← All compounds · evidence tier first, by design
| Use | E1 | E2 | E3 | E4 | E5 | E6 | E7 | E8 |
|---|---|---|---|---|---|---|---|---|
| E3 Chronic venous leg ulcers unresponsive to standard care (topical synthetic LL-37) | E3 | |||||||
| E3 Diabetic foot ulcers (topical synthetic LL-37) | E3 | |||||||
| E6 Systemic or chronic infections and immune support (injected LL-37, gray-market claims) | E6 |
LL-37
LLGDFFRKSKEKIGKEFKRIVQRIKDFLRNLVPRTES
37 residues cleaved from the C-terminus of the human cathelicidin precursor hCAP-18 (UniProt P49913, residues 134-170). Ropocamptide is the name used by its developer, Promore Pharma, for a topical synthetic LL-37 product.
Also: Cathelicidin LL-37, Human cathelicidin antimicrobial peptide, Ropocamptide
A 37-amino-acid antimicrobial peptide made naturally by human white blood cells and skin and mucosal cells, the only human member of the cathelicidin family. A synthetic version has been tested as a topical treatment for chronic leg and foot ulcers. Separately, it is sold on the gray market, often for injection, with claims for chronic infections, immune support and gut health. It is not approved as a medicine in any jurisdiction checked.
- US C gray market
- EU ? not verified
- UK ? not verified
- CA ? not verified
- AU ? not verified
- JP ? not verified
- CN ? not verified
01Regulatory status, by jurisdiction
| Jurisdiction | Status | Detail and primary source |
|---|---|---|
| US | Not approved | Not approved: FDA has approved no product containing LL-37. FDA's list of bulk substances that may present significant safety risks names cathelicidin LL-37 among substances previously in 503A Category 2 whose nominations were withdrawn; it is not on the current 503A Category 1 or 2 lists (updated 14 May 2026). FDA cites possible immunogenicity, impurity and characterisation concerns, and nonclinical findings of detrimental effects on male reproduction and protumorigenic effects in some tissues.“FDA lacks sufficient safety-related information regarding cathelicidin LL-37 to know whether the drug would cause harm when administered to humans.”Certain Bulk Drug Substances for Use in Compounding that May Present Significant Safety Risks (FDA, content current as of 04/22/2026) · retrieved 2026-10-10 |
| EU UK CA AU JP CN | Not yet verified from a primary source. No status is shown rather than an unsourced one. | |
Sport (WADA): Prohibited · class S0. “Any pharmacological substance which is not addressed by any of the subsequent sections of the List and with no current approval by any governmental regulatory health authority for human therapeutic use” WADA source
02What the human evidence shows
Chronic venous leg ulcers unresponsive to standard care (topical synthetic LL-37)
A first-in-human randomised trial in 34 patients over four weeks reported faster healing-rate constants for the two lower concentrations than for placebo, but not for the highest. The larger phase 2b trial (HEAL LL-37, 148 patients, sponsored by the developer) found no significant improvement in healing compared with placebo in the full population; benefit in patients with large ulcers came from a post hoc subgroup analysis. The randomised evidence is conflicting and the larger trial was negative.
- [1] No significant difference in ulcer healing versus placebo in 148 patients with venous leg ulcers; post hoc subgroup differences only
- [2] Higher healing-rate constants than placebo at the two lower concentrations, not the highest, in 34 patients over four weeks
Registered-study counts: ClinicalTrials.gov intervention search “LL-37”, fetched 2026-10-10. Registered studies include trials of other uses; the gap between registered and reported is itself a finding.
Diabetic foot ulcers (topical synthetic LL-37)
One small randomised, double-blind, placebo-controlled trial in Jakarta treated mildly infected diabetic foot ulcers with LL-37 cream or placebo cream for four weeks. A granulation index increased more with LL-37; wound inflammatory cytokines and aerobic bacterial counts did not differ significantly between groups. No confirmatory trial was identified.
- [3] Greater increase in granulation index than placebo over four weeks in patients with mildly infected diabetic foot ulcers; no difference in bacterial colonisation
Registered-study counts: ClinicalTrials.gov intervention search “LL-37 diabetic foot ulcer”, fetched 2026-10-10. Registered studies include trials of other uses; the gap between registered and reported is itself a finding.
Systemic or chronic infections and immune support (injected LL-37, gray-market claims)
No human trial of any design has been published for this use.
LL-37 kills a range of bacteria in laboratory assays, with activity reduced for some organisms at physiological salt concentrations. In a mouse model of polymicrobial sepsis, intravenous LL-37 improved survival and lowered bacterial counts. No human trial of injected or oral LL-37 for any infection, for immune support or for gut health was identified. The only registered human trial of injected LL-37 identified was a four-patient intratumoural melanoma study, without published results.
- [4] Intravenous LL-37 improved survival and reduced bacterial burden in mice with caecal ligation and puncture sepsis
- [5] LL-37 showed antimicrobial activity against several bacterial species in vitro; some organisms were resistant in physiological salt
Registered-study counts: ClinicalTrials.gov intervention search “LL-37”, fetched 2026-10-10. Registered studies include trials of other uses; the gap between registered and reported is itself a finding.
Key registered trials
| NCT | Title (as registered) | Phase | Status |
|---|---|---|---|
| NCT04098562 | Efficacy of LL-37 Cream on Bacteria Colonization, Inflammation Response and Healing Rate of Diabetic Foot Ulcers | 2 | Unknown |
| NCT02225366 | Intratumoral Injections of LL37 for Melanoma | 1/2 | Completed |
03Safety signals
There are no adequate human safety data. The absence of reported harm is not evidence of safety.
04What is unknown
- Human safety data come only from short topical use on ulcers; there are no published human safety or pharmacokinetic data for injected, oral or nasal LL-37
- FDA cites nonclinical findings suggesting detrimental effects on male reproduction and protumorigenic effects in some tissues; their relevance to human use is not established
- Endogenous LL-37 has been implicated in inflammatory skin disease such as rosacea and psoriasis; whether supplemental LL-37 affects these conditions is untested
- Immunogenicity of injected synthetic LL-37 is unassessed
- LL-37 is not named on the 2026 WADA Prohibited List; S0 is applied here because no approval by any regulator was identified, not because WADA has classified it by name
- Regulatory status outside the US was not verified from regulator sources for this record
05Product quality
No independent purity results have been published for this compound yet. The purity programme will publish full methods and vendor-named results, passes and failures, once its protocol has had legal review.
06Citations
- Evaluation of LL-37 in healing of hard-to-heal venous leg ulcers: A multicentric prospective randomized placebo-controlled clinical trial (2021). doi:10.1111/wrr.12977
- Treatment with LL-37 is safe and effective in enhancing healing of hard-to-heal venous leg ulcers: a randomized, placebo-controlled clinical trial (2014). doi:10.1111/wrr.12211
- Efficacy of LL-37 cream in enhancing healing of diabetic foot ulcer: a randomized double-blind controlled trial (2023). doi:10.1007/s00403-023-02657-8
- Antimicrobial cathelicidin peptide LL-37 inhibits the pyroptosis of macrophages and improves the survival of polybacterial septic mice (2016). doi:10.1093/intimm/dxv113
- Activities of LL-37, a Cathelin-Associated Antimicrobial Peptide of Human Neutrophils (1998). doi:10.1128/AAC.42.9.2206
Every DOI is resolved against Crossref and every NCT number against ClinicalTrials.gov, title for title, before publication. Regulatory sources are cited inline above with a verbatim quote and retrieval date.
07Mechanism
LL-37 is a cationic, amphipathic peptide that disrupts bacterial membranes and binds bacterial lipopolysaccharide in vitro, and modulates inflammatory cytokine production by immune cells.
Mechanism is placed last on purpose: a plausible mechanism is not evidence that a compound works in people.
Reviewed by OSMF research team (AI-assisted, source-verified) on 2026-10-10. Found an error? It goes in the corrections log: report it.