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Mitochondrial membrane phospholipids are essential structural and functional lipids, primarily located in the inner mitochondrial membrane (IMM), where they facilitate cellular energy production and maintain organelle integrity (Mejia & Hatch, 2016). The most prominent member, cardiolipin, is unique for its dimeric structure and is vital for the stability of electron transport chain supercomplexes and the formation of cristae (Claypool & Koehler, 2012). Dysregulation of these phospholipids, particularly through oxidative damage or genetic defects in remodeling enzymes like tafazzin, is a hallmark of Barth syndrome and contributes to the progression of heart failure and neurodegenerative diseases (Chavez et al., 2020). Therapeutic agents such as elamipretide (SS-31) target these phospholipids by binding to cardiolipin, thereby preventing its peroxidation and stabilizing the IMM to enhance ATP synthesis and reduce reactive oxygen species (Szeto, 2014). Consequently, these lipids represent a critical therapeutic target for restoring mitochondrial bioenergetics and preventing cell death in various metabolic and age-related pathologies.
Stabilization of cardiolipin-protein complexes, prevention of cardiolipin peroxidation, and maintenance of mitochondrial membrane curvature and cristae structure (Szeto, 2014; Mejia & Hatch, 2016).
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