Pain management. Analgesic use of BPC-157 peptide therapy

Abstract: Pain, as a distressing phenomenon occurring in the human body, leads to impairment of normal functioning. Appropriately selected therapy, depending on its intensity and associated symptoms, may result in pain relief. BPC-157 peptide therapy is a modern therapeutic approach whose analgesic effect has been demonstrated in experimental studies.

Keywords: pain; BPC-157 therapy; acute pain; chronic pain; phantom pain; spinal pain; thalamic pain; analgesic drugs

List of abbreviations: BPC – Body Protection Compound; CNS – Central Nervous System

What is pain?

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It arises as a consequence of stimulation of pain receptors (nociceptors) or a decrease in their activation threshold (so-called nociceptive pain), as well as in situations involving damage to structures of the nervous system, even without concomitant tissue injury.

The conduction and generation of pain involve peripheral nerves, such as C fibres and A-delta fibres (Fig. 1). The process of pain development includes the following stages: transduction, transmission, modulation and perception.

Figure 1. Mechanism of pain generation

Function of pain

The primary function of pain is considered to be its warning and protective role. The warning function informs us of an imminent threat of tissue damage, leading to behavioural and reflex responses that limit the consequences of potential injury. Tissue damage triggers the onset of pain within both the peripheral and central nervous systems.

The protective function of pain involves reducing the likelihood of further damage by limiting physical activity.

Pathomechanism of pain

Acute pain

Acute pain serves mainly a protective function, signalling actual tissue damage. The body responds to this type of pain with a strong stress reaction, for example, an increase in blood pressure. Acute pain is an unpleasant type of pain with high intensity and severity.

Chronic pain

Chronic pain refers to pain processes persisting over an extended period. It is sometimes regarded as a disease in its own right requiring specialist therapy. Patients present with symptoms linked to physiological, psychological and social disturbances.

Chronic nociceptive pain

This type of pain occurs in conditions such as degenerative joint disease, back pain, osteoporosis or fibromyalgia.

Chronic neuropathic pain

Chronic neuropathic pain is caused by damage to the nervous system, spinal cord or peripheral nerves. Factors that may lead to this type of pain include ischaemia, injury to neural structures or radiation.

Phantom pain

Phantom pain is pain that occurs after amputation of all or part of a limb. The person after amputation perceives the constant presence of the removed limb and experiences pain in that region. Phantom pain may also occur after tooth extraction.

Complex regional pain syndromes

Complex Regional Pain Syndrome type I (reflex sympathetic dystrophy)

Type I complex regional pain syndrome is characterised by localised pain that appears after an initiating injury and is not confined to the territory of a single peripheral nerve. Pain intensity is disproportionate to the initial trauma. Symptoms include, among others, swelling and excessive sweating in the affected region.

Complex Regional Pain Syndrome type II (causalgia)

Causalgia is characterised by burning pain, allodynia or hyperalgesia, usually affecting the hand or foot, and occurs after partial damage to a nerve or one of its main branches. Symptoms typically arise immediately after nerve injury, although in some cases they may be delayed by several months. Pain is accompanied, among other features, by marked sensitivity to temperature and its fluctuations.

Spinal pain

Spinal pain accompanies, as the name suggests, damage to the spinal cord. In such cases, pain intensity varies but is not mild; patients experience severe or very severe pain in the spinal region.

Thalamic pain

Thalamic pain is associated with damage to the brainstem and higher levels of the CNS. This results in central pain of varying intensity, often manifested as headache.

Classification of analgesic drugs

Depending on their mode of action and the nature of pain, analgesic drugs may be classified as:

• Non-opioid analgesics (e.g. paracetamol, metamizole)
• Weak opioids (e.g. tramadol, codeine)
• Strong opioids (e.g. morphine, fentanyl)

BPC-157 peptide therapy is classified among analgesic treatment modalities. It is not assigned to any of the above drug groups due to its innovative nature; however, it exhibits very potent analgesic and anti-inflammatory properties.

Mechanism of action of analgesic drugs

Depending on the drug group and type of pain, the mechanisms of action differ.

Non-opioid drugs (NSAIDs) act at the site of inflammation by influencing pain receptors and inhibiting cyclooxygenase, an enzyme necessary for the synthesis of prostaglandins, which are present in all tissues and body fluids.

Opioids, in turn, act on opioid receptors to a lesser or greater degree, depending on whether they are weak or strong opioids. Their mechanism is based on binding of the drug molecule to opioid receptors, which leads to hyperpolarisation and therefore reduced excitability of receptor nerve cells, resulting in pain relief.

Analgesic BPC-157 therapy

According to studies on the interaction between dopaminergic drugs and opioids, BPC-157 exhibits an anti-receptor effect. Through its action, BPC-157 antagonises pain.

Moreover, the analgesic effect of BPC-157 has been observed at very low doses and within a short period of time. Its mechanism is based on activity within the central dopaminergic system.

These findings indicate that BPC-157 peptide is an innovative method for managing pain of varying intensity and different classifications. The analgesic effect of BPC-157 is illustrated schematically in Fig. 2.

Figure 2. Pain inhibition via BPC-157 therapy

Conclusion

Pain is a symptom that accompanies us in everyday life. Its presence reduces our physical and psychological well-being, hence the importance of appropriate therapy to relieve it. Both established pharmacological treatments and BPC-157 peptide therapy yield the expected outcomes.

Furthermore, BPC-157 use allows elimination of pain of varying intensity with a low dose that provides the desired therapeutic effect, without causing dependence and with a favourable safety profile.

References

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2. Żylicz Z., Krajnik M. Jak powstaje ból? Neurofizjologia bólu [How does pain arise? Neurophysiology of pain]. 2003; 2(1): 49–56.