y human case series we have for BPC-157. We reviewed papers earlier this year. One of them said that this paper we're going to review had significant methodological flaws and a lack of control limits in applicability and reliability. This was a systematic review that was recently published and it shows that there were only 35 preclinical studies and one clinical study for BPC-157, which we're going to talk about now. All right, so this was a case series published in 2021 in Alternative Therapies in Health and Medicine. This is the only human clinical study we have that was identified in multiple systematic reviews. All right, so let's go through this quickly. This was not a randomized control trial. It was a retrospective chart review. It was on 17 patients who received knee injections and then were later contacted by phone. Just to be clear, there was no placebo group, no steroid comparison group, no blinding, and no standardized assessment tool. Overall, this tells us the study is at a low level of evidence. Most of the patients in the study had knee pain, but no objectively confirmed diagnosis. They were trying to study multiple types of knee pain, whether that be osteoarthritis, meniscus injury, or other ligament injuries. The problem with the data set is that the underlying diagnosis was not consistently confirmed. Only 4 out of the 16 people got an MRI prior to the injection. So for most patients, we don't know the structural problem, which makes it really difficult to analyze. So looking at the results, 91% had significant improvement, but this was self-reported. There was no validated pain scale and no functional test was performed. So this table shows the four patients who received not only BPC or TB4, thymus and beta-4. This is another naturally occurring peptide we'll cover in another video. So three out of four improved, but as you can see, the doses were completely different. And interestingly, two who received the same low dose had opposite outcomes. This actually argues against drawing any real dose based conclusions. These are the four patients that got MRIs prior to their injection, so it confirms the diagnosis. This does not demonstrate structural healing because they got no MRI post-treatment. So sure, they had symptom relief, but there's no documented regeneration of any of these structures. Now, most patients had reported improvement beyond six months, but the follow-up time varied. Once again, no objective measures, no comparative arm. So the most important thing here is that durability claims cannot be confirmed against placebo or natural histories. Now these are the reported secondary outcomes from the paper. These are completely subjective self-reported scores. Overall pain, overall mobility, and overall sleep. No validated orthopedic outcome scales were actually used here. It's like a knee injury osteoarthritis outcome scale. Anyway, these are all the limitations that I kind of drew from the paper. Next video, we'll go into more detail, but yeah, thought that was very important to review.