611: Use of Body protection compound-157 (BPC-157) in Soft Tissue Injuries: A Systematic Review

Topic: Education, Societal Impact, and Others
Subtopic: Methodology (SLRs, Meta analysis)

Background and Aims: Therapeutic peptides are promising adjuncts in the management of soft tissue injuries. BPC-157 is a naturally occurring gastric peptide that promotes mucosal integrity and homeostasis. Preclinical studies show its potential for promoting healing in musculoskeletal injuries such as tendon ruptures, ligament tears, and muscle injuries. With no US Food and Drug Administration approval and its use being banned in professional sports, it is increasingly used by clinicians and athletes.

Aim:
Two-fold: (1) To provide a comprehensive literature review of the BPC-157 in term of soft tissue regeneration and (2) reveal the mechanism of action, musculoskeletal effects, metabolism, and safety profile.

Methods: We conducted a systematic review of English-language literature, published from database inception to December 31, 2024, from PubMed, Cochrane, and Embase. We searched PROSPERO to identify any current or unpublished reviews. Studies reporting BPC-157’s mechanism, musculoskeletal outcomes, metabolism, and safety were included. Two reviewers screened the articles in three stages. Blinding was eliminated when the two reviewers couldn't agree, and a third author made the final judgment about eligibility after reaching a group consensus.

Results: A total of 544 articles from 1993 to 2024 were identified. After duplicates were removed, 39 studies were included (36 preclinical studies, 3 clinical study). The studies suggest that BPC-157 enhances growth hormone receptor expression and several pathways involved in cell growth and angiogenesis, while reducing inflammatory cytokines. In preclinical models, BPC-157 improved functional, structural, and biomechanical outcomes in muscle, tendon, ligament, and bony injuries. BPC-157 is metabolized in the liver, has a half-life of less than 30 minutes, and is eliminated by the kidneys. Preclinical safety studies indicated no adverse effects. However, no clinical safety data were available.

Conclusions: Conclusion: This systematic review of level IV and level V studies suggests that BPC-157 shows promise for promoting recovery from musculoskeletal injuries. Adverse effects are possible due to unregulated manufacturing, contamination, or unknown clinical safety. We recommend that clinicians should urge athletes to understand their organizations’ rules and be cautious of the medication or supplements they take to remain compliant with safety and testing standards.

References: 1. Brcic L, Brcic I, Staresinic M, Novinscak T, Sikiric P, Seiwerth S. Modulatory effect of gastric pentadecapeptide BPC 157 on angiogenesis in muscle and tendon healing. J Physiol Pharmacol Off J Pol Physiol Soc. 2009;60(Suppl 7):191–196.
2. Cameron D, Burger H, Catt C, Gordon E, Watts J. Metabolic clearance of human growth hormone in patients with hepatic and renal failure, and in the isolated perfused pig liver. Metabolism. 1972;21(10):895–904.
3. Cerovecki T, Bojanic I, Brcic L, et al. Pentadecapeptide BPC 157 (PL 14736) improves ligament healing in the rat. J Orthop Res. 2010;28:1155–1161.
4. Chang CH, Tsai WC, Hsu YH, Pang JH. Pentadecapeptide BPC 157 enhances the growth hormone receptor expression in tendon fibroblasts. Molecules. 014;19:19066–19077.
5. Cushman CJ, Ibrahim AF, Smith AD, Hernandez EJ, MacKay B, Zumwalt M. Local and Systemic Peptide Therapies for Soft Tissue Regeneration: A Narrative Review. Yale J Biol Med. 2024 Sep 30;97(3):399-413. doi: 10.59249/TKNM3388.
6. Lee E, Padgett B. Intra-Articular Injection of BPC 157 for Multiple Types of Knee Pain. Altern Ther Health Med. 2021;27(4):8-13.
7. Lee E, Walker C, Ayadi B. Effect of BPC-157 on Symptoms in Patients with Interstitial Cystitis: A Pilot Study. Altern Ther Health Med. 2024;30(10):12-17.
8. Lee E, Burgess K. Safety of Intravenous Infusion of BPC157 in Humans: A Pilot Study. Altern Ther Health Med. 2025 Sep;31(5):20-24.

Presenting Author: Rifat Rehmani
Submitting Author: Rifat Rehmani

Senior Author: Hany Demian

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Hany Demian: MD, MBBCH, CCFP, MCFP, CEUSIP, - Assistant Clinical Professor, McMaster University.