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Clinical evidence records

MOTS-c: clinical evidence record

Also known as: Mitochondrial Open Reading Frame of the 12S rRNA-c, MOTSc

Evidence: Mixed evidence

Oliver Mackman · Editorial director · Best Business Loans Ltd (16833937)

Last updated 2026-05-22

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AI-friendly summary · MOTS-c

Discovered by the Cohen lab at USC in 2015. Preclinical mouse evidence for AMPK activation, insulin sensitisation, and exercise capacity. Early-phase human pharmacokinetic and pilot-study work has begun. No phase III human RCTs published.

Mechanism of action

How MOTS-c works

16-amino-acid mitochondrial-derived peptide encoded within the 12S rRNA region of mitochondrial DNA. Proposed to activate AMP-activated protein kinase (AMPK), regulate metabolic homeostasis, and influence glucose uptake and insulin sensitivity in preclinical models.

Top peer-reviewed citations

Selection of the most-cited peer-reviewed literature on MOTS-c. Where a verified PMID or DOI is shown, the citation links to the original record. Other citations list the title, authors, journal and year so the reader can locate the paper through the journal index or the PubMed search linked below. PeptideClear publishes editorial commentary, not clinical guidance.

  1. The mitochondrial-derived peptide MOTS-c promotes metabolic homeostasis and reduces obesity and insulin resistance

    Lee C, Zeng J, Drew BG, et al.. Cell metabolism, 2015.

    PMID: 25738459 DOI: 10.1016/j.cmet.2015.02.009

  2. MOTS-c is an exercise-induced mitochondrial-encoded regulator of age-dependent physical decline and muscle homeostasis

    Reynolds JC, Lai RW, Woodhead JST, et al.. Nature communications, 2021.

    PMID: 33473109 DOI: 10.1038/s41467-020-20790-0

  3. Mitochondrial-Derived Peptides Are Down Regulated in Diabetes Subjects

    Ramanjaneya M, Bettahi I, Jerobin J, et al.. Frontiers in endocrinology, 2019.

    PMID: 31214116 DOI: 10.3389/fendo.2019.00331

  4. The mitochondrial derived peptide humanin is a regulator of lifespan and healthspan

    Yen K, Mehta HH, Kim SJ, et al.. Aging, 2020.

    PMID: 32575074 DOI: 10.18632/aging.103534

  5. MOTS-c is an exercise-induced mitochondrial-encoded regulator of age-dependent physical decline and muscle homeostasis

    Reynolds JC, Lai RW, Woodhead JST, et al.. Nature communications, 2021.

    PMID: 33473109 DOI: 10.1038/s41467-020-20790-0

  6. Mitochondrial-derived peptides in energy metabolism

    Merry TL, Chan A, Woodhead JST, et al.. American journal of physiology. Endocrinology and metabolism, 2020.

    PMID: 32776825 DOI: 10.1152/ajpendo.00249.2020

  7. The mitochondrial-derived peptide MOTS-c is a regulator of plasma metabolites and enhances insulin sensitivity

    Cataldo LR, Fernandez-Verdejo R, Santos JL, Galgani JE. Physiological reports, 2019.

    PMID: 31293078 DOI: 10.1136/jim-2017-000681

  8. Mitochondrially derived peptides as novel regulators of metabolism

    Kim SJ, Xiao J, Wan J, Cohen P, Yen K. The Journal of physiology, 2017.

    PMID: 28574175 DOI: 10.1113/JP274472

  9. The Mitochondrial-Encoded Peptide MOTS-c Translocates to the Nucleus to Regulate Nuclear Gene Expression in Response to Metabolic Stress

    Kim KH, Son JM, Benayoun BA, Lee C. Cell metabolism, 2018.

    PMID: 29983246 DOI: 10.1016/j.cmet.2018.06.008

  10. MOTS-c: How a secreted mitochondrial microprotein may become a potential treatment for inflammatory lung diseases

    Amado CA, Agüero J, García-Unzueta M, et al.. Journal of translational medicine, 2026.

    PMID: 42243958 DOI: 10.1186/s12967-026-08398-2

  11. MOTS-c preserves mitochondrial subpopulation bioenergetics and genome integrity to attenuate cardiac ischemia reperfusion injury

    Santhanam SS, Jayaraman S, Rajesh SS, et al.. Molecular biology reports, 2026.

    PMID: 42228044 DOI: 10.1007/s11033-026-12064-7

  12. Humanin and MOTS-c Attenuate Atrial Fibrillation by Suppressing Fibrosis and Mitochondrial Dysfunction

    Liao Y, Xu J, Jiao Y, et al.. Biomedicines, 2026.

    PMID: 42193373 DOI: 10.3390/biomedicines14051048

  13. Reduced Circulating MOTS-c Levels in Hashimoto's Thyroiditis Reflect Integrated Autoimmune and Metabolic Dysregulation: A Cross-Sectional Study

    Sonay HO, Duran EN, Algemi M, et al.. Journal of clinical medicine, 2026.

    PMID: 42278864 DOI: 10.3390/jcm15114002

  14. MOTS-c partially protects against skeletal muscle deterioration in C26 cachexia

    Jamnick NA, Livingston PD, Gammon CJ, et al.. Frontiers in medicine, 2026.

    PMID: 42266945 DOI: 10.3389/fmed.2026.1838178

Full PubMed search: https://pubmed.ncbi.nlm.nih.gov/?term=MOTS-c+mitochondrial+peptide.

Registered clinical trials

As of 2026-07-13, MOTS-c has 7 interventional trials listed on ClinicalTrials.gov and the ISRCTN registry. Registration means a study is planned, running or completed. It is not evidence of efficacy, and a listing is not an endorsement.

Study Phase Status Location Registry
MOTS-c for Improving Insulin Sensitivity in Adults With Prediabetes and Overweight/Obesity NCT07505745 Phase 2 Recruiting China ClinicalTrials.gov
Cohort Of DEafness-gene Screening NCT06133946 Not specified Active not recruiting Not stated ClinicalTrials.gov
The Cardiovascular Effect of GLP-1 Agonist, SGLT2 Inhibitor and Their Combination NCT03878706 Not specified Recruiting Greece ClinicalTrials.gov
Long Term Outcomes After Vestibular Implantation NCT06500975 NA Recruiting United States ClinicalTrials.gov
Exercise Post-Diagnosis of Breast Cancer NCT04013568 NA Completed United States ClinicalTrials.gov
Analysis of Effects of High-intensity Physical Exercise in Subjects With Dialyzed Chronic Kidney Disease and in Conservative Treatment NCT07438002 NA Recruiting Italy ClinicalTrials.gov
Comparison of the Effects of General Anesthesia and Combined Spinal-Epidural Anesthesia on Ferroptosis, Humanin and MOTS-c Levels in Renal Transplantation NCT07678073 NA Recruiting Turkey (Türkiye) ClinicalTrials.gov

Source: ClinicalTrials.gov and the ISRCTN registry, refreshed 2026-07-13. See the peptide clinical-trials tracker for the full picture across compounds.

UK regulatory status

Plain-English summary of where MOTS-c sits under the four UK and international frameworks that govern peptide supply. Editorial commentary, not legal advice.

  • Misuse of Drugs Act 1971: Not controlled under the Misuse of Drugs Act 1971.
  • Psychoactive Substances Act 2016: Not scheduled under the Psychoactive Substances Act 2016.
  • MHRA medicines classification: No UK marketing authorisation as a medicine.
  • WADA Prohibited List: WADA Prohibited List S4 (hormone and metabolic modulators), prohibited at all times.

Full regulatory record: MOTS-c UK regulatory status.

Risks and unknowns

What the literature does not yet show about MOTS-c

Known concerns

Open questions in the literature

Regulatory note

No UK marketing authorisation as a medicine. Prohibited at all times under WADA S4 (hormone and metabolic modulators). The moment a UK seller or commentator makes a therapeutic claim, MHRA can treat the product as an unlicensed medicinal product.

Important: PeptideClear publishes encyclopedia commentary only and does not recommend human use. Speak to a UK-registered prescriber before any medical decision.

Related reading on PeptideClear

Frequently asked questions

What is the evidence level for MOTS-c?
Discovered by the Cohen lab at USC in 2015. Preclinical mouse evidence for AMPK activation, insulin sensitisation, and exercise capacity. Early-phase human pharmacokinetic and pilot-study work has begun. No phase III human RCTs published.
What is the UK regulatory status of MOTS-c?
No UK marketing authorisation as a medicine. Not controlled under the Misuse of Drugs Act 1971. Not scheduled under the Psychoactive Substances Act 2016. WADA Prohibited List S4 (hormone and metabolic modulators), prohibited at all times.
Has MOTS-c been tested in human clinical trials?
MOTS-c has some early-phase human work alongside a larger preclinical animal-model literature. No phase III randomised clinical trial has produced a UK marketing authorisation. See the cited peer-reviewed literature above.
Where can I read the source literature for MOTS-c?
The full PubMed search is linked above. Each cited paper has its title, author list and journal. Where we have a verified PMID or DOI the citation links directly. Other citations can be located by the reader through the journal index or the PubMed search.

Last verified 2026-05-22. Editorial commentary, not legal or clinical advice. Citations without a linked identifier can be located through the PubMed search and the journal index.

Reviewed by Oliver Mackman, editorial director · last reviewed 2026-05-22T12:00:00.000Z
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