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The mitochondrial quality control (MQC) machinery is a complex, multi-tiered regulatory system that maintains mitochondrial health and cellular homeostasis through the coordination of biogenesis, dynamics (fission and fusion), proteostasis, and mitophagy [1, 2]. This machinery acts as a surveillance system to identify, repair, or eliminate damaged mitochondria, thereby preventing the accumulation of dysfunctional organelles and the excessive production of reactive oxygen species (ROS) [4, 10]. In healthy cells, MQC ensures a robust pool of mitochondria to meet metabolic demands, but its failure is a central driver in the pathogenesis of neurodegenerative diseases, cardiovascular disorders, and metabolic syndromes [2, 8]. Therapeutic interventions targeting MQC components, such as DRP1 inhibitors or mitophagy inducers, are being explored to restore mitochondrial function and slow disease progression [3, 9]. For instance, drugs like Mdivi-1 target the fission protein DRP1 to prevent excessive mitochondrial fragmentation, while Urolithin A promotes the clearance of damaged mitochondria via mitophagy [1, 9]. However, the high degree of integration between MQC pathways poses significant challenges for drug development, as disrupting the delicate balance of mitochondrial turnover can lead to unintended cellular stress or death [4, 12]. Furthermore, the systemic nature of mitochondria means that targeting these pathways requires high specificity to avoid off-target effects in healthy tissues [1, 4]. Despite these challenges, the MQC system remains a high-priority area for therapeutic innovation in aging and chronic diseases [7, 11].
Modulation of mitochondrial dynamics, induction of mitophagy, enhancement of mitochondrial biogenesis, and maintenance of mitochondrial proteostasis.
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