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Systemic cardiovascular exercise also supports tissue perfusion, which may complement the peptide's proposed mechanism

FDA cites potential immunogenicity and impurity/characterization concerns for compounded BPC-157

Under physiological conditions, Nrf2 remains sequestered in the cytoplasm by its inhibitor, the Kelch-like ETC-associated protein 1 (Keap1), but oxidative or electrophilic stress triggers Nrf2 dissociation, nuclear translocation, and binding to antioxidant response elements (AREs), upregulating genes such as heme oxygenase-1 (HO-1), NAD(P)H quinone oxidoreductase 1 (NQO1), and glutathione S-transferases (GSTs) (Simes e Silva, 2025

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