining popularity amongst professional athletes and body builders, a large number of whom are being guided by health professionals such as doctors and physiotherapists.

However, it is important to note that there has been no formal research into the efficacy of BPC 157 in human injuries. This means it is lacking reputable trials to guide usage, prove effectiveness of the treatment and explore side effects especially long term.

Numerous studies have looked into tendon and muscle healing nature of BPC 157 in rats with findings of: accelerated healing of transected Achilles tendon, in vitro tendocyte growth stimulation, promoted tendon-to-bone healing, opposed corticosteroid aggravation, ligament healing, and consistent improvement of transected quadriceps muscle healing (4) (5) (6) (7) (8).

Due to its reported effectiveness, the World Anti-Doping Agency has banned BPC 157 and a recent decision was made by Medsafe of New Zealand, which regulates medicines, to make BPC 157 a prescription medicine (9).

Evidence in Reducing Knee Pain

A retrospective study (10) was done at the Institute for Hormonal Balance in Orlando, Florida, USA to see whether intra-articular injection of the peptide BPC 157, alone or combined with TB4, helped relieve knee pain in a primary care setting.

The peptides were created via solid phase peptide synthesis. BPC157 was compounded at 2000 mcg/ml concentration and TB4 at 3000 mcg/ml concentration. Both were buffered with sodium phosphate buffer and benzyl alcohol for sterility and stability.

After consent, patients were injected with a 25 G 1.5-inch needle into the knee via the medial tibia plateau area. Two cc of BPC 157 was injected into the knee joint. Injections of BPC 157 with TB4 ranged from 1 cc of BPC157 plus 1 cc of TB4 to 2 cc of BPC 157.

A 1-year chart review from 2019 to 2020 was performed. Since this was a retrospective study, patient follow-up varied, with most patients having had an injection of peptide into their knee 6 months to 1 year prior to the study.

Of the 17 patients in the study, 16 were contacted by phone to follow up on the status of their knee pain. Only 1 patient could not be reached for the survey. Patients were asked to rate their pain prior to injection, the length of time the peptides helped ease the pain and the degree to which the injection helped them. No specific tools were used to measure their improvement in function, quality of life, stiffness or activities of daily living. The survey’s main goal was to determine whether BPC 157 helped with multiple types of knee pain in a primary care setting.

Result was that: Of the 16 patients, 12 had received only BPC 157 as an intra-articular injection. In this group, 11 of the 12 patients (91.6%) had significant improvement in knee pain, whereas 1 patient (8.3 %) had no improvement. The other 4 patients received a combination of 2 peptide injections of BPC 157 and TB4. Of the patients who received both peptides, 75% showed significant improvement, but 25% had no relief of their knee pain.

Overall, 14 of 16 patients (87.5%) had relief of their knee pain when BPC 157 or a combination of BPC 157 and TB4 was used.

However, the obvious limitation with this study is the general poor quality of research performed. Limited sample size, lack of a placebo and a retrospective nature with unclear sampling of patients.

Mechanism of Action (How it works)

Currently, the mechanism by which BPC 157 accelerates healing is not clearly understood. Current theories are: upregulation of growth factors, pro-angiogenic effects and modulation of nitric oxide (NO) synthesis, which have not been proved definitely yet experimentally (11) (12).

Route of Administration

Safety and Reported Side Effects

Side effects are anecdotal and have not been published in a research article.

If injected, BPC 157 like any other drug can cause redness, swelling, itching or skin reactions at the injection site. Other side effects include nausea, appetitie changes, diarrhoea, gas and bloating, dizziness and headache. 

Despite a recent gain in popularity in its use in injuries, no severe or long term side effect has been associated with BPC 157 yet.

References

1. Sikiric P, Hahm KB, Blagaic AB, Tvrdeic A, Pavlov KH, Petrovic A, et al. Stable Gastric Pentadecapeptide BPC 157, Robert’s Stomach Cytoprotection/Adaptive Cytoprotection/Organoprotection, and Selye’s Stress Coping Response: Progress, Achievements, and the Future. Gut and Liver. 2020 Mar 15;14(2):153–67.
 
2. Jakša Vukojević, Marija Milavić, Darko Perović, Spomenko Ilić, Andrea Zemba Čilić, Nataša Đuran, et al. Pentadecapeptide BPC 157 and the central nervous system. Neural Regeneration Research. 2022 Jan 1;17(3):482–2.
 
3. Sikiric P, Seiwerth S, Rucman R, Turkovic B, Rokotov DS, Brcic L, et al. Stable gastric pentadecapeptide BPC 157: novel therapy in gastrointestinal tract. Current Pharmaceutical Design [Internet]. 2011 [cited 2020 Apr 3];17(16):1612–32. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21548867
 
4. Staresinic M, Sebecic B, Patrlj L, Jadrijevic S, Suknaic S, Perovic D, et al. Gastric pentadecapeptide BPC 157 accelerates healing of transected rat Achilles tendon and in vitro stimulates tendocytes growth. Journal of Orthopaedic Research. 2003 Nov;21(6):976–83.
 
5. Krivic A, Anic T, Seiwerth S, Huljev D, Sikiric P. Achilles Detachment in Rat and Stable Gastric Pentadecapeptide BPC 157: Promoted Tendon-to-Bone Healing and Opposed Corticosteroid Aggravation. Journal of Orthopaedic Research. 2006 Mar 31;24(5):982–9.
 
6. Staresinic M, Petrovic I, Novinscak T, Jukic I, Pevec D, Suknaic S, et al. Effective therapy of transected quadriceps muscle in rat: Gastric pentadecapeptide BPC 157. Journal of Orthopaedic Research. 2006 Apr 11;24(5):1109–17.
 
7. Andrija Krivić, Mate Majerović, Jelić I, Sven Seiwerth, Predrag Sikirić. Modulation of early functional recovery of Achilles tendon to bone unit after transection by BPC 157 and methylprednisolone. Inflammation Research. 2008 May 1;57(5):205–10.
 
8. Cerovecki T, Bojanic I, Brcic L, Radic B, Vukoja I, Seiwerth S, et al. Pentadecapeptide BPC 157 (PL 14736) improves ligament healing in the rat. Journal of Orthopaedic Research. 2010 Mar 11;28(9):1155–61.
 
9. Minutes of the 70th meeting of the Medicines Classification Committee – 25 May 2023 [Internet]. http://www.medsafe.govt.nz. Medsafe; [cited 2023 Sep 30]. Available from: https://www.medsafe.govt.nz/profs/class/Minutes/2021-2025/mccMin25May2023.htm#5.2
 
10. Lee E, Padgett B. Intra-Articular Injection of BPC 157 for Multiple Types of Knee Pain. Alternative Therapies in Health and Medicine [Internet]. 2021 Jul 1 [cited 2023 Sep 30];27(4):8–13. Available from: https://pubmed.ncbi.nlm.nih.gov/34324435/
 
11. Chang CH, Tsai WC, Lin MS, Hsu YH, Pang JHS. The promoting effect of pentadecapeptide BPC 157 on tendon healing involves tendon outgrowth, cell survival, and cell migration. Journal of applied physiology (Bethesda, Md : 1985) [Internet]. 2011;110(3):774–80. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21030672
 
12. Gwyer D, Wragg NM, Wilson SL. Gastric pentadecapeptide body protection compound BPC 157 and its role in accelerating musculoskeletal soft tissue healing. Cell and Tissue Research. 2019 Mar 27;377(2):153–9.

 

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