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Under low oxygen conditions, HIF-1 acts as a key modulator of mitochondrial metabolism, actively repressing oxidative phosphorylation (OXPHOS) to reduce cellular oxygen consumption and mitochondrial-generated reactive oxygen species (ROS), which can be toxic at high levels (78)

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Bottom Line BPC157 remains an experimental peptide with mechanistic plausibility derived from preclinical models but insufficient human data to claim clinical efficacy or long term safety, and its regulatory and anti doping status increase risk for patients and athletes considering unsupervised use

Authors also thank Elisabeth Bascuana, Jordi Hernndez, Montserrat Jimnez, Damir Garcia-Cehic, Leonardo Nieto-Aponte, and Josep Gregori for their help in specimen processing