SS-31 (Elamipretide)

Product Overview

Elamipretide was approved for medical use in the United States in September 2025, indicated to improve muscle strength in people with Barth syndrome. It localizes to the inner mitochondrial membrane, binding cardiolipin with high affinity. This interaction promotes cytochrome c function as an electron carrier rather than a peroxidase, directly supporting ATP synthesis. Unlike antioxidants that clean up damage after it occurs, SS-31 works upstream at the source of energy production.

Mechanism of Action

SS-31 binds to cardiolipin, stabilizing mitochondrial membrane structure, preventing cardiolipin oxidation, maintaining membrane potential, and reducing ROS production. It enhances respiratory complex activity for efficient electron transfer and ATP synthesis. It also inhibits the mitochondrial permeability transition pore (mPTP), protecting against cell death during ischemia-reperfusion injury.

Key Benefits

Mitochondrial Function Restoration — Stabilizes the inner mitochondrial membrane, prevents ongoing decline, and improves ATP energy production efficiency. Gives cells the fuel they need for optimal function.

Physical Endurance Enhancement — Restores muscle performance by improving redox homeostasis and skeletal muscle function. Clinical trials in Barth syndrome showed improved muscle strength and heart function after 12 weeks.

Cognitive Health Support — Improves cerebral blood vessel dilation, working memory, and motor skill learning in aged mice. Protecting mitochondria shows direct impact on brain function.

Heart Function Protection — Normalizes proton leak and reduces ROS buildup in cardiac mitochondria. May slow or reverse age-related diastolic dysfunction by restoring mitochondrial stability.

References

1. Szeto HH. First-in-class cardiolipin-protective compound as a therapeutic agent to restore mitochondrial bioenergetics. *Br J Pharmacol.* 2014;171(8):2029–2050.
2. Birk AV, et al. The mitochondrial-targeted compound SS-31 re-energizes ischemic mitochondria by interacting with cardiolipin. *J Am Soc Nephrol.* 2013;24(8):1250–1261.
3. Paradies G, et al. Role of cardiolipin in mitochondrial function and dynamics in health and disease. *Cells.* 2019;8:728.