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Peer-reviewedCC BYBiomedical Technology

Research progress and prospect in mitochondrial-targeted therapy

4 affiliations
  1. 1Department of Thoracic Surgery, Organ Transplantation Center, The First Hospital of Jilin University, Changchun, China; Pharmaceutical Sciences Laboratory, Åbo Akademi University, Turku, 20520, Finland; Changchun University of Traditional Chinese Medicine, Changchun, China
  2. 2Department of Thoracic Surgery, Organ Transplantation Center, The First Hospital of Jilin University, Changchun, China; Pharmaceutical Sciences Laboratory, Åbo Akademi University, Turku, 20520, Finland
  3. 3Pharmaceutical Sciences Laboratory, Åbo Akademi University, Turku, 20520, Finland
  4. 4Department of Thoracic Surgery, Organ Transplantation Center, The First Hospital of Jilin University, Changchun, China; Changchun University of Traditional Chinese Medicine, Changchun, China; Corresponding author. Department of Thoracic Surgery, Organ Transplantation Center, The First Hospital of Jilin University, Changchun, China.

Abstract

Background: As the core organelles of eukaryotic cells, mitochondria play an indispensable role in physiological processes such as energy production and signal transduction. Their functional abnormalities are closely associated with the onset and progression of diverse diseases, including cancers, neurodegenerative disorders, metabolic diseases, and inherited mitochondrial diseases. However, the therapeutic objectives differ fundamentally across these conditions: in neurodegenerative, metabolic, and inherited mitochondrial diseases, the goal is to restore mitochondrial bioenergetics, redox balance, and quality control; conversely, in cancers, the objective is often to disrupt mitochondrial homeostasis—exploiting the reliance of tumor cells on glycolysis, elevated reactive oxygen species (ROS), and anti-apoptotic defenses to trigger metabolic catastrophe and cell death. Current treatments for mitochondrial-related diseases still face technical challenges, including insufficient targeting efficiency and limited mechanistic diversity, necessitating the development of precise and effective targeted therapeutic strategies tailored to each paradigm. Technology: This study systematically reviews three core technologies for mitochondrial-targeted therapy: firstly, small-molecule drugs targeting mitochondrial metabolism and ROS regulation (e.g., idebenone, imeglimin); secondly, nanoscale targeted delivery systems based on materials such as liposomes, micelles, and metal-organic frameworks, achieving mitochondrial-specific enrichment through surface modification; thirdly, emerging mitochondrial transplantation techniques restore damaged cellular function by infusing healthy mitochondria. All these technologies must meet critical requirements, including targeting specificity, biological stability, and efficient delivery. This review evaluates mitochondrial-targeting as a therapeutic strategy rather than a biological subject. We evaluate all strategies using a five-domain technical framework encompassing design logic, delivery efficiency, biosafety, manufacturing scalability and regulatory translatability—moving beyond conventional mitochondrial pathology reviews to deliver a translational design guide for clinical translation. Results: Preclinical and clinical studies indicate that small-molecule drugs demonstrate symptomatic improvement in conditions such as optic neuropathy and muscular dystrophy; nanosystems significantly enhance mitochondrial drug delivery efficiency, amplifying therapeutic outcomes such as chemotherapy efficacy; mitochondrial transplantation has demonstrated preliminary feasibility and efficacy signals in early-phase studies for conditions including cardiac ischemia-reperfusion injury and mitochondrial DNA deletion syndromes; however, definitive therapeutic efficacy awaits confirmation in adequately powered controlled trials. This review provides a comprehensive reference for fundamental research and clinical translation in mitochondrial-targeted therapies, charting new pathways for precision treatment of related diseases.

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BibTeX
@article{wang2026research,
  title = {{Research progress and prospect in mitochondrial-targeted therapy}},
  author = {Tengyu Wang and Yonghui Wang and Oliver Koivisto and Youbin Cui and Hongbo Zhang},
  journal = {Biomedical Technology},
  year = {2026},
  month = oct,
  doi = {10.1016/j.bmt.2026.100183},
  url = {https://doi.org/10.1016/j.bmt.2026.100183},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Research progress and prospect in mitochondrial-targeted therapy
AU  - Tengyu Wang
AU  - Yonghui Wang
AU  - Oliver Koivisto
AU  - Youbin Cui
AU  - Hongbo Zhang
PY  - 2026
DA  - 2026/10/30
JO  - Biomedical Technology
DO  - 10.1016/j.bmt.2026.100183
UR  - https://doi.org/10.1016/j.bmt.2026.100183
AB  - Background: As the core organelles of eukaryotic cells, mitochondria play an indispensable role in physiological processes such as energy production and signal transduction. Their functional abnormalities are closely associated with the onset and progression of diverse diseases, including cancers, neurodegenerative disorders, metabolic diseases, and inherited mitochondrial diseases. However, the therapeutic objectives differ fundamentally across these conditions: in neurodegenerative, metabolic, and inherited mitochondrial diseases, the goal is to restore mitochondrial bioenergetics, redox balance, and quality control; conversely, in cancers, the objective is often to disrupt mitochondrial homeostasis—exploiting the reliance of tumor cells on glycolysis, elevated reactive oxygen species (ROS), and anti-apoptotic defenses to trigger metabolic catastrophe and cell death. Current treatments for mitochondrial-related diseases still face technical challenges, including insufficient targeting efficiency and limited mechanistic diversity, necessitating the development of precise and effective targeted therapeutic strategies tailored to each paradigm. Technology: This study systematically reviews three core technologies for mitochondrial-targeted therapy: firstly, small-molecule drugs targeting mitochondrial metabolism and ROS regulation (e.g., idebenone, imeglimin); secondly, nanoscale targeted delivery systems based on materials such as liposomes, micelles, and metal-organic frameworks, achieving mitochondrial-specific enrichment through surface modification; thirdly, emerging mitochondrial transplantation techniques restore damaged cellular function by infusing healthy mitochondria. All these technologies must meet critical requirements, including targeting specificity, biological stability, and efficient delivery. This review evaluates mitochondrial-targeting as a therapeutic strategy rather than a biological subject. We evaluate all strategies using a five-domain technical framework encompassing design logic, delivery efficiency, biosafety, manufacturing scalability and regulatory translatability—moving beyond conventional mitochondrial pathology reviews to deliver a translational design guide for clinical translation. Results: Preclinical and clinical studies indicate that small-molecule drugs demonstrate symptomatic improvement in conditions such as optic neuropathy and muscular dystrophy; nanosystems significantly enhance mitochondrial drug delivery efficiency, amplifying therapeutic outcomes such as chemotherapy efficacy; mitochondrial transplantation has demonstrated preliminary feasibility and efficacy signals in early-phase studies for conditions including cardiac ischemia-reperfusion injury and mitochondrial DNA deletion syndromes; however, definitive therapeutic efficacy awaits confirmation in adequately powered controlled trials. This review provides a comprehensive reference for fundamental research and clinical translation in mitochondrial-targeted therapies, charting new pathways for precision treatment of related diseases.
SN  - 2949-723X
ER  -