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22 Insulin signaling pathways Physiologically, insulin binds to the extracellular α subunit of insulin receptor, a receptor tyrosine kinase which recruits and phosphorates insulin receptor substrate (IRS)-1, thus activating phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling and diverse downstream pathways to maintain the glucose homeostasis

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Thus, BPC 157 and resolved vesicovaginal fistula issue—elaborated in this study, along with the other fistulas’ healing [5,6,7,8,9,10]—would certainly indicate BPC 157 as a noteworthy agent for fistula healing