The application of the BPC-157 peptide's therapy in skin diseases

Abstract: The regenerative function mentioned above enables the use of BPC-157 peptide therapy in skin diseases. The peptide not only accelerates the healing of existing dermatoses, but also alleviates their symptoms and limits their spread. Keywords: skin; epidermis; dermis; sweat glands; hair; hair follicles; skin disease; dermatoses; impetigo contagiosa; atopic dermatitis; lupus erythematosus; BPC-157 peptide therapy; folliculitis; skin burn; psoriasis; rosacea List of abbreviations: AD – Atopic Dermatitis; BPC-157 – Body Protection Compound; VEGF – Vascular Endothelial Growth Factor

Skin

Structure of the skin

The skin covering our body is classified as one of the largest organs. In an adult, its surface area ranges from 1.6 to 2.0 m², with a thickness of 0.5 to 1.0 mm. It is composed of three basic layers: the epidermis, dermis and subcutaneous tissue, along with associated sweat and sebaceous glands, hair, nails, blood and lymphatic vessels, and nerve endings.

The epidermis, the outermost layer of the skin, consists of the basal, spinous, granular, clear and cornified layers. The dermis is formed by the reticular and papillary layers, as well as the skin appendages. The network of nerve vessels is located in the dermis, and the skin’s vascularisation includes arterial-venous and lymphatic circulation.

In addition, the surface of the skin is covered by a lipid mantle and desquamated epidermis. A schematic reminder of the structure of the skin is presented in the diagram below (Fig. 1).

Figure 1. Schematic structure of human skin

Functions of the skin

By fulfilling important physiological roles, the skin protects internal organs from harmful environmental, physical, chemical and microbiological factors. It also allows the maintenance of balance between the body and its surroundings.

The most important and commonly recognised functions of the skin include the protective function, thermoregulation of the body, participation in water and excretory balance, involvement in the synthesis of proteins and certain compounds, and participation in the metabolism of proteins, lipids and carbohydrates. Additionally, the skin plays a crucial role in the immune response and in the conduction of sensory stimuli.

Skin diseases (Dermatoses)

Dermatoses are pathological changes that occur within the skin. They may involve all layers of the skin and even blood, lymphatic and nerve vessels. The diagnosis of a skin disease is associated with the presence of lesions (efflorescences), which are divided into primary and secondary. Primary lesions arise directly from the disease process, whereas secondary lesions are a consequence of primary lesions, such as scars.

Dermatoses can be classified into several groups, for example according to the aetiology of the condition (viral, bacterial or parasitic), the location of lesions (hair or nails), or the characteristics of primary lesions. Skin diseases are not only troublesome in terms of normal body function; their unaesthetic appearance also lowers our sense of well-being. Therefore, appropriate therapy is crucial to achieve cure or at least alleviate symptoms.

Some of these diseases are presented illustratively in the table below (Tab. 1).

Table 1. Selected skin diseases – illustrative overview

BPC-157 peptide therapy in selected dermatoses

1. Folliculitis

It is well known that BPC-157 peptide therapy is used for regenerative purposes. Hair follicles, which are channels from which hairs grow and which form part of the skin structure, together with the lipid mantle, protect the skin from damage. When a hair follicle is damaged, microorganisms penetrate into the channels, where they begin to multiply. In response, the body mounts a defence, leading to inflammation.

Folliculitis has two main causes: non-infectious and infectious. The former is associated with the use of preparations such as corticosteroids, but can also be the result of radiation-induced inflammation from excessive sun exposure. The infectious background is linked to bacteria of the streptococcal and staphylococcal groups, as well as infection with Pseudomonas aeruginosa, most often due to staying in swimming pools with contaminated water.

Factors that increase the risk of folliculitis include everyday activities such as depilation, shaving and intensive contact of the skin with clothing. Folliculitis presents as a red papule or pustule surrounding a hair. If left untreated or if the hair is improperly removed, relapses and more serious conditions such as furuncles may develop, which is why this state should not be underestimated. Folliculitis of infectious origin may occur in the setting of reduced immunity.

In both cases, it is essential to provide the body with substances that prevent the onset of symptoms. One method of treatment and prophylaxis is BPC-157 peptide therapy.

a. BPC-157 therapy

Skin diseases are accompanied by pain, discomfort and an unsightly appearance, which is why the ability of BPC-157 to restore the skin to its original state is highly valued. Through the action of BPC-157, proliferation and differentiation of the basal layer of the epidermis occur, which is of key importance in folliculitis. Rapid closure of the follicular wound through migration and proliferation of epithelial cells is crucial for restoring barrier function, which is essential for protecting the body.

The peptide stimulates the activity of macrophages and fibroblasts, leading to faster elimination of inflammation and wound healing by releasing growth factors that drive further migration and proliferation of fibroblasts. Pro-inflammatory cytokines are also released to trigger an immune response that eliminates the infection.

Systematic use of the BPC-157 peptide allows for rapid resolution of infection-related lesions, so that even when exposed to predisposing factors, the risk of folliculitis remains minimal. Use of BPC-157 in existing folliculitis reduces symptoms, accelerates healing and inhibits the spread of the inflammatory process.

Figure 2. BPC-157 therapy in the treatment of folliculitis

2. Atopic dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin disease. Its cause is not clearly defined or fully understood; however, genetic factors are considered the most probable and most common. Other causes include inadequate hygiene, allergens and abnormalities in the immune system.

Symptoms of atopic dermatitis include pruritus, oedema, eczema, dryness and erythema of the skin, as well as lichenification. Over time, the skin may become scaly and thickened due to increased sensitivity, especially with constant scratching of itchy areas. Appropriate treatment is required to alleviate symptoms and to prevent the spread of lesions through the formation of larger foci and the transfer of lesions to neighbouring areas of skin.

a. BPC-157 therapy

Considering the pathomechanism of AD, an imbalance between TH1 and TH2 lymphocytes is observed; balance between these populations is necessary for normal skin structure without pathological changes. In atopic dermatitis, BPC-157 therapy enables targeted therapeutic intervention in T-cell pathways by blocking specific molecules involved in pruritus and inflammation.

As mentioned in the context of folliculitis, BPC-157 stimulates macrophage activity. This is crucial in the treatment of atopic dermatitis, as stimulation of macrophages increases the production of B, T and NK lymphocytes, which restores the balance between T lymphocytes and thereby alleviates the symptoms of AD, including excessive hyperkeratosis and lichenification caused by intense itching.

In the treatment of AD, corticosteroids are most commonly used, but prolonged use is associated with a wide spectrum of adverse effects. Therefore, it is important to introduce alternative therapies that achieve the desired effect while eliminating serious side effects. BPC-157, as a fully safe product even during long-term use, may become a new mediator in the treatment of atopic dermatitis.

Figure 3. Effect of BPC-157 therapy on alleviating symptoms of atopic dermatitis

3. Skin burns

In the case of skin, a burn is characterised by damage of varying depth. Several degrees of burns are distinguished: first-degree burns involve only the epidermis; second-degree burns affect all layers of the epidermis and part of the dermis; and third-degree burns involve all layers of the skin and epidermis, extending into the subcutaneous connective tissue. Fourth-degree burns affect deeper tissues and cause necrosis.

Depending on the surface area involved, burns are divided into minor, moderate and severe. Treatment of burns is often long-lasting and painful, so appropriate therapy is needed to relieve symptoms and accelerate healing.

a. BPC-157 therapy

During BPC-157 peptide therapy, production of collagen fibres increases. Studies have also shown a reduced number of inflammatory cells. The peptide promotes the action of vascular endothelial growth factor (VEGF), inducing the formation of blood vessels, which supports skin regeneration processes.

In the context of burns, the action profile of BPC-157 includes less extensive necrosis and formation of cutaneous reticulin. As a result of these processes, burns heal faster and more effectively, and the scars that form are smaller and more flattened.

4. Skin necrosis

Skin necrosis occurs at the site of an existing wound, most often one caused by crushing, frostbite or burns. The causes of skin necrosis include hypoxia or ischaemia of tissues as well as bacterial infection. In skin necrosis, two types are distinguished: dry gangrene, which is not caused by bacteria, and wet gangrene, which develops due to bacterial proliferation near the wound.

Symptoms associated with necrosis include pain, oedema and erythema, followed by the appearance of blisters filled with pus and gas. In addition, necrosis is accompanied by systemic symptoms such as malaise and elevated blood pressure or body temperature.

Treatment of necrosis involves antibiotics, hyperbaric oxygen therapy or surgical removal of necrotic tissue. Modern approaches indicate the use of BPC-157 peptide therapy in the treatment of skin necrosis.

a. BPC-157 therapy

Through its regenerative action, BPC-157 reduces ulceration or prevents its development within the wound area. The peptide decreases the extent of necrosis and results in a more shallow wound. By activating transforming growth factor (TGF)-β1, BPC-157 increases the number of capillaries without increasing their diameter, enhances the formation of cutaneous reticulin and collagen fibres, and preserves a greater number of hair follicles. Altogether, these processes indicate the effectiveness of BPC-157 therapy in skin necrosis.

5. Psoriasis

Psoriasis is a chronic, recurrent skin disease that is not infectious. The lesions are visible and usually occur on such areas as the elbows, knees and scalp. The cause of psoriasis is not clearly defined, but genetic factors associated with polymorphism of the HLA-Cw6 gene are most often indicated. Psoriasis may also have an immunological background, in which Langerhans cells, thymus-dependent lymphocytes and T lymphocytes play a significant role.

The initial symptoms of psoriasis are scaly lesions of a red-brown colour. After scraping off the characteristic scales, the skin is smooth and shiny. Another possible symptom is heightened skin sensitivity to trauma: even minimal scratching may lead to rupture of blood vessels and bleeding at the site.

The method of treating psoriasis depends on disease severity and includes topical and systemic therapy.

a. BPC-157 therapy

BPC-157 peptide has the ability to inhibit the increased expression of β-defensins, LL-37, RNase 7, psoriasin and lysozyme, and thus may in patients with psoriasis be one of the main factors responsible for reduced susceptibility to skin infections. Although the peptide does not eliminate the disease itself, it significantly improves the quality of life in affected individuals and minimises symptoms.

The course of the disease is also important. Skin changes in psoriasis follow a strictly defined sequence of stages. During BPC-157 therapy, some of these stages may be halted, leading to inhibition of disease spread and prevention of more severe manifestations.

Figure 4. Effect of BPC-157 therapy in psoriatic lesions

6. Rosacea

Rosacea is a chronic skin disease limited to the facial area. It is worth noting that it typically begins after the age of 30, even in individuals with no prior symptoms. The causes of rosacea include genetic predisposition, and hormonal and vascular factors.

Additionally, exogenous factors may contribute to rosacea, such as local infectious agents (including infections), dietary factors (inappropriate diet), psychogenic factors (stress) and atmospheric conditions (sun, humidity, cold). Less commonly, rosacea develops as a consequence of the use of antibiotics or statins.

Symptoms usually start with changes on the skin of the nose, then extend to the cheeks, chin, forehead, neck and décolletage. Treatment of rosacea requires lifestyle modification, and both topical and systemic therapies generally include antibiotics. BPC-157 peptide is used as a novel therapeutic option in rosacea.

a. BPC-157 therapy

In rosacea, skin changes are characterised by high expression of cathelicidin. The action of BPC-157 initiates the activity of the KLK5 enzyme, which is present at high concentrations within skin lesions. In rosacea-affected skin, KLK5 is present throughout the epidermis, whereas the effect of BPC-157 reduces its concentration so that it is found only in the upper layers of the epidermis (granular and cornified layers.

This process leads to a reduction in symptoms, decreased visibility of lesions and inhibition of the spread of rosacea to neighbouring facial skin areas.

Conclusion

Healthy skin, its integrity and aesthetic appearance ensure quality of life and proper functioning of the body. Pathological changes known as dermatoses may involve both small and extensive skin areas. In both cases, appropriate therapeutic management is essential to alleviate symptoms and halt the spread of disease.

BPC-157 peptide therapy is effective and safe in many dermatoses. Prophylactic use of the peptide, even at high doses, does not produce adverse effects; on the contrary, it exerts a therapeutic effect.

References

1. Takeo M., Lee W., Ito M., Wound Healing and Skin Regeneration. 2015; DOI:10.1101/cshperspect.a023267
2. Wolk K., Kunz S., Witte E., Friedrich M., Asadullah K., Sabat R., IL-22 increases the innate immunity of tissues. 2004; 21: 241–254; DOI: 10.1016/j.immuni.2004.07.007
3. Rieg S., Steffen H., Seeber S., Humeny A., Kalbacher H., Dietz K., Deficiency of dermcidin-derived antimicrobial peptides in sweat of patients with atopic dermatitis correlates with an impaired innate defense of human skin in vivo. 2005; 174: 8003–8010; DOI:10.4049/jimmunol.174.12.8003
4. Seiwerth S., Mikus D., Sikirica P., Perovic D., Kokic N., Pentadecapeptide BPC 157 cream improves burn-wound healing and attenuates burn-gastric lesions in mice. 2001; DOI:10.1016/S0305-4179(01)00055-9
5. Bilic M., Bumber Z., Blagaic A., Sikiric P., The stable gastric pentadecapeptide BPC 157, given locally, improves CO₂ laser healing in mice. 2004; DOI:10.1016/j.burns.2004.10.013
6. Sørensen E., Cowland J., Ganz T., Borregaard N., Wound healing and expression of antimicrobial peptides/polypeptides in human keratinocytes, a consequence of common growth factors. 2003; 170: 5583–5589; DOI:10.4049/jimmunol.170.11.5583
7. Christophers E., Henseler T., Contrasting disease patterns in psoriasis and atopic dermatitis. 2000; 48–51; 10.1007/BF00585919