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LL-37 Guide: Evidence & Sourcing

LL-37 is the human cathelicidin-derived antimicrobial peptide studied for its bactericidal and immunomodulatory activity; this guide compiles reported examples for educational use only, not medical advice.

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LL-37 Guide: Available Now

Educational use only — not medical advice. This guide summarizes information reported in published research and community practice for educational purposes. It is not medical advice and not a recommendation to use any compound. Any doses, schedules, or combinations shown are examples of what has been reported, not instructions for you. Many peptides described here are research compounds that are not FDA-approved for the uses discussed and may be investigational or restricted. Effects, risks, and legal status vary; individual needs and results vary. Consult a qualified, licensed healthcare professional before making any decision. Do not use this content to diagnose, treat, or dose yourself.

LL-37 at a glance

What it is
The 37-residue peptide LLGDFFRKSKEKIGKEFKRIVQRIKDFLRNLVPRTES, cleaved from the human cathelicidin precursor hCAP-18; INN ropocamptide (PubChem CID 16198951; C205H340N60O53; about 4,493 g/mol; CAS 154947-66-7)
Researched for
Topical healing of chronic leg and foot ulcers (three small human trials) and injection into melanoma skin metastases (one phase 1/2 study, four patients); antimicrobial and immune activity in laboratory and animal work
Plasma half-life
Not measured in humans: no pharmacokinetic study of administered LL-37 has been published. The ~1 hour figure this page previously gave is withdrawn as unsourced
Regulatory status
Not approved as a medicine anywhere and no US drug label; FDA has published a safety-risk assessment of it, and it is on neither current FDA compounding list after its nomination was withdrawn; not named by WADA, but covered by section S0 (non-approved substances)

Educational reference. This page does not publish dose ranges or reconstitution arithmetic.

What it is / mechanism

LL-37 is the only member of the cathelicidin family expressed in humans, released when the precursor protein hCAP-18 is proteolytically cleaved by serine proteases such as proteinase 3. The mature 37-amino-acid peptide carries a net positive charge of about +6 and folds into an amphipathic alpha-helix, most strongly in the presence of negatively charged microbial membranes. This cationic, amphipathic structure lets it bind bacterial membranes and, depending on lipid composition, either form transient pores or disrupt the membrane, killing Gram-positive and Gram-negative bacteria, some fungi, and enveloped viruses. Beyond direct killing, research describes immunomodulatory roles: LL-37 signals through receptors such as formyl peptide receptor 2 (FPR2/FPRL1), influences chemotaxis, binds nucleic acids, and modulates inflammatory cytokine responses and tissue-repair pathways. These are described mechanisms from laboratory research, not clinically guaranteed effects in humans. Three identity details matter when checking any of this against a registry. The sequence is LLGDFFRKSKEKIGKEFKRIVQRIKDFLRNLVPRTES: eleven basic residues (lysine and arginine) against five acidic ones (aspartate and glutamate), which is where the net charge of about +6 comes from. In PubChem the name route is consistent — LL-37, cathelicidin and the International Nonproprietary Name ropocamptide all resolve to CID 16198951 (C205H340N60O53, about 4,493 g/mol) — but the CAS route, 154947-66-7, now returns seven records (checked 28 September 2026): that one, two more with the same formula — one with its stereochemistry left undefined — and four for LL-37 trifluoroacetate, among them CID 137699475 (C207H341F3N60O55, about 4,607 g/mol). Trifluoroacetate is the counter-ion synthetic peptides commonly carry after purification, so a certificate of analysis should say whether its mass and purity refer to the peptide or to the salt. And PubChem files the precursor's names — Cap-18, hCAP 18, even a rabbit CAP18 fragment — as synonyms of the 37-residue peptide. hCAP-18 is the 18 kDa precursor protein that LL-37 is cut from, not the same molecule, so a search on those names can land on the wrong thing. These are described mechanisms and registry facts, not statements of clinical benefit.

Researched effects

Laboratory and animal work describes broad antimicrobial and antibiofilm activity, antiviral and antifungal effects in vitro, modulation of inflammation, and promotion of new blood vessel growth and wound closure. In people the picture is narrower and more mixed than that list suggests. Three controlled trials have applied LL-37 to chronic wounds: a first-in-human trial in 34 people with hard-to-heal venous leg ulcers found faster healing at the two lower concentrations but not the highest (Grönberg et al., Wound Repair Regen 2014, PMID 25041740); the larger phase IIb follow-up in 148 patients found no significant improvement in the full study population (Mahlapuu et al., Wound Repair Regen 2021, PMID 34687253); and a trial in diabetic foot ulcers found better granulation but no change in inflammatory markers or bacterial counts (Miranda et al., Arch Dermatol Res 2023, PMID 37480520). Injected LL-37 has been given to four patients, into melanoma skin metastases, in a phase 1/2 study. Community reports describe use for gut and skin support; those are anecdotes, not trial results. LL-37 also has context-dependent biology: elevated levels of the body's own LL-37 have been associated in the literature with chronic inflammatory and autoimmune conditions, and researchers emphasise its narrow window between beneficial and cytotoxic concentrations.

Evidence & regulatory status

  • The first human trial was small and its dose response ran backwards. Grönberg et al. (Wound Repair Regen 2014;22(5):613-21, PMID 25041740) enrolled 34 people with hard-to-heal venous leg ulcers: a three-week open run-in on placebo, then four weeks of double-blind treatment with LL-37 applied twice weekly at 0.5, 1.6 or 3.2 mg/mL or placebo, then four weeks of follow-up. The healing rate constant was about six times placebo at 0.5 mg/mL (p = 0.003) and about three times at 1.6 mg/mL (p = 0.088, not statistically significant), and mean ulcer area fell 68% and 50% in those two groups. The highest concentration, 3.2 mg/mL, did no better than placebo. There were no local or systemic safety concerns.
  • The confirmatory trial missed its main result. The phase IIb HEAL LL-37 study (Mahlapuu et al., Wound Repair Regen 2021;29(6):938-950, PMID 34687253) randomised 148 patients with hard-to-heal venous leg ulcers, mean age 67.6 years, to LL-37 at 0.5 or 1.6 mg/mL or placebo on top of compression therapy. Analysed across the whole study population, LL-37 did not improve healing compared with placebo. An analysis made after the fact found improvement in patients whose ulcers were at least 10 cm², which the authors present as a reason for a further, adequately powered study — not as a demonstrated effect. Three authors were employees of Promore Pharma, which is developing LL-37 under the name ropocamptide. The drug was well tolerated at both strengths.
  • Diabetic foot ulcers: one trial, a partial result. Miranda et al. (Arch Dermatol Res 2023;315(9):2623-2633, PMID 37480520; ClinicalTrials.gov NCT04098562) applied LL-37 cream or placebo cream twice a week for four weeks to diabetic foot ulcers with mild infection in Jakarta. The granulation index rose more in the LL-37 group at days 7, 14, 21 and 28 (p = 0.031, 0.009, 0.006 and 0.037), but LL-37 did not lower IL-1α or TNF-α, and the difference in bacterial colonisation was not statistically significant.
  • Injected LL-37 has been studied in four people. A phase 1/2 study at MD Anderson Cancer Center (ClinicalTrials.gov NCT02225366) injected LL-37 weekly into the skin metastases of melanoma for up to eight weeks, with the optimal biological dose, judged by toxicity, as its primary outcome. It started in July 2015, completed in November 2020 and enrolled four participants. One of them is described in a case report (Dolkar et al., J Cutan Pathol 2018, PMID 29665030): the injected lesions shrank, but about 45 days in, multiple wart-like and keratoacanthoma-like skin lesions appeared on the trunk and limbs, and 11 of 12 biopsies showed the same pattern. All of them resolved within two months of stopping the injections.
  • By mouth, only as a bacterium. A 2023 randomised, open-label, placebo-controlled trial at a single hospital (Zhao et al., J Med Virol 2023;95(8):e29035, PMID 37605995) gave 238 adults admitted with the Omicron variant of COVID-19 either placebo or Oral LL-37 — a Lactococcus lactis bacterium genetically engineered to produce the peptide in the gut. Started within six days of diagnosis, it shortened the time to a negative PCR test (9.8 against 14.0 days), and no serious adverse events were reported. The outcome was a test result, not recovery or survival, patients and doctors knew who received what, and no study has given people synthetic LL-37 by mouth.
  • No human pharmacokinetics. No published study has measured LL-37 in the blood of people given it, so there is no human half-life to quote. What has been measured is stability outside the body: at 37 °C, 10 µg/mL LL-37 was completely degraded by trypsin within six hours but not by the wound enzyme MMP-9, and showed no apparent breakdown for up to 24 hours in fluid taken from nine non-healing venous leg ulcers (Grönberg et al., Acta Derm Venereol 2011, PMID 21547341).
  • Trial registry: a ClinicalTrials.gov search for LL-37 as the intervention returns 20 records, and most of them measure the body's own LL-37 — in vitamin D, saliva and gum-disease studies — rather than giving it. Only two administer LL-37 itself: the melanoma injection study and the diabetic foot ulcer cream trial. A search for semaglutide returns 760 (28 September 2026), so the query works.
  • Regulatory, United States. FDA's page on bulk drug substances that may present significant safety risks in compounding carries an assessment of cathelicidin LL-37: compounded drugs containing it “may pose risk for immunogenicity for certain routes of administration and may have complexities with regard to peptide-related impurities and API characterization”, and nonclinical research suggests detrimental effects on male reproduction and that it can be protumorigenic in some tissues. LL-37 now sits in that page's section for substances whose nominations were withdrawn (page updated 22 April 2026), and it appears on neither the 503A list for pharmacies (updated 14 May 2026) nor the 503B list for outsourcing facilities (updated 21 March 2025). An openFDA drug-label search for ropocamptide or LL-37 returns no matches; the same search for semaglutide returns 5.
  • Regulatory, sport: LL-37 is not named on the World Anti-Doping Agency's Prohibited List, but “not named” is not “permitted”. Section S0 prohibits, at all times, any pharmacological substance not addressed elsewhere on the list and with no current approval by a government health authority for human therapeutic use, which describes LL-37.
  • Research-use: sold and handled as a research chemical only; not intended for human or veterinary therapeutic use, and not approved to treat, cure or prevent any condition.

Research timeline

Dated milestones taken from the primary records: the molecule's discovery, its first registered human study, the trials that shaped the evidence and the regulatory decisions. Each entry links to the record it comes from.

  1. Researchers in Stockholm screening a human bone-marrow library for a counterpart of a pig antibiotic peptide instead find a new human peptide antibiotic, FALL-39, from a cathelin-like precursor. PMID 7529412
  2. The same group sequences the human gene, finds it is the only cathelin-family gene in the human genome, and isolates the mature 37-amino-acid peptide from white blood cells, naming it LL-37 after its first two amino acids. PMID 8681941
  3. A Nature Medicine study finds abnormally high cathelicidin levels, processed into unusual fragments, in the facial skin of people with rosacea, and shows in mice that these peptides increase skin inflammation. PMID 17676051
  4. A Nature study identifies LL-37 as the key factor that lets immune plasmacytoid dendritic cells respond to the body's own DNA in psoriasis, binding the DNA into complexes that trigger interferon production. PMID 17873860
  5. The first-in-man trial of topical LL-37, in 34 people with hard-to-heal venous leg ulcers, reports faster healing than placebo at the two lower strengths tested over four weeks of randomised treatment. PMID 25041740
  6. HEAL LL-37, a Phase 2b double-blind trial in 148 patients with hard-to-heal venous leg ulcers, finds no significant improvement in healing with topical LL-37 over placebo in the full population; benefit appeared only in a post-hoc subgroup with large wounds. PMID 34687253
  7. FDA's page on compounding safety risks, as updated on this date, lists cathelicidin LL-37 among substances that had been in Category 2 and whose nominations were withdrawn, noting non-clinical findings that suggest harm to male reproduction and tumour-promoting effects in some tissues. FDA · compounding safety risks, Apr 22, 2026

Records checked Oct 4, 2026

Claims at a glance

The claims most often made about this compound, each with the strongest kind of evidence we found for it. The grade says what was studied, not whether the claim is true; the line beside it says what that study showed.

  • Heals chronic leg ulcersHuman, randomised trial. Applied to the wound, it did no better than placebo across 148 patients in the confirmatory trial; a benefit appeared only in a subgroup chosen afterwards. PMID 34687253
  • Speeds healing of diabetic foot ulcersHuman, randomised trial. A double-blind trial of a cream found faster new-tissue growth in the wound, but no fall in inflammatory markers or in the bacteria on the wound. PMID 37480520
  • Fights viral infectionsHuman, randomised trial. In an open-label trial of 238 COVID-19 inpatients, a gut bacterium engineered to make LL-37 shortened the time to a negative test; no study has given people synthetic LL-37 for this. PMID 37605995
  • Clears Lyme disease and biofilm infectionsCell or tissue studies only. All four PubMed records pairing LL-37 with Borrelia or Lyme are laboratory work; no person with Lyme disease has been given it in a published study. PubMed search, Oct 7, 2026
  • Boosts the immune system when injectedNo study found. A PubMed search pairing LL-37 with injection routes in humans returned 16 records; none gave people LL-37 itself, most measured the body's own supply or used animals. PubMed search, Oct 7, 2026
  • Has anti-cancer effectsHuman, non-randomised. Injected into melanoma skin metastases in four patients; in the one described in detail the lesions shrank, but widespread wart-like skin growths appeared and cleared after stopping. PMID 29665030

The reasoning behind each grade, study by study, is in this guide's Benefit & Outcome Review.

Grades checked Oct 7, 2026

A printable reference sheet with the compound's key facts, storage guidance and a vial record comes with All-Access Lifetime.

Half-life & pharmacokinetics

This page previously stated a functional half-life on the order of about one hour, extending past 12 hours when protease activity is blocked. Those figures are withdrawn: we could not trace either to a study, and no published work has measured LL-37 in the blood of people given it, so a human half-life has never been measured. What the literature does measure is stability outside the body, and it depends heavily on which enzymes are present. At 37 °C, LL-37 at 10 µg/mL was completely broken down by trypsin, a serine protease, within six hours, but not by MMP-9; incubated in fluid from nine non-healing venous leg ulcers, it showed no apparent breakdown for up to 24 hours, including fluid from ulcers carrying Pseudomonas aeruginosa (Grönberg et al., Acta Derm Venereol 2011, PMID 21547341). Those are hours in a test tube, not a half-life in a person. In solution the peptide is chemically unstable, which is why researchers reconstitute it fresh and store it cold.

Reported side effects & toxicology

Human safety data are limited and come almost entirely from skin application. In the first leg-ulcer trial there were no local or systemic safety concerns across three concentrations (PMID 25041740), and the 148-patient phase IIb trial reported LL-37 well tolerated at both strengths (PMID 34687253). Injected LL-37 has a much thinner record: four patients in one melanoma study, one of whom developed multiple wart-like and keratoacanthoma-like skin lesions about 45 days after starting weekly injections, which resolved within two months of stopping (PMID 29665030). FDA's safety-risk assessment names immunogenicity for certain routes, difficulties characterising the peptide and its impurities, and nonclinical signals of harm to male reproduction and of tumour promotion in some tissues. The biology adds two cautions: a narrow window between antimicrobial and cytotoxic concentrations, and an association in the literature between elevated levels of the body's own LL-37 and chronic inflammatory and autoimmune conditions of the skin and lungs. This page once said small oral studies reported no serious adverse events, and later that no published study had given people LL-37 by mouth. Both statements are withdrawn. The one oral study is a 2023 open-label trial in 238 hospitalised COVID-19 patients given a genetically modified Lactococcus lactis bacterium that makes LL-37, which reported no serious adverse events (PMID 37605995); synthetic LL-37 itself has never been studied by mouth. This is not a complete list and not medical advice.

Storage & handling

  • Lyophilized (freeze-dried) powder is reported to be stable when kept sealed, cold, and protected from light; refrigeration is common and long-term freezing is used for extended storage.
  • Once reconstituted, LL-37 is unstable in solution and should be refrigerated (about 2–8°C / 36–46°F), protected from light, not frozen or shaken, and used promptly since it degrades over time.

References

Identity: PubChem CID 16198951 and CID 137699475. Human trials: Grönberg et al., Wound Repair Regen 2014, PMID 25041740; Mahlapuu et al., Wound Repair Regen 2021, PMID 34687253; Miranda et al., Arch Dermatol Res 2023, PMID 37480520 (NCT04098562); ClinicalTrials.gov NCT02225366 and Dolkar et al., J Cutan Pathol 2018, PMID 29665030; Zhao et al., J Med Virol 2023, PMID 37605995. Stability: Grönberg et al., Acta Derm Venereol 2011, PMID 21547341. Regulatory: FDA's page on bulk drug substances that may present significant safety risks (updated 22 April 2026), FDA 503A (14 May 2026) and 503B (21 March 2025) bulk drug substance lists, openFDA drug labels; WADA Prohibited List, section S0. Educational only, not medical advice.

Guide FAQ

Quick answers about guide scope, access, and educational use context.

Is LL-37 approved by the FDA?

No. LL-37 is not approved as a medicine in the US or anywhere else, and there is no US drug label for it. It is handled as a research-use-only material. It is also on neither of FDA's current compounding lists: its nomination was withdrawn, and FDA's safety-risk page still carries its assessment of the substance.

What has LL-37 been tested for in people?

Mostly chronic wounds, applied to the skin. A 34-person trial in venous leg ulcers used 0.5, 1.6 and 3.2 mg/mL twice weekly for four weeks and saw faster healing at the two lower concentrations only (PMID 25041740); the 148-patient phase IIb follow-up found no significant benefit across all patients (PMID 34687253); a diabetic foot ulcer trial saw better granulation but no change in inflammation or bacteria (PMID 37480520). The only injected use is a four-patient melanoma study. There is no established human protocol for injection.

What is LL-37's half-life?

It has never been measured in people: no study has tracked LL-37 in the blood after giving it. The ~1 hour figure this page previously gave is withdrawn as unsourced. Outside the body, trypsin destroyed it within six hours, while in fluid from chronic leg ulcers it showed no apparent breakdown for 24 hours (PMID 21547341). In solution it is unstable, so it is stored cold and used promptly.

Did the LL-37 wound-healing trial work?

Not on its main question. The phase IIb HEAL LL-37 trial in 148 patients with hard-to-heal venous leg ulcers found no significant improvement in healing with LL-37 compared with placebo across the whole study population (PMID 34687253). A later look at patients with ulcers of at least 10 cm² found improvement, but that subgroup was analysed after the fact, and the authors call for a new, adequately powered study to test it.

What is FDA's position on LL-37?

FDA has published a safety-risk assessment of cathelicidin LL-37 for compounding: possible immunogenicity for certain routes, complexities with peptide-related impurities and characterisation, and nonclinical signals of harm to male reproduction and of tumour promotion in some tissues. Its nomination for compounding was later withdrawn, so it is on neither the 503A pharmacy list (updated 14 May 2026) nor the 503B outsourcing list (updated 21 March 2025). Always follow the laws and regulations that apply to you.

Is LL-37 banned by WADA?

It is not named on the WADA Prohibited List, but that does not make it permitted. Section S0 prohibits at all times any pharmacological substance not addressed elsewhere on the list and not approved by a government health authority for human therapeutic use, and LL-37 has no such approval. Athletes should check the current list before any decision.

Is research-grade LL-37 the same molecule as the body's own?

The sequence is the same 37 residues, LLGDFFRKSKEKIGKEFKRIVQRIKDFLRNLVPRTES (PubChem CID 16198951). Synthetic material is often supplied as a trifluoroacetate salt, which PubChem files as a separate record (CID 137699475, about 4,607 g/mol against 4,493 for the peptide). A certificate of analysis should state which form its mass and purity figures refer to. Note that hCAP-18 is the larger precursor protein LL-37 is cut from, not the peptide itself.

Can LL-37 cause harm?

Topically, the trials reported it well tolerated. Injected, the record is four melanoma patients, one of whom developed multiple wart-like skin lesions that cleared after the injections stopped (PMID 29665030). FDA's assessment adds nonclinical signals on male reproduction and tumour promotion, and the peptide has a narrow gap between antimicrobial and cytotoxic concentrations. Elevated levels of the body's own LL-37 are associated with inflammatory and autoimmune conditions.

Compliance and trust notes

  • Educational content only; no personalized health or outcome claims.
  • No personalized use recommendation outputs.
  • Use this material for general learning and research-context literacy.

Reading an LL-37 certificate of analysis

A certificate of analysis (COA) is a laboratory’s report on one sample of one batch. The single most useful thing to know about it is that purity and identity are two separate results that fail in different ways. A high purity figure says the sample was mostly one substance; it does not say that substance was LL-37. Identity — normally a mass-spectrometry result matching the expected molecular weight — is what establishes what the material actually is, and a certificate reporting purity alone has not answered that question.

Two further limits are worth holding onto. Mass per vial is its own test: a vial can be 99% pure and still contain less material than the label claims. And sterility, endotoxin, heavy metals and residual solvent screening are separately commissioned tests, usually priced individually — so a “third-party tested” badge asserts none of them unless the certificate names them. Check that the batch or lot number on the document matches the vial in front of you; an unmatched certificate describes someone else’s material.

Medibact does not test, endorse or resell peptides, and publishes no rating of any laboratory. How to read a peptide certificate of analysis walks through the document section by section, and what each COA field establishes covers the field-by-field detail and the laboratories that publish their methods.

You’ll need bacteriostatic water

The diluent for reconstituting LL-37

Reconstitution is volume arithmetic — it assumes a lyophilized vial is dissolved in bacteriostatic water, which is sterile water preserved with 0.9% benzyl alcohol. The preservative is what allows a vial to be entered more than once; plain sterile water carries none and is single-entry by design. Medibact supplies USP-grade Bacteriostatic Water for Injection in a 30 mL multi-dose vial, made in the United States and shipped from the United States, for research use only. One 30 mL vial covers 30 reconstitutions at 1 mL each, 15 at 2 mL, or 10 at 3 mL — division only, not a dosing recommendation.

New to reconstitution? Read how to reconstitute peptides or bacteriostatic water vs sterile water. Medibact does not sell peptides.

Educational use only — not medical advice. This guide summarizes information reported in published research and community practice for educational purposes. It is not medical advice and not a recommendation to use any compound. Any doses, schedules, or combinations shown are examples of what has been reported, not instructions for you. Many peptides described here are research compounds that are not FDA-approved for the uses discussed and may be investigational or restricted. Effects, risks, and legal status vary; individual needs and results vary. Consult a qualified, licensed healthcare professional before making any decision. Do not use this content to diagnose, treat, or dose yourself.