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LL-37
Cathelicidin, Human Cathelicidin Antimicrobial Peptide
A macrocyclic peptide complement C5 inhibitor FDA-approved for generalized myasthenia gravis. One of the newest peptide drugs, representing the cutting edge of peptide therapeutics in autoimmune disease.
The only human cathelicidin antimicrobial peptide, LL-37 is a 37-amino-acid peptide naturally produced by immune cells, epithelial cells, and barrier tissues. It plays a critical role in innate immunity by directly killing bacteria, viruses, and fungi, while also modulating inflammatory responses. Increasingly studied for chronic infections, biofilm disruption, and immune regulation.
Binds to complement component C5, preventing its cleavage into C5a and C5b, thereby blocking the terminal complement cascade and formation of the membrane attack complex (MAC). This reduces complement-mediated destruction of the neuromuscular junction in myasthenia gravis.
Disrupts microbial membranes through electrostatic interaction with negatively charged bacterial surfaces, creating pores that kill pathogens. Also modulates immune responses by recruiting immune cells, promoting wound healing, and disrupting bacterial biofilms. Acts as a bridge between innate and adaptive immunity.
- Generalized myasthenia gravis (anti-AChR antibody positive)
- Immune system support
- Chronic infection management
- Biofilm disruption (Lyme, SIBO)
- Wound healing
- Upper respiratory infection support
- Increased risk of meningococcal infections (requires vaccination)
- Injection site reactions
- Upper respiratory infections
- Diarrhea
- Requires daily self-injection
- Injection site reactions (pain, redness)
- Potential autoimmune activation at high doses
- Limited human clinical data for therapeutic use
- Overexpression linked to psoriasis and rosacea in some contexts
FDA-approved as Zilbrysq (2023) for generalized myasthenia gravis in adults who are anti-acetylcholine receptor antibody positive. First subcutaneous complement inhibitor — previous options (eculizumab) required IV infusion.
Not FDA-approved as a therapeutic. LL-37 is an endogenous human peptide being studied in clinical trials for wound healing and infection. Some compounding pharmacies have offered it, but it has no formal FDA category for compounding. Research is ongoing for topical wound applications.
- Zilucoplan in generalized myasthenia gravis (RAISE)
2023 · PubMed
This comparison is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any peptide therapy.