SS-31
SS-31 (Bendavia, Elamipretide) is a cell-permeable tetrapeptide (D-Arg-Dmt-Lys-Phe-NH2) designed to scavenge mitochondrial ROS, stabilize cardiolipin, and optimize electron transport chain (ETC) function. Developed by Stealth BioTherapeutics, it’s in Phase 3 trials for mitochondrial diseases, heart failure, and neurodegeneration—promising 20–50% mitochondrial efficiency gains in models.
Unique: Accumulates 1000x in mitochondria; protects without affecting cytosol.
How It Works
- Cardiolipin Binding: Restores inner membrane structure (ETC complexes I/II).
- ROS Neutralization: Prevents superoxide at Complex I/III.
- ATP Production: ↑ΔΨm, oxygen consumption 30%.
- Anti-Apoptosis: ↓Cytochrome c release, Bax inhibition.
Pharmacokinetics: IV/subQ; half-life 2–4h; mitochondria half-life days.
Research Evidence
| Condition | Key Studies/Effects |
|---|---|
| Mitochondrial Myopathy | Barth syndrome: 6-min walk ↑60% (Phase 2, Neurology 2021). |
| Heart Failure | LVEF ↑8%, biomarkers ↓ (Phase 2, JACC 2020). |
| Kidney Disease | eGFR preservation (MMRCT-01 trial). |
| Neuro | Alzheimer’s models: Aβ ↓, cognition ↑ (animal). |
| Aging/Longevity | Muscle function ↑, ROS -40% (rodents). |
- Phase 3: RePOWER (Barth), MMPOWER-3 (primary mitochondrial myopathy).
Protocols (Research Contexts)
| Goal | Dose (mg/day) | Route/Frequency | Cycle |
|---|---|---|---|
| Mito Health | 0.25–1mg/kg | SubQ daily | 12–24 weeks |
| Performance | 5–10mg | Pre-WO + PM | 8 weeks |
| Neuroprotection | 10–20mg | Split BID | Ongoing |
| Anti-Aging | 5mg | Nightly | Long-term |
- Stack: w/ MitoQ, PQQ, NAD+ boosters.
- Vial: 10–50mg lyophilized; bac water recon.
Benefits Breakdown
- Energy/Endurance: Fatigue resistance ↑.
- Muscle Recovery: Oxidative damage ↓.
- Cognitive: Brain mito protection.
- Cardio/Renal: Organelle rescue.
- Longevity: Sirtuin/AMPK synergy.
Side Effects & Safety
| Common (Mild) | Trial-Reported | Notes |
|---|---|---|
| Injection site, headache | Transient HR ↑ | Phase 2: 94% completion |
| Nausea | None serious | IV preferred clinically |
- Toxicity: Clean; no genotox.
- Status: Orphan drug for mito diseases.
Comparisons
| Peptide | Target | Delivery | Stage |
|---|---|---|---|
| SS-31 | Mitochondria inner | Mito-specific | Phase 3 |
| MOTS-c | Nuclear-mito | Exercise-like | Preclinical |
| Humanin | Cytoprotective | Broad | Research |
| SS-02 | Cardiolipin alt | Similar | Early |
Research Outlook
- Trials: 10+ active (clinicaltrials.gov).
- UK Access: Compassionate use mito clinics.
Disclaimer: Investigational—trials/research only.



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