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The Sikiric group has proposed several overlapping mechanisms: Nitric Oxide System Multiple rodent studies from the Zagreb group show BPC-157 influences endothelial nitric oxide synthase (eNOS) activity

The copper component of the peptide serves as an essential cofactor for lysyl oxidase and lysyl hydroxylase , enzymes critical for proper collagen cross-linking and stability

Blood was collected at 0, 0.5, 1, 1.5, 2, 2.5, 16, 18, 20, 22, 24, and 48 h post-OCC

Biomechanically, the healed tendons (over 14 days) showed an increased load to tendon failure and significantly higher functionality (Achilles functional IndexAFI)

Some peptides like BPC-157 can also be taken orally or applied topically, though absorption varies

However, if the symptoms occur regularly or in controlled environments without allergens present, it is a sign of MCAS