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SS-31 (Elamipretide): A Deep Dive into Mitochondrial Health
By PeptidePedia Research Team on October 14, 2025

SS-31 (Elamipretide): Recharging the Cell's Powerhouse

SS-31, also known as Elamipretide, is a novel, water-soluble tetrapeptide. Its unique structure allows it to easily penetrate cell membranes and specifically target the inner membrane of mitochondria—the powerhouses of our cells. By addressing mitochondrial dysfunction at its core, SS-31 represents a new frontier in treating a wide range of age-related and chronic diseases. Its primary mission is to restore cellular energy production and protect against oxidative stress.

Mechanism of Action: A Four-Step Process

  1. Cellular Entry: SS-31 efficiently crosses the plasma membrane of cells.
  2. Mitochondrial Targeting: It selectively accumulates within the mitochondria.
  3. Cardiolipin Binding: Binds to cardiolipin, a key lipid in the inner mitochondrial membrane.
  4. Restores Function: Stabilizes structure, enhances ATP production, and reduces oxidative stress.

This targeted mechanism is the foundation of SS-31's therapeutic potential. By repairing the cell's energy-producing machinery, it can have profound effects on tissues with high energy demands, such as the brain, heart, muscles, and kidneys.

A Spectrum of Therapeutic Benefits

  • Neuroprotection: Investigated for its potential to improve cognitive function.
  • Cardiovascular Health: Studied for its role in protecting heart tissue.
  • Muscle Function: Shows promise in treating Primary Mitochondrial Myopathy.
  • Kidney Health: Demonstrated protective effects against acute kidney injury.
  • Anti-Aging Potential: By targeting mitochondrial decline, it may promote cellular health.

Clinical Dosing Protocols

  • Subcutaneous (SC) Injection: Common dose is 40 mg once daily.
  • Intravenous (IV) Infusion: Dose range is 0.01 to 0.25 mg/kg/hour.

Safety Profile: Elamipretide vs. Placebo

Based on data from the MMPOWER-3 clinical trial, SS-31 is generally well-tolerated. The most common side effects are injection site reactions.

| Adverse Event | Elamipretide (%) | Placebo (%) | |------------------------------|------------------|-------------| | Injection Site Erythema | 86.2 | 28.4 | | Injection Site Pruritus | 75.2 | 9.2 | | Injection Site Pain | 39.4 | 18.3 | | Injection Site Swelling | 38.5 | 6.4 | | Headache | 7.3 | 3.7 | | Nasopharyngitis | 7.3 | 1.8 |

A Regulatory Milestone: FDA Approval

In September 2025, the FDA granted Accelerated Approval to Elamipretide for the treatment of Barth syndrome, making it the first-ever FDA-approved mitochondria-targeted therapeutic.