Skip to content

Patients › General-Health

Peptide Therapy in Musculoskeletal Medicine

PDF Evidence

Injectable and regenerative peptide therapies in orthopaedics and sports medicine — what the evidence shows for tendon, cartilage and bone healing, and where the hype outpaces the data.

Updated Sep 202614 citations
A peptide molecular chain beside a small vial.
Peptide therapies are heavily marketed for healing and recovery; the evidence for musculoskeletal use is limited. Kieran Hirpara 4.0

What it is

Peptide therapy uses tiny chains of building blocks called peptides, which your body already makes to send signals between cells. The idea is that these signals could help damaged tissue heal. In bone and joint medicine, most of this is still at the research stage.

Right now, the evidence does not support using injectable peptides for orthopaedic and sports problems [1]. They remain largely experimental [2]. Peptide supplements are not recommended as a replacement for, or an add-on to, standard care [3]. One peptide called BPC-157 is widely promoted for sports recovery, but there are no randomised controlled trials of it in humans [4], so its effectiveness and safety are unknown [4].

You may also see peptides sold online and through social media, often with exaggerated claims and little regulatory oversight [5]. Be cautious about what these products promise.

There is one clear exception. Two growth factors, called BMP-2 and BMP-7, can be recommended based on level I studies [6]. Growth factors are natural substances that encourage cells to grow and specialise. BMP stands for bone morphogenetic protein, and these two are approved for specific bone healing problems: open tibial fractures treated with intramedullary fixation, and tibial non-union, where a broken shin bone fails to heal [7].

Other peptides are being studied in the lab. In animal models of rotator cuff tears, BMP-7 improved the quality of tendon-to-bone healing [8], and a peptide called GHRP-2 improved tendon-bone healing properties [9]. These findings are early steps, not treatments you can access yet.

Your doctor will talk you through any option with solid evidence behind it, and will tell you plainly when something is still experimental.

Does it work?

For most peptides, the honest answer is that we do not know yet. Good-quality trials in humans are missing for many of these treatments. BPC-157, for example, is widely promoted for sports recovery, but there are no randomised controlled trials of it in people [1]. Without those trials, there is no reliable way to judge whether it helps or how safe it is.

There is one clear exception. BMP, short for bone morphogenetic protein, is a natural substance that encourages bone cells to grow. It has two approved uses: treating open shin bone fractures fixed with a rod inside the bone, and treating a shin bone that has failed to heal after a break [2]. These are specific situations, not general uses.

Other work is still at the laboratory stage. In animal studies, a peptide called BDNF placed in a gel showed promise for protecting nerve tissue after severe spinal cord injury [3]. Another study looked at combining a peptide gel with a cartilage repair technique in horses and found it could improve cartilage healing [4]. These findings are early steps. What works in animals does not always work in people, and these treatments are not available as standard care.

One more finding is worth knowing. Two peptides your body makes, called substance P and calcitonin gene-related peptide, appear in higher amounts in tendons that are more badly worn [5]. This tells researchers these peptides are linked to tendon problems, but it does not mean taking them as a treatment will help.

So the picture is mixed. Some peptides have solid evidence in narrow situations. Most do not, and some are being sold with claims that outrun the science. If you are considering peptide therapy, ask what trials have tested it in people, and be wary of anything that promises more than the research can back.

What are the risks?

For most peptide treatments, the honest answer is that nobody knows the full risk picture yet. Researchers have said plainly that there is a lack of evidence to support using peptide therapy in bone and joint care [1]. For BPC-157, the science is not there to judge how safe it is or when it should be used [2]. That means any side effects are not well mapped out. If you use a peptide product sold online, you cannot know what it contains or how your body will react to it.

The clearest safety information comes from the treatments with the strongest evidence. BMP-2 and BMP-7 are the only peptides recommended based on level I studies [3], and they are approved for two specific bone healing problems [4]. Outside those approved uses, the risks of other peptides in people have not been studied properly.

Some findings come from animal research, which cannot tell you what would happen in your body. In rat studies of rotator cuff tears, BMP-7 improved tendon-to-bone healing [5] and GHRP-2 improved healing properties [6]. A gel containing BDNF protected nerve tissue in animals with severe spinal cord injury, but the animals did not regain movement [7]. These are early laboratory steps, not proof of safety in people.

One small human finding exists. A treatment called EGYFIL seemed to reduce pain and stiffness within 3 hours of the first application, and during 3 days of treatment [8]. That is a short study window, so longer-term effects are unknown.

The practical risk is not only physical. Peptide products sold online and through social media often carry exaggerated claims with little oversight [9]. Using them instead of standard care could delay treatment that has evidence behind it. If you are considering any peptide therapy, ask what trials have tested it in people, what side effects were seen, and whether it is approved for your condition.

Is it right for you?

For most bone and joint problems, peptide therapy is not ready to be part of your care. The evidence does not support using it yet [1]. Your doctor will tell you plainly if a treatment is still experimental, and will talk you through options that have solid research behind them.

There is one narrow exception. For a specific type of cartilage damage in the knee, one study found that treating the defect with a peptide called KLD, or with a standard cartilage repair technique called microfracture, both improved symptoms compared with no treatment [2]. That finding comes from early research, not from large trials in many people. It does not mean peptides are a general answer for worn or damaged joints.

So who tends to suit this kind of treatment? Almost nobody right now, outside carefully run trials and the specific bone healing situations described earlier on this page. If you have a sports injury, a tendon problem or wear-and-tear arthritis, standard care has far more evidence behind it than any peptide product you can buy.

The decision should be a shared one. Bring your questions to your doctor. Ask what trials have tested the treatment in people, what side effects were seen, and whether it is approved for your condition. If the honest answer is that nobody knows, that is useful information too. The risks section above explains what is and is not known about safety.

The bottom line

For most bone and joint problems, peptide therapy is not something to seek out yet. The evidence does not support using it in orthopaedic and sports medicine at this stage [1]. There is one narrow exception: for a specific type of knee cartilage damage, early research found that treatment with a peptide called KLD, or with a standard cartilage repair technique called microfracture, both improved symptoms compared with no treatment [2]. If you are thinking about peptides, hold a realistic expectation: most of this field is still experimental, and the single most important caveat is that many promoted products have never been tested in proper human trials.

Reviewed by Kieran Hirpara · 12 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

References
  1. Injectable Peptide Therapy: A Primer for Orthopaedic and Sports Medicine Physicians. *The American Journal of Sports Medicine*. 2026. 10.1177/03635465251357593
  2. Injectable Peptides in Sports Medicine: A Structured Narrative Review of Evidence, Safety, and Antidoping Implications. *JBJS Reviews*. 2026. 10.2106/jbjs.rvw.26.00027
  3. Peptide Supplements and Their Therapeutic Applications in Sports Medicine. *The American Journal of Sports Medicine*. 2026. 10.1177/03635465261464420
  4. Injectable Therapeutic Peptides—An Adjunct to Regenerative Medicine and Sports Performance?. *Arthroscopy*. 2024. 10.1016/j.arthro.2024.09.005
  5. Paper 32. Performance & Promises: A Social Media Review of Alleged Indications, Risks and Usage of “Peptides” in Musculoskeletal Health. *Orthopaedic Journal of Sports Medicine*. 2026. 10.1177/2325967126s00290
  6. Carrier systems and application of growth factors in orthopaedics. *Injury*. 2008. 10.1016/s0020-1383(08)70014-7
  7. Clinical applications of growth factors in bone injuries: Experience with BMPs. *Injury*. 2013. 10.1016/s0020-1383(13)70008-1
  8. Effects of BMP-7 and Low Molecular Weight Peptide Solution on Healing in a Rotator Cuff Tear Model: A Histopathological and Biomechanical Study in Rats. *Journal of Shoulder and Elbow Surgery*. 2026. 10.1016/j.jse.2026.04.003
  9. Growth Hormone–Releasing Peptide 2 May Be Associated With Decreased M1 Macrophage Production and Increased Histologic and Biomechanical Tendon‐Bone Healing Properties in a Rat Rotator Cuff Tear Model. *Arthroscopy*. 2024. 10.1016/j.arthro.2024.11.094
  10. Biofunctionalized peptide-based hydrogel as an injectable scaffold for BDNF delivery can improve regeneration after spinal cord injury. *Injury*. 2019. 10.1016/j.injury.2018.12.027
  11. Microfracture Augmentation With Trypsin Pretreatment and Growth Factor–Functionalized Self-assembling Peptide Hydrogel Scaffold in an Equine Model. *The American Journal of Sports Medicine*. 2021. 10.1177/03635465211021798
  12. The expression of substance P and calcitonin gene-related peptide is associated with the severity of tendon degeneration in lateral epicondylitis. *BMC Musculoskeletal Disorders*. 2021. 10.1186/s12891-021-04067-1
  13. A pre-market interventional, single-arm clinical investigation of a new topical lotion based on hyaluronic acid and peptides, EGYFILTM, for the treatment of pain and stiffness in soft tissues. *BMC Musculoskeletal Disorders*. 2023. 10.1186/s12891-023-06903-y
  14. Effects of the Combination of Microfracture and Self-Assembling Peptide Filling on the Repair of a Clinically Relevant Trochlear Defect in an Equine Model. *Journal of Bone and Joint Surgery*. 2014. 10.2106/jbjs.m.01408
Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Injectable peptide therapy may possess significant therapeutic and regenerative potential [1].
  • There is a current lack of evidence to support the clinical use of injectable peptides [1].
  • Injectable peptides for sports medicine remain largely experimental [4].
  • Peptide supplements should not currently be recommended as a replacement or adjunct for existing orthopaedic standard of care due to the lack of robust efficacy and safety data [2].
  • Peptides are being widely advertised and sold through social media, often with exaggerated claims and minimal regulatory oversight [6].
  • Loss of function in musculoskeletal tissues initiates from either a failure of the cells that produce and maintain the extracellular matrix (ECM) or as a consequence of material failure of the ECM itself [13].
  • Advances in the identification of candidate therapeutic cell populations and the development of new biomaterials have occurred over the last three decades to address degenerative processes in musculoskeletal tissues [13].
  • Therapeutic cell populations and new biomaterials can be applied alone or in combination to promote healing that alters the trajectory of disease or potentially replace an entire tissue when damage has progressed to later stages [13].
  • The use of BMP currently has two FDA-approved indications: treatment of open tibial fractures treated with intramedullary fixation and treatment of tibia long bone non-union [8].
  • Only BMP-2 and BMP-7 can be recommended based on level I studies [5].
  • GLP-1 agonists may not produce sufficient weight loss to achieve body mass index cutoffs for total joint arthroplasty depending on individual patient factors, including starting bodyweight [7].

How It Works

  • Peptide therapy may possess significant therapeutic and regenerative potential [1].
  • There is a current lack of evidence to support the clinical use of peptides in orthopaedic and sports medicine [1].
  • Robust efficacy and safety data for peptide supplements are currently lacking [2].
  • Peptide supplements should not currently be recommended as a replacement or adjunct for existing orthopaedic standard of care [2].
  • BMP-2 and BMP-7 are the only growth factors that can be recommended based on level I studies [5].
  • BMP currently has two FDA-approved indications: treatment of open tibial fractures treated with intramedullary fixation and treatment of tibia long bone non-union [8].
  • Therapeutic strategies for microfracture augmentation using growth factor–functionalized self-assembling peptide hydrogel scaffolds can be cost-effective ways to improve cartilage healing outcomes [9].
  • BMP-7 application significantly enhances the quality of tendon-to-bone healing by promoting structural maturation and functional stability in a rat rotator cuff tear model [10].
  • GHRP-2 administration reduced M1 macrophage polarization and enhanced histologic and biomechanical tendon-bone healing properties in a rat rotator cuff tear model [11].
  • Exosomes offer a promising cell-free alternative to mesenchymal stem cell therapies for upper-extremity tissue regeneration by overcoming limitations such as donor-site morbidity and tumorigenesis [12].
  • A better understanding of exosome mechanisms and standardized isolation methods is required before clinical application [12].

What the Evidence Shows

Current Clinical Status and Recommendations

  • Orthopaedic and sports medicine providers must understand the current lack of evidence to support the clinical use of peptide therapy [1].
  • The use of BPC-157 for sports performance and recovery is not recommended because there are no randomized controlled trials investigating its use in human subjects [14].
  • The science is lacking to determine the overall effectiveness, safety profile, and clinical indications for BPC-157 in sports enhancement in athletes [14].

Regulatory and Commercial Context

  • Various materials are on the market for which no clinical or experimental long-term data on soft tissue or bone reaction is available [18].

Specific Peptide Applications and Outcomes

  • EGYFIL is safe and seems to reduce pain and stiffness in patients during the 3 days of treatment, already after 3 h from the first application [15].
  • Treatment of trochlear defects with only KLD or with only microfracture resulted in an improvement in clinical symptoms compared with no treatment in an equine model [17].
  • Therapeutic strategies for microfracture augmentation, such as those using trypsin pretreatment and growth factor–functionalized self-assembling peptide hydrogel scaffolds, can be cost-effective ways to improve cartilage healing outcomes in an equine model [9].

Adjunctive Therapies

Practical Considerations

  • Orthopaedic and sports medicine providers must understand the current lack of evidence supporting the clinical use of peptide therapies [1].
  • Peptides are widely advertised and sold through social media, often with exaggerated claims and minimal regulatory oversight [6].
  • Therapeutic strategies for microfracture augmentation, such as those using trypsin pretreatment and growth factor–functionalized self-assembling peptide hydrogel scaffolds, can be cost-effective ways to improve cartilage healing outcomes [9].

Key Evidence

  • [L5] While peptide therapy may possess significant therapeutic and regenerative potential, it is critical that orthopaedic and sports medicine providers understand the current lack of evidence to support the clinical use of these peptides. [1] (10.1177/03635465251357593)
  • [L5] Because of the lack of robust efficacy and safety data, peptide supplements should not currently be recommended as a replacement or adjunct for existing orthopaedic standard of care. [2] (10.1177/03635465261464420)
  • [L5] Injectable peptides for sports medicine remain largely experimental. [4] (10.2106/jbjs.rvw.26.00027)
  • [Paper] Today only BMP-2 and BMP-7 can be recommended based on level I studies. [5] (10.1016/s0020-1383(08)70014-7)
  • [Paper] Peptides are being widely advertised and sold through social media, often with exaggerated claims and minimal regulatory oversight. [6] (10.1177/2325967126s00290)
  • [Paper] While efficacious, GLP-1 agonists may not produce sufficient weight loss to achieve body mass index cutoffs for total joint arthroplasty depending on individual patient factors, including starting bodyweight. [7] (10.2106/jbjs.rvw.23.00167)
  • [Paper] The use of BMP currently has two FDA-approved indications: treatment of open tibial fractures treated with intramedullary fixation and treatment of tibia long bone non-union. [8] (10.1016/s0020-1383(13)70008-1)
  • [L5] Therapeutic strategies for microfracture augmentation, such as those presented in this study, can be cost-effective ways to improve cartilage healing outcomes. [9] (10.1177/03635465211021798)
  • [L5] BMP-7 application significantly enhances the quality of tendon-to-bone healing by promoting structural maturation and functional stability. [10] (10.1016/j.jse.2026.04.003)
  • [L5] GHRP-2 administration reduced M1 macrophage polarization and enhanced histologic and biomechanical tendon-bone healing properties in a rat rotator cuff tear model. [11] (10.1016/j.arthro.2024.11.094)
  • [L5] Exosomes offer a promising cell-free alternative to mesenchymal stem cell therapies for upper-extremity tissue regeneration by overcoming limitations such as donor-site morbidity and tumorigenesis, though a better understanding of their mechanisms and standardized isolation methods is required before clinical application. [12] (10.1016/j.jhsa.2023.11.016)
  • [L5] The authors do not recommend the use of BPC-157 for sports performance and recovery because there are no randomized controlled trials investigating its use in human subjects, and the science is clearly lacking to determine the overall effectiveness, safety profile, and clinical indications for sports enhancement in athletes. [14] (10.1016/j.arthro.2024.09.005)
  • [L4] EGYFIL is safe and seems to reduce pain and stiffness in patients during the 3 days of treatment, already after 3 h from the first application. [15] (10.1186/s12891-023-06903-y)
  • [L5] Treatment of defects with only KLD or with only microfracture resulted in an improvement in clinical symptoms compared with no treatment; the improvement likely resulted from different causes depending on the treatment. [17] (10.2106/jbjs.m.01408)
  • [Paper] However, various materials are on the market for which no clinical or experimental long-term data on soft tissue or bone reaction is available. [18] (10.1016/s0020-1383(02)00128-6)

References

[1] Injectable Peptide Therapy: A Primer for Orthopaedic and Sports Medicine Physicians. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251357593

[2] Peptide Supplements and Their Therapeutic Applications in Sports Medicine. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261464420

[4] Injectable Peptides in Sports Medicine: A Structured Narrative Review of Evidence, Safety, and Antidoping Implications. JBJS Reviews. 2026. DOI: 10.2106/jbjs.rvw.26.00027

[5] Carrier systems and application of growth factors in orthopaedics. Injury. 2008. DOI: 10.1016/s0020-1383(08)70014-7

[6] Paper 32. Performance & Promises: A Social Media Review of Alleged Indications, Risks and Usage of “Peptides” in Musculoskeletal Health. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/2325967126s00290

[7] Glucagon-like Peptide-1 Agonists. JBJS Reviews. 2024. DOI: 10.2106/jbjs.rvw.23.00167

[8] Clinical applications of growth factors in bone injuries: Experience with BMPs. Injury. 2013. DOI: 10.1016/s0020-1383(13)70008-1

[9] Microfracture Augmentation With Trypsin Pretreatment and Growth Factor–Functionalized Self-assembling Peptide Hydrogel Scaffold in an Equine Model. The American Journal of Sports Medicine. 2021. DOI: 10.1177/03635465211021798

[10] Effects of BMP-7 and Low Molecular Weight Peptide Solution on Healing in a Rotator Cuff Tear Model: A Histopathological and Biomechanical Study in Rats. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2026.04.003

[11] Growth Hormone–Releasing Peptide 2 May Be Associated With Decreased M1 Macrophage Production and Increased Histologic and Biomechanical Tendon‐Bone Healing Properties in a Rat Rotator Cuff Tear Model. Arthroscopy. 2024. DOI: 10.1016/j.arthro.2024.11.094

[12] The Role of Exosomes in Upper-Extremity Tissue Regeneration. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2023.11.016

[13] Orthopaedic Basic Science Fifth Edition Print Ebook. Cells and Materials for Soft-Tissue Repair and Regeneration > Introduction.

[14] Injectable Therapeutic Peptides—An Adjunct to Regenerative Medicine and Sports Performance?. Arthroscopy. 2024. DOI: 10.1016/j.arthro.2024.09.005

[15] A pre-market interventional, single-arm clinical investigation of a new topical lotion based on hyaluronic acid and peptides, EGYFILTM, for the treatment of pain and stiffness in soft tissues. BMC Musculoskeletal Disorders. 2023. DOI: 10.1186/s12891-023-06903-y

[17] Effects of the Combination of Microfracture and Self-Assembling Peptide Filling on the Repair of a Clinically Relevant Trochlear Defect in an Equine Model. Journal of Bone and Joint Surgery. 2014. DOI: 10.2106/jbjs.m.01408

[18] Biodegradable implants in soft tissue refixation: Experimental evaluation, clinical experience, and future needs. Injury. 2002. DOI: 10.1016/s0020-1383(02)00128-6

Creative Commons BY-NC 4.0

CC Creative Commons licence
BY Attribution — you must credit the source
NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International

Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.