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how could this peptide have any systemic activity?

Sikiric P, Seiwerth S, Grabarevic Z, Petek M, Rucman R, Turkovic B, et al

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The following discussion will substantiate that BPC 157 neutralizes NOs cytotoxic and damaging effects while supporting its beneficial and essential protective functions

Epigenetic and Cellular Reprogramming: By blocking NNMT-mediated methylation of nicotinamide, preserves NAD salvage pathway activity, increases SIRT-1 signaling, reduces histone deacetylation, and promotes metabolic reprogramming toward oxidative phosphorylation and glycolysis balance, supporting tissue repair and energy homeostasis 1-4

Some of them can be prevented, while others cannot