Vasireddi Nikhil, Hahamyan Henrik, Salata Michael J, Karns Michael, Calcei Jacob G, Voos James E, Apostolakos John M
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
East Tennessee State University, Quillen College of Medicine, Johnson City, TN, USA.
HSS J. 2025 Jul 31:15563316251355551. doi: 10.1177/15563316251355551.
Body protection compound-157 (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 fractures, tendon ruptures, ligament tears, and muscle injuries. Despite lacking US Food and Drug Administration approval and its use being banned in professional sports, it is increasingly used by clinicians and athletes. We sought to (1) provide a comprehensive synthesis of the BPC-157 literature from an orthopedic sports medicine perspective and (2) elucidate the mechanism of action, musculoskeletal effects, metabolism, and safety profile. We conducted a systematic review of English-language literature, published from database inception to June 3, 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 We searched PROSPERO to identify any current or unpublished reviews.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. Articles were screened in 3 phases by 2 reviewers. In cases of a disagreement between the 2 reviewers, blinding was removed, and eligibility was determined by group consensus, with a third author making the final decision. A total of 544 articles from 1993 to 2024 were identified. After duplicates were removed, 36 studies were included (35 preclinical studies, 1 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. In a retrospective study of musculoskeletal pain following intraarticular injection of BPC-157 for unspecified chronic knee pain, 7 of 12 patients reported relief for >6 months. BPC-157 is metabolized in the liver, with a half-life of less than 30 minutes, and is cleared by the kidneys. Preclinical safety studies showed no adverse effects across several organ systems. No clinical safety data were found. 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 counsel athletes to understand their organizations' rules to remain compliant with medication/supplement safety and testing standards.
身体保护化合物-157（BPC-157）是一种天然存在的胃肽，可促进黏膜完整性和内环境稳定。临床前研究表明其在促进骨折、肌腱断裂、韧带撕裂和肌肉损伤等肌肉骨骼损伤愈合方面具有潜力。尽管未获得美国食品药品监督管理局的批准且在职业体育中被禁止使用，但临床医生和运动员对其使用却越来越多。我们旨在（1）从骨科运动医学角度对BPC-157的文献进行全面综述，（2）阐明其作用机制、对肌肉骨骼的影响、代谢及安全性。我们对从数据库建立至2024年6月3日发表于PubMed、Cochrane和Embase的英文文献进行了系统综述。我们检索了国际前瞻性注册系统（PROSPERO）以确定当前或未发表的综述。纳入了报告BPC-157机制、肌肉骨骼结局、代谢和安全性的研究。文章由两名评审员分三个阶段进行筛选。若两名评审员意见不一致，则取消盲态，通过小组共识确定入选资格，由第三位作者做出最终决定。共识别出1993年至2024年的544篇文章。去除重复项后，纳入36项研究（35项临床前研究，1项临床研究）。研究表明，BPC-157可增强生长激素受体表达以及参与细胞生长和血管生成的多种途径，同时减少炎性细胞因子。在临床前模型中，BPC-157改善了肌肉、肌腱、韧带和骨损伤的功能、结构和生物力学结局。在一项关于关节腔内注射BPC-157治疗不明原因慢性膝关节疼痛后肌肉骨骼疼痛的回顾性研究中，12名患者中有7名报告疼痛缓解超过6个月。BPC-157在肝脏中代谢，半衰期小于30分钟，经肾脏清除。临床前安全性研究表明，在多个器官系统中均未发现不良反应。未找到临床安全性数据。这项对IV级和V级研究的系统综述表明，BPC-157在促进肌肉骨骼损伤恢复方面显示出前景。由于生产无监管、污染或临床安全性未知，可能会出现不良反应。我们建议临床医生告知运动员了解其所在组织的规定，以遵守药物/补充剂安全和检测标准。
