Bioregulator Compounds · Checked
SS-31 (Elamipretide)
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Cardiolipin-binding mitochondrial-targeted tetrapeptide
Mitochondria-targeting tetrapeptide (D-Arg-Dmt-Lys-Phe-NH₂) that binds cardiolipin on the inner mitochondrial membrane. FDA-approved as FORZINITY for Barth syndrome. Studied for cardioprotection, aging muscle, and neurodegenerative disease research.
A synthetic 4-residue peptide (D-Arg-Dmt-Lys-Phe-NH₂) engineered to concentrate more than a thousand-fold at the inner mitochondrial membrane, where it binds cardiolipin in in-vitro assays. FDA-approved as FORZINITY (2025) for Barth syndrome. For laboratory characterisation only.
SS-31 (Elamipretide) — clinical & mechanistic profile
SS-31 (elamipretide) is a mitochondria-targeting tetrapeptide that binds cardiolipin on the inner mitochondrial membrane. FDA-approved for Barth syndrome (FORZINITY). 2025-2026 preclinical data shows neuroprotection: upregulates mitochondrial biogenesis against Aβ in Alzheimer's models, protects dopaminergic neurons in Parkinson's, and improves retinal survival in diabetic models. AMD trials slowed progressive ellipsoid zone degradation.
Studied applications
- Cardiolipin binding
- stabilizes cardiolipin content, prevents peroxidation and oxidation critical for mitochondrial structure and ETC function
- Membrane stabilization
- protects cristae structure and prevents destabilization during apoptosis
- mPTP inhibition
- inhibits mitochondrial permeability transition pore opening, accelerates ATP supply
- Calcium stress reduction
- modulates surface electrostatics of mitochondrial membranes, reducing calcium stress
- FDA approval
- approved as FORZINITY for Barth syndrome (2025)
- Selective action
- rapidly improves physiological function in aging and mitochondrial disorders, no effect on healthy mitochondria
Research constraints & safety notes
- FDA approved only for Barth syndrome—other indications still investigational
- Clinical trials for primary mitochondrial myopathy showed mixed Phase 3 results
- Selective for dysfunctional mitochondria—no benefit in healthy tissue
- Subcutaneous administration required for chronic use
- Cost and availability limitations as orphan drug
SS-31 is a synthetic cell-permeable tetrapeptide (D-Arg-Dmt-Lys-Phe-NH2) engineered to concentrate more than a thousand-fold inside the inner mitochondrial membrane. It has molecular formula C32H49N9O5 and mass 639.76 Da. Common synonyms in the literature include Elamipretide, Bendavia, MTP-131, and FORZINITY. SS-31's defining feature is a rationally designed alternating aromatic–cationic motif — a 2′,6′-dimethyltyrosine residue paired with D-arginine — that exploits the negative membrane potential of energized mitochondria (Δψₘ ≈ −180 mV) to selectively accumulate at the cristae, where it binds reversibly to cardiolipin, a phospholipid unique to mitochondrial membranes.
What it’s studied for
Research into SS-31 is clinical-investigational, with several completed and ongoing human trials. It became the first mitochondria-targeted therapeutic to receive FDA approval when Bendavia/FORZINITY was cleared in 2025 for Barth syndrome, a rare paediatric cardiomyopathy driven by cardiolipin dysfunction. Beyond that indication, published work referencing SS-31 spans Barth syndrome (FDA approved): Clinical trials demonstrated improved energy production, protein complex assembly, and exercise tolerance in Barth syndrome patients. Participants showed functional improvements such as walking 1 mile without breaks. FDA approval was granted based on these meaningful clinical benefits in this rare mitochondrial disorder, Primary mitochondrial myopathy trials: Phase 1/2 IV dose-escalation trial (Class I evidence) showed dose-dependent 6-minute walk test improvement (+51.2 meters at highest dose vs. +3.0 meters placebo, p=0.0297). Phase 3 MMPOWER-3 trial (NCT03323749) evaluated subcutaneous dosing with mixed results on primary endpoints, and Heart failure research: Studies in heart failure models showed improved stroke volume, ejection fraction, cardiac output, and reduced left ventricular end-diastolic pressure. Biomarkers including natriuretic peptides were reduced. Normalized bioenergetics observed in failing cardiac tissue. Proposed mechanisms cited across the primary literature include Cardiolipin interaction: binds reversibly to cardiolipin, stabilizing content and preventing peroxidation/oxidation, Cristae protection: maintains cristae structure and prevents destabilization during apoptosis, and mPTP regulation: inhibits mitochondrial permeability transition pore opening, promotes electron transfer while reducing electron leakage. A defining property, replicated across multiple in-vitro and animal models, is selectivity: SS-31 restores function in stressed, aged, or diseased mitochondria while leaving healthy mitochondria unchanged — a pharmacological profile rarely seen in bioenergetic research tools. None of this material describes therapeutic outcomes for buyers, and No vendor listed here provides dosing guidance for SS-31 outside laboratory research.
Related research
For the full mechanistic profile, published references, cardiolipin-binding structural detail, and constraint notes on SS-31, see the SS-31 (Elamipretide) research page. For a deeper mechanism-focused review covering the tetrapeptide's cardioprotection, neuromuscular, and age-Related compounds studied alongside it include MOTS-c, studied for exercise-mimetic signalling and metabolic health. All references cited on the research pages are peer-reviewed primary literature.
For research use only. This summary is a research-scientific overview compiled from peer-reviewed sources. It is not medical advice and is not intended for human or veterinary consumption.
Receptor engagement in the primary literature
Binding and functional-assay data for SS-31 (Elamipretide), from peer-reviewed in-vitro pharmacology publications. Values are receptor activity parameters — not clinical outcomes.
Isothermal titration calorimetry and NMR studies report reversible binding of SS-31 to cardiolipin, the phospholipid unique to the inner mitochondrial membrane. This is the defining biochemical feature of the molecule.
Source: Mitchell et al., PNAS 2020
Isolated mitochondria studies report improved coupling of Complex IV and reduced electron leak with SS-31 pretreatment. Proposed mechanism is cardiolipin-mediated cristae stabilisation.
Source: Birk et al., J Am Soc Nephrol 2013
In-vitro / preclinical characterisation only — no clinical or therapeutic claim is expressed or implied. Research use only.
Investigational context
Study designs referencing this compound in the published literature. Descriptions cover framework only — phase, participant count, duration, and citation — not outcomes. Click a card to review the source directly.
Specifications
| Attribute | Value |
|---|---|
| Molecular Formula | C32H49N9O5 |
| INN | elamipretide |
| Trade name | FORZINITY (Stealth BioTherapeutics) |
| FDA status | accelerated approval, Sep 2025 · NDA 215244 |
| Molecular Weight | 639.76 g/mol |
| Sequence | D-Arg-Dmt-Lys-Phe-NH2 |
| Sequence length | 4 residues |
| Physical form | Lyophilized powder |
| PubChem CID | 11785459 ↗ |
Chemistry comparison — mitochondrial-targeted research peptides
Two published mitochondrial-targeted peptides with distinct primary targets in the inner mitochondrial membrane. Reference chemistry only.
| Compound | Sequence | MW | Half-life (lit.) | Reference |
|---|---|---|---|---|
| SS-31 (Elamipretide)peptide | 4 residues | 639.76 g/mol | ~3 hours (lit.) | Szeto Br J Pharmacol 2014 |
| MOTS-cpeptide | 16 residues | 2174.5 g/mol | in-vitro dependent | Lee Cell Metab 2015 |
Reference chemistry only. Receptor-binding indications are qualitative (compound engages / does not engage the receptor in in-vitro assays as reported in the cited literature). No comparative-effectiveness claim is expressed or implied.