Elamipretide mitigates ischemia-reperfusion injury in a swine model of hemorrhagic shock.

Patel N, Johnson MA, Vapniarsky N, Van Brocklin MW, Williams TK, Youngquist ST, Ford R, Ewer N, Neff LP, Hoareau GL

Scientific reports18 Mar 2023Cited by 10 (Europe PMC)

PMID36934127PMCIDPMC10024723DOI10.1038/s41598-023-31374-5PepBankPUB-36934127

Summary

ischemia-reperfusion injury (IRI) after hemorrhage is potentiated by aortic occlusion or resuscitative endovascular balloon occlusion of the aorta (REBOA). Given the central role of mitochondrial injury in shock, we hypothesized that Elamipretide, a peptide that protects mitochondria, would mitigate IRI after hemorrhagic shock and REBOA. Twelve pigs were subjected to hemorrhagic shock and 45 min of REBOA. After 25 min of REBOA, animals received either saline or Elamipretide. Animals were transfused with autologous blood during balloon deflation, and pigs were resuscitated with isotonic crystalloids and norepinephrine for 4.25 h. Elamipretide-treated animals required less crystalloids than the controls (62.5 [50-90] and 25 [5-30] mL/kg, respectively), but similar amounts of norepinephrine (24.7 [8.6-39.3] and 9.7 [2.1-12.5] mcg/kg, respectively). Treatment animals had a significant reduction in serum creatinine (control: 2.7 [2.6-2.8]; Elamipretide: 2.4 [2.4-2.5] mg/dL; p = 0.04), troponin (control: 3.20 [2.14-5.47] ng/mL, Elamipretide: 0.22 [0.1-1.91] ng/mL; p = 0.03), and interleukin-6 concentrations at the end of the study. There were no differences in final plasma lactate concentration. Elamipretide reduced fluid requirements and protected the kidney and heart after profound IRI. Further understanding the subcellular consequences of REBOA and mitochondrial rescue will open new therapeutic avenues for patients suffering from IRI after hemorrhage.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study6

6 results from studies that gave the peptide. No result from this study comes from people.

01AnimalAnimal study (in vivo)Efficacy outcome
In pigs with hemorrhagic shock and REBOA, Elamipretide-treated animals required less crystalloid fluid than controls.
In plain wordsIn pigs with blood loss, animals given Elamipretide needed less intravenous fluid than animals given saline.
Peptide
Elamipretide (SS-31)
Outcome
DecreaseCrystalloid requirement
Study
pign = 12
Swine model of hemorrhagic shock with REBOA
Comparator
Saline
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated
Source sentences
Summary
Elamipretide-treated animals required less crystalloids than the controls
2 context sentences(design, population, supporting numbers)
Summary · context
Twelve pigs were subjected to hemorrhagic shock and 45 min of REBOA.
Summary · context
After 25 min of REBOA, animals received either saline or Elamipretide.
Show in the study text Report a problemFND-3693412701
02AnimalAnimal study (in vivo)Efficacy outcome
In pigs with hemorrhagic shock and REBOA, Elamipretide-treated animals required similar amounts of norepinephrine as controls.
In plain wordsIn pigs with blood loss, animals given Elamipretide needed about the same amount of norepinephrine as animals given saline.
Peptide
Elamipretide (SS-31)
Outcome
No significant changeNorepinephrine requirement
Study
pign = 12
Swine model of hemorrhagic shock with REBOA
Comparator
Saline
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
Dose not stated
Source sentences
Summary
but similar amounts of norepinephrine (24.7 [8.6-39.3] and 9.7 [2.1-12.5] mcg/kg, respectively).
2 context sentences(design, population, supporting numbers)
Summary · context
Twelve pigs were subjected to hemorrhagic shock and 45 min of REBOA.
Summary · context
After 25 min of REBOA, animals received either saline or Elamipretide.
Show in the study text Report a problemFND-3693412702
03AnimalAnimal study (in vivo)Efficacy outcome
In pigs with hemorrhagic shock and REBOA, Elamipretide significantly reduced serum creatinine at the end of the study.
In plain wordsIn pigs with blood loss, Elamipretide lowered a blood marker of kidney injury compared with saline.
Peptide
Elamipretide (SS-31)
Outcome
DecreaseSerum creatinine
Study
pign = 12
Swine model of hemorrhagic shock with REBOA
Comparator
Saline
Outcome group
Kidney function · Kidney and urinary
Studied dose
Dose not stated
Measurements
Serum creatinine
2.4 mg/dL
Elamipretide
Source sentences
Summary
Treatment animals had a significant reduction in serum creatinine (control: 2.7 [2.6-2.8]; Elamipretide: 2.4 [2.4-2.5] mg/dL; p = 0.04)
2 context sentences(design, population, supporting numbers)
Summary · context
Twelve pigs were subjected to hemorrhagic shock and 45 min of REBOA.
Summary · context
After 25 min of REBOA, animals received either saline or Elamipretide.
Show in the study text Report a problemFND-3693412703
04AnimalAnimal study (in vivo)Efficacy outcome
In pigs with hemorrhagic shock and REBOA, Elamipretide significantly reduced troponin at the end of the study.
In plain wordsIn pigs with blood loss, Elamipretide lowered a blood marker of heart injury compared with saline.
Peptide
Elamipretide (SS-31)
Outcome
DecreaseTroponin
Study
pign = 12
Swine model of hemorrhagic shock with REBOA
Comparator
Saline
Outcome group
Heart function · Cardiovascular
Studied dose
Dose not stated
Measurements
Troponin
0.22 ng/mL
Elamipretide
Source sentences
Summary
Treatment animals had a significant reduction in serum creatinine (control: 2.7 [2.6-2.8]; Elamipretide: 2.4 [2.4-2.5] mg/dL; p = 0.04), troponin (control: 3.20 [2.14-5.47] ng/mL, Elamipretide: 0.22 [0.1-1.91] ng/mL; p = 0.03), and interleukin-6 concentrations at the end of the study.
2 context sentences(design, population, supporting numbers)
Summary · context
Twelve pigs were subjected to hemorrhagic shock and 45 min of REBOA.
Summary · context
After 25 min of REBOA, animals received either saline or Elamipretide.
Show in the study text Report a problemFND-3693412704
05AnimalAnimal study (in vivo)Efficacy outcome
In pigs with hemorrhagic shock and REBOA, Elamipretide significantly reduced interleukin-6 concentrations at the end of the study.
In plain wordsIn pigs with blood loss, Elamipretide lowered a blood marker of inflammation compared with saline.
Peptide
Elamipretide (SS-31)
Outcome
DecreaseInterleukin-6
Study
pign = 12
Swine model of hemorrhagic shock with REBOA
Comparator
Saline
Outcome group
Inflammation markers · Immune and inflammation
Studied dose
Dose not stated
Source sentences
Summary
Treatment animals had a significant reduction in serum creatinine (control: 2.7 [2.6-2.8]; Elamipretide: 2.4 [2.4-2.5] mg/dL; p = 0.04), troponin (control: 3.20 [2.14-5.47] ng/mL, Elamipretide: 0.22 [0.1-1.91] ng/mL; p = 0.03), and interleukin-6 concentrations at the end of the study.
2 context sentences(design, population, supporting numbers)
Summary · context
Twelve pigs were subjected to hemorrhagic shock and 45 min of REBOA.
Summary · context
After 25 min of REBOA, animals received either saline or Elamipretide.
Show in the study text Report a problemFND-3693412705
06AnimalAnimal study (in vivo)Efficacy outcome
In pigs with hemorrhagic shock and REBOA, final plasma lactate did not differ between Elamipretide and control animals.
In plain wordsIn pigs with blood loss, final blood lactate was the same with Elamipretide and with saline.
Peptide
Elamipretide (SS-31)
Outcome
No significant changePlasma lactate
Study
pign = 12
Swine model of hemorrhagic shock with REBOA
Comparator
Saline
Outcome group
Cardiovascular events · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
There were no differences in final plasma lactate concentration.
2 context sentences(design, population, supporting numbers)
Summary · context
Twelve pigs were subjected to hemorrhagic shock and 45 min of REBOA.
Summary · context
After 25 min of REBOA, animals received either saline or Elamipretide.
Show in the study text Report a problemFND-3693412706

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
10 Oct 2026, 08:19 UTC
Study results updated
Version 1
9 Oct 2026, 02:47 UTC
First added · source update from Europe PMC

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