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A review on inhibitors ERAP1 and ERAP2 was recently published (Georgiadis et al., 2019)

But its effects extend far beyond the gut

Long arginine 3-IGF-1, abbreviated as IGF-1 LR3 or LR3-IGF-1, is a synthetic protein and lengthened analogue of human insulin-like growth factor 1 (IGF-1).[1][2] It differs from native IGF-1 in that it possesses an arginine instead of a glutamic acid at the third position in its amino acid sequence (arginine 3), and also has an additional 13 amino acids at its N-terminus (MFPAMPLLSLFVN) (long), for a total of 83 amino acids (relative to the 70 of IGF-1).[2] The consequences of these modifications are that IGF-1 LR3 retains the pharmacological activity of IGF-1 as an agonist of the IGF-1 receptor, has very low affinity for the insulin-like growth factor-binding proteins (IGFBPs), and has improved metabolic stability.[1][2] As a result, it is approximately three times more potent than IGF-1,[3] and possesses a significantly longer half-life of about 2030 hours (relative to IGF-1s half-life of about 1215 hours).[4] IGF-1 LR3 Peptide is under active investigation in a number of cell culture and animal models

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The combination of peptide therapy and skilled physiotherapy produces results neither approach achieves alone