Quick summary
SS-31 (elamipretide) is a mitochondria-targeted tetrapeptide that binds cardiolipin on the inner mitochondrial membrane, optimizing electron transport and reducing oxidative stress. It is in Phase II/III clinical trials for Barth syndrome, heart failure, and age-related mitochondrial dysfunction.
Overview
SS-31 (Elamipretide) is a mitochondria-targeted tetrapeptide that specifically concentrates in the inner mitochondrial membrane. Developed by Hazel Szeto at Weill Cornell Medical College, it is in advanced clinical trials for Barth syndrome, heart failure, and age-related mitochondrial dysfunction. It is one of the most clinically advanced anti-aging peptides.
Mechanism of action
SS-31 selectively binds to cardiolipin, a phospholipid unique to the inner mitochondrial membrane that is essential for electron transport chain (ETC) function. By stabilizing cardiolipin interactions with cytochrome c, SS-31 optimizes electron transfer, reduces electron leak and reactive oxygen species (ROS) production, and improves ATP synthesis. It concentrates 1000-5000x in mitochondria relative to cytoplasm due to its alternating aromatic-cationic structure.
Dosing protocols
| Purpose | Route | Dosage | Frequency | Notes |
|---|---|---|---|---|
| mitochondrial optimization | subcutaneous | 20–40 mg | daily | Clinical trial doses range from 4mg to 40mg daily. Limited availability outside clinical settings. 4-8 week cycles in research contexts. |
Dosing information is for educational purposes only. Consult a qualified healthcare professional before using any peptide.
Research summary
Multiple clinical trials: Phase III for Barth syndrome (TAZPOWER), Phase II for heart failure (PROGRESS-HF), Phase II for age-related macular degeneration (ReCLAIM). Barth syndrome trial showed improvements in cardiac function and exercise tolerance. Animal studies demonstrate reversal of age-related mitochondrial dysfunction, improved cardiac function, kidney protection, and skeletal muscle recovery. Szeto's research shows reversal of age-related decline in mitochondrial function within hours of administration.[1][2][3][4]
Evidence grading
Each claimed benefit is graded by the strength of available evidence. Grades reflect study quality, not effect size.
Strong = multiple RCTs · Moderate = limited trials or observational · Preliminary = animal or in vitro only · Insufficient = anecdotal or no published data
Side effects
Side effects vary by individual. This is not an exhaustive list. Report unusual symptoms to a healthcare professional.
Common stacks
Peptides commonly paired with SS-31 for synergistic effects.
Legal status
Investigational drug in clinical trials (Stealth BioTherapeutics). Not yet FDA-approved. Orphan drug designation for Barth syndrome. Not available as a standard research peptide from most suppliers.
Sourcing & access
Research compound
SS-31 is classified as a research compound. Regulatory status varies by jurisdiction. Always verify current legal status and source from vendors providing third-party certificates of analysis (COA).
Frequently asked questions
SS-31, also known as elamipretide or Bendavia, is a mitochondria-targeted tetrapeptide developed by Hazel Szeto at Weill Cornell Medical College. It concentrates 1000-5000x in mitochondria relative to cytoplasm and is one of the most clinically advanced anti-aging peptides.
SS-31 selectively binds cardiolipin, a phospholipid unique to the inner mitochondrial membrane essential for electron transport chain function. By stabilizing cardiolipin-cytochrome c interactions, it optimizes electron transfer, reduces reactive oxygen species, and improves ATP synthesis.
In clinical trials, reported side effects include injection site reactions, headache, dizziness, and nausea. SS-31 is an investigational drug (Stealth BioTherapeutics) with orphan drug designation for Barth syndrome but is not yet FDA-approved.
SS-31 has been evaluated in Phase III for Barth syndrome (TAZPOWER), Phase II for heart failure (PROGRESS-HF), and Phase II for age-related macular degeneration (ReCLAIM). Animal studies also show reversal of age-related mitochondrial dysfunction.
Research references
- First-in-class cardiolipin-protective compound as a therapeutic agent to restore mitochondrial bioenergeticsReview
- The mitochondria-targeted peptide SS-31 binds lipid bilayers and modulates surface electrostatics as a key component of its mechanism of actionPubMed
- Mitochondrial protein interaction landscape of SS-31PubMed
- Peptide Szeto-Schiller 31 ameliorates doxorubicin-induced cardiotoxicity by inhibiting the activation of the p38 MAPK signaling pathwayPubMed