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Examination of electron transport chain function in muscle and fibroblast culture, histological and electron microscopy examination of muscle and other biomarkers of mitochondrial metabolism revealed a pattern consistent with the notion that PPA could be interfering with mitochondrial metabolism at the level of the tricarboxylic-acid cycle (TCAC)

Absence of disulfide bridges: unlike many therapeutic peptides (somatostatin, octreotide, insulin), BPC-157 contains no cysteine and is therefore not stabilized by disulfide bridges

Activation of AMPK by upstream kinases phosphorylates target enzymes, such as acetyl-coA carboxylase (ACC), leading to inhibition of lipogenic pathways and activation of FA oxidation 22

That's not a footnote, it's a prescribing decision