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& Sjholm, K

BPC-157 is not aspirin, but the principle that adding vascular-active agents to a DOAC increases bleeding risk is well established

Its defining structural feature is the gamma-glutamyl linkage: the glutamate residue is joined through its side-chain carboxyl rather than the usual alpha-peptide bond, which makes the molecule resistant to most intracellular peptidases and means it is cleaved almost exclusively by gamma-glutamyl transpeptidase at the outer cell surface (Zhang, Forman and Choi, Methods in Enzymology, 2005)