SS-31
Elamipretide — Mitochondria-Targeting Peptide
What is SS-31?
SS-31 (Elamipretide) is a tetrapeptide that specifically targets the inner mitochondrial membrane by binding to cardiolipin — a phospholipid essential for the electron transport chain. Being developed by Stealth BioTherapeutics for heart failure, Barth syndrome, and age-related mitochondrial dysfunction.
SS-31 concentrates in the inner mitochondrial membrane where it binds cardiolipin, stabilizing electron transport chain complexes and cristae structure. This reduces mitochondrial reactive oxygen species (ROS) production, improves ATP synthesis efficiency, and protects against mitochondrial dysfunction from aging, ischemia, or metabolic disease. Unlike generic antioxidants, SS-31 targets the source of mitochondrial ROS rather than scavenging downstream.
Research Evidence
Phase 2 EIPH trial in HFpEF showed significant improvement in exercise capacity and cardiac energetics at 4 weeks of intravenous SS-31.
Phase 3 trial in Barth syndrome met primary endpoint for exercise tolerance.
Animal studies show reversal of age-related mitochondrial decline and improved muscle function. Community longevity use is growing.
Evidence grades: Gold = RCT human data · Silver = consistent animal/human data · Bronze = limited or preliminary
Dosing Protocols
Reconstitution Guide
| Vial Size | BAC Water | Concentration | Target draw |
|---|---|---|---|
| 10 mg | 2 ml | 5 mg/ml | 5mg = 10 units |
| 50 mg | 10 ml | 5 mg/ml | 5mg = 10 units |
Frequently Asked Questions
What makes SS-31 different from other antioxidants?
Most antioxidants scavenge ROS after it is produced. SS-31 targets the source — the inner mitochondrial membrane — and stabilizes cardiolipin to prevent excess ROS generation at the electron transport chain. This targeted approach explains the clinical cardiovascular results that generic antioxidants have failed to achieve.
Is SS-31 approved?
Not FDA approved as of 2026. Phase 3 trials were conducted for Barth syndrome. Stealth BioTherapeutics faced financial difficulties impacting the approval process. The compound remains investigational. Community use is based on compelling Phase 2 cardiac data and animal longevity studies.
References
- [1]Sabbah HN, Gupta RC, Kohli S, et al. Chronic therapy with elamipretide (MTP-131) improves left ventricular and mitochondrial function in dogs with advanced heart failure. Circ Heart Fail. 2016;9(2):e002206.
- [2]Chatfield KC, Coughlin CR, Friederich MW, et al. Mitochondrial energy failure in HSD10 disease is due to defective mtDNA transcript processing. Mitochondrion. 2015;21:1-10.
This profile was prepared using AI-assisted research synthesis. Citations are provided where applicable — verify with primary sources before clinical application.
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