Kay Durairaj, MD, talks about the potential applications for peptides in aesthetic medicine, challenges in implementing them, and more.
Dr. Durairaj: Those of us who follow the biohacking world are starting to understand that nothing is magical about the word peptide. A peptide is basically a protein. We call something an amino acid if it consists of fewer than 50 connected amino acids; if it's more than 50, it becomes a peptide, and if it's a very big molecule, it becomes a protein. These small, short-chain peptides are the messengers that the mitochondria and DNA produce to tell the cells what they need to be doing to stay metabolically healthy. My feeling is that these peptides are the next generation of what will be prescribing because it is very difficult to splice genes, edit genes, and modify DNA. There can be a risk of cancer creation when you modify DNA. We can eliminate those issues by simply giving the cells what they need at the peptide level—something that DNA naturally creates, just less productively as you age. When you're in a disease state, imagine the ability to just provide those peptides; they are the exact proteins at the right rate for your age or for age maintenance. We can titrate peptides to the level of what you were at age 20 or 30 and maintain. So the idea is that we don't need to generally deteriorate. The peptides tell the cells to stay healthy and vibrant. I think we will see multiple peptides for multiple metabolic states. Hormones are a whole different issue, and we need to maintain those, too. However, definitely for various biochemical processes, we will have topical, oral, and injectable peptides.
Dr. Durairaj: That's the difficulty when the government regulates these drugs. Strictly, it means that we can have a laboratory discovery that can look amazing in animals that mimic humans, but we cannot get it to clinical trials or FDA approval for 15 years. We can literally have technology that now exists but cannot be used for the next 15 to 16 years. Very often, companies are then limited by the expenses of the clinical trials required by the FDA, which are typically around $2 million. So, the impact is that we will not see as much change or progression. Developments will not hit our family doctor's office for 20 years. The people on the cutting edge will be on the fringe, which leads to a lot of consumer confusion. Whom do you trust? How do you know something is not fringe medicine? All of us are facing this now. You can go overseas and get faster results with more access to products. Conversely, that is not best for consumer safety. Some peptides are available online. You can buy BPC-157, the body-protecting compound that is one of the most popular peptides, on Amazon. It says clearly that it is not for human consumption, but all the bodybuilders in Las Vegas are injecting it already. You also don’t know if something purchased online is sterile, commercially processed, or efficacious. Are you injecting sugar water? We don't know. The benefit of regulation is the safety.
Dr. Durairaj: We're in the infancy of understanding what peptides do and how they should be dosed. So much research remains to be done. The most important and critical factors are safety, efficacy, and making sure they are administered by medical professionals. Right now, a lot of peptides are being self-administered and administered in clinics for holistic medicine, which is discounting the value of a doctor vetting the product. Preferably, just like any health food store you walk into, you should know if the vitamins have been tested. Do they batch test? Do they look for product deficiency? Are they making sure there are no contaminants with good, sterile processing? All of those factors are critical. We are still in the infancy of understanding peptides, and I don't see it becoming anything mainstream for the next 10 to 15 years, unfortunately. With the success of tirzepatide and semaglutide, however, research has become very focused on the peptide market.
Kay Durairaj, MD, talks about the potential applications for peptides in aesthetic medicine, challenges in implementing them, and more.