Novel Cytoprotective Mediator, Stable Gastric Pentadecapeptide BPC 157. Vascular Recruitment and Gastrointestinal Tract Healing

This 2018 review in *Current Pharmaceutical Design* is the most-cited synthesis of the BPC-157 mechanistic story by Sikiric and the Zagreb group — the laboratory that has published the bulk of the world's BPC-157 literature for three decades. The authors frame BPC-157 as a cytoprotective mediator whose effects depend on three coupled functions: protecting epithelial cells, protecting vascular endothelium, and dynamically modulating vascular tone in response to injury. Across rodent models the peptide is reported to accelerate ulcer healing, antagonize anticoagulant-induced bleeding, prevent both arterial and venous thrombosis, and recruit collateral circulation around vascular obstructions. The review surveys the experimental evidence supporting an angiogenic, NO-system-coupled mechanism and notes that human Phase I/II trials had begun for ulcerative colitis (under the development code PL 14736) and multiple sclerosis at the time of writing. It is the entry point for anyone trying to understand why a single short peptide appears to act across so many tissue systems.

This is a narrative review, not a meta-analysis — there is no systematic methodology, no risk-of-bias assessment, and the authors are the primary investigators of nearly every paper they cite. That isn't a disqualification (the field is small enough that the same group does much of the work), but it does mean the synthesis reflects one school's interpretation. The reviewed evidence is overwhelmingly rodent. The human trials referenced have not produced peer-reviewed Phase II efficacy publications since this review appeared. Read it as the most authoritative articulation of the mechanistic hypothesis, not as evidence that the hypothesis has been confirmed in humans.