Putting a mitochondrial idea to a functional test

# Putting a mitochondrial idea to a functional test OCTOBER 15, 2026 | LONGEVITY SPECIAL A University of Washington team has won $1 million to test whether a drug aimed at the cell's energy machinery can help ordinary older adults keep their muscle, memory and immune function. A positive result would suggest that some age-related decline might be treated at the cellular level. A negative one would count against that idea for this drug, though one trial could not settle the question. The drug is approved only for a rare disease, so any use for aging would be off-label. A proposed trial brings a cellular hypothesis toward outcomes that older adults can experience. Muscle, cognition, and immune performance give the research a demanding set of questions to answer. The award comes from XPRIZE Healthspan, a $101 million global competition launched in November 2023. According to the University of Washington Institute for Stem Cell & Regenerative Medicine, its goal is to develop and clinically test treatments that restore muscle, cognitive and immune performance in older adults by the equivalent of at least 10 years. The stretch goal is 20 years. The UW group, which calls itself the Mitochondrial All-Stars, learned in August 2026 that it was one of 10 Milestone 2 awardees. It had already received $250,000 in 2025 for a pilot study that, according to the institute, produced encouraging results. The team is led by Dr. David Marcinek, a UW professor of radiology and of laboratory medicine and pathology, working with the company Mighty Therapeutics. The drug is elamipretide. Mitochondria are the parts of a cell that turn nutrients into ATP, the energy cells use for most of their work. They also help cells handle stress and regulate metabolism and inflammation. Damaged or less efficient mitochondria have been linked to heart and neurodegenerative disease and to biological changes of aging. Marcinek says elamipretide works through a structural interaction with mitochondria. "Aging leads to a breakdown in the health of the mitochondria," he says. "We think elamipretide helps mitochondria work more efficiently by stabilizing the structure of the membrane, where much of the cell's energy is produced." That is the team's working idea, not a settled finding. The drug was developed by Stealth BioTherapeutics, now Mighty Therapeutics. In 2025 the FDA granted it accelerated approval for muscle weakness in patients weighing at least 30 kg who have Barth syndrome, a rare inherited disorder that disrupts mitochondria. That approval does not cover healthy aging. In earlier UW work, Marcinek and Dr. Kevin Conley used magnetic resonance measurements to show that a single dose improved mitochondrial performance in older adults. The new money will fund a randomized, double-blind, placebo-controlled trial, scheduled to run through 2029. It will test whether elamipretide improves muscle, cognitive and immune function in older adults. Dr. Suman Jayadev, a UW neurologist who cares for patients with brain disease, will help guide the clinical evaluation. That includes blood and other fluid samples, cognitive tests and strength assessments. Because the work is at an early stage, the team also wants to learn which measures best show how the drug affects health over time. Jayadev says one question is whether the compound could also give a metabolic boost to neurons exposed to risk factors such as amyloid plaque buildup. The weakest point in the case is that the evidence so far is a small pilot and a single-dose measurement, not proof of benefit in healthy aging. For now, this is a plan to test an idea, not evidence that the drug works in healthy aging. The UW report does not address exercise. As general background not drawn from that report, exercise is the established, widely recommended way to support muscle health. Readers should not start or stop any medication or supplement without consulting their clinician. Watch for the trial's start and enrollment details, and for any results as the study moves toward 2029. The trial's design and eventual results will determine how far the idea travels. Function provides a meaningful place for laboratory ambition to meet clinical evidence. Source: University of Washington Institute for Stem Cell & Regenerative Medicine ---