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Further, LR3 IGF-I forms crucial ternary complexes with integrins (ITGAV:ITGB3 and ITGA6:ITGB4) and IGFR1, essential for comprehensive IGF1 signaling, influencing the phosphorylation and activation of IGFR1, MAPK3/ERK1, MAPK1/ERK2, and AKT1

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This is the central regulatory problem that full FDA approval would need to solve — and it is the reason PCAC reviews for peptides like BPC-157 often hinge on available safety data rather than efficacy evidence from controlled human studies