SS-31 (Elamipretide)
A mitochondria-targeted peptide that restores mitochondrial bioenergetics and reduces oxidative stress.
Common Dosage
Research dependent
Category
Mitochondrial
- Mitochondrial health
- Energy restoration
- Heart health
SS-31 (elamipretide, MTP-131) was developed by Hazel Szeto and Peter Schiller at Weill Cornell Medicine as part of a series of aromatic-cationic peptides designed to target the inner mitochondrial membrane. It entered clinical trials as a cardioprotective agent under the name Bendavia and has been studied in heart failure, ischemia-reperfusion injury, and other mitochondrial dysfunction states. It represents one of the most clinically advanced mitochondria-targeted therapeutic peptides.
SS-31 selectively accumulates in the inner mitochondrial membrane (IMM) approximately 5000-fold relative to cytoplasm, driven by electrostatic interaction with the large negative membrane potential. It binds to cardiolipin — a phospholipid unique to the IMM that is required for the proper assembly and function of the electron transport chain (ETC) complexes. By protecting cardiolipin from oxidative damage and maintaining ETC complex architecture, SS-31 preserves mitochondrial energy production and reduces electron leak (a source of reactive oxygen species).
- Heart failure with preserved ejection fraction (HFpEF) — major clinical trial program
- Ischemia-reperfusion injury protection (heart, kidney)
- Mitochondrial myopathy research
- Age-related mitochondrial dysfunction
- Diabetic cardiomyopathy
- Renal protection during cardiac surgery
PREMIER Trial in HFpEF
The PREMIER trial demonstrated improved 6-minute walk distance and exercise capacity in HFpEF patients receiving elamipretide compared to placebo, with effects consistent across multiple cardiac functional parameters. HFpEF is a condition with very limited pharmacological options, making this result clinically significant.
Aging Mitochondrial Function
Studies in aged mice treated with SS-31 demonstrated restoration of skeletal muscle mitochondrial function to near-youthful levels, with improvements in physical performance and reduced oxidative stress markers — a compelling anti-aging profile.
- Injection site reactions are consistent in clinical trials
- Requires refrigeration and careful handling
- Not yet FDA-approved for any indication — clinical data is promising but ongoing
- Limited study in conditions beyond cardiovascular — off-target effects unknown
- High research cost and limited availability outside clinical trial settings
- Injection site irritation