SS-31 (also known as Elamipretide or MTP-131, sequence: D-Arg-Dmt-Lys-Phe-NH2) belongs to the Szeto-Schiller peptide class, developed by Hazel Szeto at Weill Cornell Medicine. Its key property is a 1,000–5,000 fold selective concentration in the inner mitochondrial membrane, driven by its alternating aromatic-cationic amino acid structure and affinity for the phospholipid cardiolipin.
Cardiolipin is uniquely present in the inner mitochondrial membrane and plays a critical structural role in organising the electron transport chain complexes into functional supercomplexes. In conditions of oxidative stress or ageing, cardiolipin is peroxidised and loses this organising function, impairing mitochondrial efficiency. SS-31 prevents cardiolipin peroxidation, preserving electron transport chain function.