SS-31 (D-Arg-2,6-Dmt-Lys-Phe-NH₂; also designated elamipretide) is an aromatic-cationic tetrapeptide developed by Hazel H. Szeto at Weill Cornell Medical College, where the compound class was first described in the early 2000s. The Szeto-Schiller (SS) peptides are defined by an alternating aromatic–cationic backbone motif that confers high affinity for the inner mitochondrial membrane and selective accumulation in mitochondria independent of membrane potential.

The primary mechanistic focus of published research is SS-31’s interaction with cardiolipin — the signature phospholipid of the inner mitochondrial membrane. Work from Szeto’s laboratory and from Birk, Lim, and colleagues at Weill Cornell demonstrated that SS-31 stabilizes cardiolipin’s association with cytochrome c, preventing its conversion to a peroxidase and preserving electron transport chain architecture under ischemic and oxidative stress conditions. Additional preclinical models have examined SS-31 in renal ischemia-reperfusion, heart failure, and skeletal muscle mitochondrial dysfunction. All findings referenced here derive from preclinical models and have not been validated in controlled human clinical trials.

SS-31 research appears in British Journal of Pharmacology, Journal of the American Society of Nephrology, and Journal of Molecular and Cellular Cardiology. It is not approved by the U.S. Food and Drug Administration for any diagnostic, therapeutic, or preventive application. It is classified as a research compound only.