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Tepes M, Krezic I, Vranes H, Smoday IM, Kalogjera L, Zizek H, Vukovic V, Oroz K, Kovac KK, Madzar Z, Rakic M, Miskic B, Sikiric S, Barisic I, Strbe S, Antunovic M, Novosel L, Kavelj I, Vlainic J, Dobric I, Staresinic M, Skrtic A, Seiwerth S, Blagaic AB, Sikiric P. Stable Gastric Pentadecapeptide BPC 157 Therapy: Effect on Reperfusion Following Maintained Intra-Abdominal Hypertension (Grade III and IV) in Rats. Pharmaceuticals (Basel) 2023;16:1554. [PMID: 38004420 PMCID: PMC10675657 DOI: 10.3390/ph16111554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open

Abstract

Given in reperfusion, the use of stable gastric pentadecapeptide BPC 157 is an effective therapy in rats. It strongly counteracted, as a whole, decompression/reperfusion-induced occlusion/occlusion-like syndrome following the worst circumstances of acute abdominal compartment and intra-abdominal hypertension, grade III and grade IV, as well as compression/ischemia-occlusion/occlusion-like syndrome. Before decompression (calvariectomy, laparotomy), rats had long-lasting severe intra-abdominal hypertension, grade III (25 mmHg/60 min) (i) and grade IV (30 mmHg/30 min; 40 mmHg/30 min) (ii/iii), and severe occlusion/occlusion-like syndrome. Further worsening was caused by reperfusion for 60 min (i) or 30 min (ii/iii). Severe vascular and multiorgan failure (brain, heart, liver, kidney, and gastrointestinal lesions), widespread thrombosis (peripherally and centrally) severe arrhythmias, intracranial (superior sagittal sinus) hypertension, portal and caval hypertension, and aortal hypotension were aggravated. Contrarily, BPC 157 therapy (10 µg/kg, 10 ng/kg sc) given at 3 min reperfusion times eliminated/attenuated venous hypertension (intracranial (superior sagittal sinus), portal, and caval) and aortal hypotension and counteracted the increases in organ lesions and malondialdehyde values (blood ˃ heart, lungs, liver, kidney ˃ brain, gastrointestinal tract). Vascular recovery promptly occurred (i.e., congested inferior caval and superior mesenteric veins reversed to the normal vessel presentation, the collapsed azygos vein reversed to a fully functioning state, the inferior caval vein-superior caval vein shunt was recovered, and direct blood delivery returned). BPC 157 therapy almost annihilated thrombosis and hemorrhage (i.e., intracerebral hemorrhage) as proof of the counteracted general stasis and Virchow triad circumstances and reorganized blood flow. In conclusion, decompression/reperfusion-induced occlusion/occlusion-like syndrome counteracted by BPC 157 therapy in rats is likely for translation in patients. It is noteworthy that by rapidly counteracting the reperfusion course, it also reverses previous ischemia-course lesions, thus inducing complete recovery.

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Affiliation(s)

Marijan Tepes Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.) Department of Clinical Medicine, Faculty of Dental Medicine and Health Osijek, 31000 Osijek, Croatia; PhD Program Translational Research in Biomedicine-TRIBE, School of Medicine, University of Split, 21000 Split, Croatia
Ivan Krezic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Hrvoje Vranes Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Ivan Maria Smoday Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Luka Kalogjera Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Helena Zizek Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Vlasta Vukovic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Katarina Oroz Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Katarina Kasnik Kovac Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Zrinko Madzar Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Mislav Rakic Department of Abdominal Surgery, Clinical Hospital Dubrava, 10040 Zagreb, Croatia;
Blazenka Miskic Department of Clinical Medicine, Faculty of Dental Medicine and Health Osijek, 31000 Osijek, Croatia;
Suncana Sikiric Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.S.); (S.S.)
Ivan Barisic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Sanja Strbe Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Marko Antunovic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Luka Novosel Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Ivana Kavelj Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Josipa Vlainic Laboratory for Advanced Genomics, Division of Molecular Medicine, Institute Ruder Boskovic, 10000 Zagreb, Croatia;
Ivan Dobric Department of Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
Mario Staresinic Department of Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
Anita Skrtic Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.S.); (S.S.)
Sven Seiwerth Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (S.S.); (S.S.)
Alenka Boban Blagaic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)
Predrag Sikiric Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (M.T.); (I.K.); (H.V.); (I.M.S.); (L.K.); (H.Z.); (V.V.); (K.O.); (K.K.K.); (Z.M.); (I.B.); (S.S.); (L.N.); (I.K.); (A.B.B.)

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Kalogjera L, Krezic I, Smoday IM, Vranes H, Zizek H, Yago H, Oroz K, Vukovic V, Kavelj I, Novosel L, Zubcic S, Barisic I, Beketic Oreskovic L, Strbe S, Sever M, Sjekavica I, Skrtic A, Boban Blagaic A, Seiwerth S, Sikiric P. Stomach perforation-induced general occlusion/occlusion-like syndrome and stable gastric pentadecapeptide BPC 157 therapy effect. World J Gastroenterol 2023;29:4289-4316. [PMID: 37545637 PMCID: PMC10401663 DOI: 10.3748/wjg.v29.i27.4289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 06/01/2023] [Accepted: 06/19/2023] [Indexed: 07/13/2023] Open

Abstract

BACKGROUND

Using rat stomach perforation as a prototypic direct lesion applied in cytoprotection research, we focused on the first demonstration of the severe occlusion/ occlusion-like syndrome induced by stomach perforation. The revealed stomach-induced occlusion/occlusion-like syndrome corresponds to the previously described occlusion/occlusion-like syndromes in rats suffering multicausal pathology and shared severe vascular and multiorgan failure. This general point was particularly reviewed. As in all the described occlusion/occlusion-like syndromes with permanent occlusion of major vessels, peripheral and central, and other similar noxious procedures that severely affect endothelium function, the stable gastric pentadecapeptide BPC 157 was resolving therapy.

AIM

To reveal the stomach perforation-induced general occlusion/occlusion-like syndrome and BPC 157 therapy effect.

METHODS

The procedure included deeply anesthetized rats, complete calvariectomy, laparotomy at 15 min thereafter, and stomach perforation to rapidly induce vascular and multiorgan failure occlusion/occlusion-like syndrome. At 5 min post-perforation time, rats received therapy [BPC 157 (10 µg or 10 ng/kg) or saline (5 mL/kg, 1 mL/rat) (controls)] into the perforated defect in the stomach). Sacrifice was at 15 min or 60 min post-perforation time. Assessment (gross and microscopy; volume) included: Brain swelling, peripheral vessels (azygos vein, superior mesenteric vein, portal vein, inferior caval vein) and heart, other organs lesions (i.e., stomach, defect closing or widening); superior sagittal sinus, and peripherally the portal vein, inferior caval vein, and abdominal aorta blood pressures and clots; electrocardiograms; and bleeding time from the perforation(s).

RESULTS

BPC 157 beneficial effects accord with those noted before in the healing of the perforated defect (raised vessel presentation; less bleeding, defect contraction) and occlusion/occlusion-like syndromes counteraction. BPC 157 therapy (into the perforated defect), induced immediate shrinking and contraction of the whole stomach (unlike considerable enlargement by saline application). Accordingly, BPC 157 therapy induced direct blood delivery via the azygos vein, and attenuated/eliminated the intracranial (superior sagittal sinus), portal and caval hypertension, and aortal hypotension. Thrombosis, peripherally (inferior caval vein, portal vein, abdominal aorta) and centrally (superior sagittal sinus) BPC 157 therapy markedly reduced/annihilated. Severe lesions in the brain (swelling, hemorrhage), heart (congestion and arrhythmias), lung (hemorrhage and congestion), and marked congestion in the liver, kidney, and gastrointestinal tract were markedly reduced.

CONCLUSION

We revealed stomach perforation as a severe occlusion/occlusion-like syndrome, peripherally and centrally, and rapid counteraction by BPC 157 therapy. Thereby, further BPC 157 therapy may be warranted.

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Sikiric P, Gojkovic S, Krezic I, Smoday IM, Kalogjera L, Zizek H, Oroz K, Vranes H, Vukovic V, Labidi M, Strbe S, Baketic Oreskovic L, Sever M, Tepes M, Knezevic M, Barisic I, Blagaic V, Vlainic J, Dobric I, Staresinic M, Skrtic A, Jurjevic I, Boban Blagaic A, Seiwerth S. Stable Gastric Pentadecapeptide BPC 157 May Recover Brain-Gut Axis and Gut-Brain Axis Function. Pharmaceuticals (Basel) 2023;16:ph16050676. [PMID: 37242459 DOI: 10.3390/ph16050676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/12/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open

Abstract

Conceptually, a wide beneficial effect, both peripherally and centrally, might have been essential for the harmony of brain-gut and gut-brain axes' function. Seen from the original viewpoint of the gut peptides' significance and brain relation, the favorable stable gastric pentadecapeptide BPC 157 evidence in the brain-gut and gut-brain axes' function might have been presented as a particular interconnected network. These were the behavioral findings (interaction with main systems, anxiolytic, anticonvulsive, antidepressant effect, counteracted catalepsy, and positive and negative schizophrenia symptoms models). Muscle healing and function recovery appeared as the therapeutic effects of BPC 157 on the various muscle disabilities of a multitude of causes, both peripheral and central. Heart failure was counteracted (including arrhythmias and thrombosis), and smooth muscle function recovered. These existed as a multimodal muscle axis impact on muscle function and healing as a function of the brain-gut axis and gut-brain axis as whole. Finally, encephalopathies, acting simultaneously in both the periphery and central nervous system, BPC 157 counteracted stomach and liver lesions and various encephalopathies in NSAIDs and insulin rats. BPC 157 therapy by rapidly activated collateral pathways counteracted the vascular and multiorgan failure concomitant to major vessel occlusion and, similar to noxious procedures, reversed initiated multicausal noxious circuit of the occlusion/occlusion-like syndrome. Severe intracranial (superior sagittal sinus) hypertension, portal and caval hypertensions, and aortal hypotension were attenuated/eliminated. Counteracted were the severe lesions in the brain, lungs, liver, kidney, and gastrointestinal tract. In particular, progressing thrombosis, both peripherally and centrally, and heart arrhythmias and infarction that would consistently occur were fully counteracted and/or almost annihilated. To conclude, we suggest further BPC 157 therapy applications.

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Affiliation(s)

Predrag Sikiric Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Slaven Gojkovic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Ivan Krezic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Ivan Maria Smoday Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Luka Kalogjera Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Helena Zizek Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Katarina Oroz Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Hrvoje Vranes Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Vlasta Vukovic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
May Labidi Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Sanja Strbe Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Lidija Baketic Oreskovic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Marko Sever Department of Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Marijan Tepes Department of Clinical Medicine, Faculty of Dental Medicine and Health, University of Osijek, 31000 Osijek, Croatia
Mario Knezevic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Ivan Barisic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Vladimir Blagaic Department of Obstetrics and Gynecology, Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia
Josipa Vlainic Laboratory for Advanced Genomics, Division of Molecular Medicine, lnstitute Ruder Boskovic, 10000 Zagreb, Croatia
Ivan Dobric Department of Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Mario Staresinic Department of Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Anita Skrtic Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Ivana Jurjevic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Alenka Boban Blagaic Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
Sven Seiwerth Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia

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Stable Gastric Pentadecapeptide BPC 157 as Useful Cytoprotective Peptide Therapy in the Heart Disturbances, Myocardial Infarction, Heart Failure, Pulmonary Hypertension, Arrhythmias, and Thrombosis Presentation. Biomedicines 2022;10:biomedicines10112696. [PMID: 36359218 PMCID: PMC9687817 DOI: 10.3390/biomedicines10112696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/08/2022] [Accepted: 10/15/2022] [Indexed: 11/30/2022] Open

Abstract

In heart disturbances, stable gastric pentadecapeptide BPC 157 especial therapy effects combine the therapy of myocardial infarction, heart failure, pulmonary hypertension arrhythmias, and thrombosis prevention and reversal. The shared therapy effect occurred as part of its even larger cytoprotection (cardioprotection) therapy effect (direct epithelial cell protection; direct endothelium cell protection) that BPC 157 exerts as a novel cytoprotection mediator, which is native and stable in human gastric juice, as well as easily applicable. Accordingly, there is interaction with many molecular pathways, combining maintained endothelium function and maintained thrombocytes function, which counteracted thrombocytopenia in rats that underwent major vessel occlusion and deep vein thrombosis and counteracted thrombosis in all vascular studies; the coagulation pathways were not affected. These appeared as having modulatory effects on NO-system (NO-release, NOS-inhibition, NO-over-stimulation all affected), controlling vasomotor tone and the activation of the Src-Caveolin-1-eNOS pathway and modulatory effects on the prostaglandins system (BPC 157 counteracted NSAIDs toxicity, counteracted bleeding, thrombocytopenia, and in particular, leaky gut syndrome). As an essential novelty noted in the vascular studies, there was the activation of the collateral pathways. This might be the upgrading of the minor vessel to take over the function of the disabled major vessel, competing with and counteracting the Virchow triad circumstances devastatingly present, making possible the recruitment of collateral blood vessels, compensating vessel occlusion and reestablishing the blood flow or bypassing the occluded or ruptured vessel. As a part of the counteraction of the severe vessel and multiorgan failure syndrome, counteracted were the brain, lung, liver, kidney, gastrointestinal lesions, and in particular, the counteraction of the heart arrhythmias and infarction.

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