Acute kidney injury (AKI) remains a significant global health challenge, with high
mortality rates and the potential for progression to
chronic kidney disease. One promising avenue of intervention is targeting
mitochondrial biogenesis (MB), a critical cellular process that promotes
energy metabolism,
stress resistance, and
cell survival. By enhancing MB, it may be possible to restore
mitochondrial function, alleviate
oxidative stress, and improve
renal recovery.
The kidneys, particularly
renal tubular epithelial cells, are highly dependent on robust mitochondrial function due to their substantial
energy demands. During AKI,
mitochondrial dysfunction leads to
decreased energy production, heightened
oxidative damage, and
cell death, exacerbating kidney injury. Suppressing MB not only disrupts
cellular energy balance but also impairs the ability to respond to
injurious stimuli, accelerating disease progression. Therefore, therapeutic strategies aimed at boosting MB could significantly mitigate AKI severity and improve patient outcomes.
Several factors regulate MB, including
PGC-1α, a key
transcriptional coactivator that stimulates the expression of genes involved in
mitochondrial function. Activation of PGC-1α enhances
ATP production, reduces
reactive oxygen species (ROS), and supports
cell survival during stress. Compounds like
resveratrol, which activate PGC-1α via
SIRT1-mediated deacetylation, have shown potential in promoting
mitochondrial health. Furthermore, small molecules like
ZLN005 and
pyrroloquinoline quinone (PQQ) can enhance
MB through pathways involving
AMPK activation and
CREB phosphorylation, respectively.
However, MB regulation is complex, and excessive activation may lead to
protein misfolding, mitochondrial damage, and
cellular toxicity. Thus, achieving a balanced activation of MB is essential to prevent unintended consequences. Advances in understanding
MB signaling pathways and identifying
modulatory compounds offer new therapeutic possibilities. Notably,
nanotechnology-based drug delivery systems are being developed to precisely target
mitochondrial dysfunction in AKI, improving therapeutic efficacy while minimizing side effects.
Translating these insights into clinical practice requires overcoming challenges related to
drug specificity,
targeted delivery, and
patient variability. Personalized approaches that consider the
etiology and subtype of AKI, as well as patient-specific factors like
comorbidities, are essential for optimizing treatment. Additionally, integrating
multi-omics data can help identify biomarkers predictive of
treatment response, enabling more
precise and effective therapies.
Mitochondria-targeted therapies hold immense potential for transforming AKI treatment. By addressing the underlying
mitochondrial dysfunction, these strategies offer a pathway to enhance
renal recovery, reduce
disease progression, and improve
patient survival. As research advances, integrating these innovative therapies into clinical protocols could revolutionize the management of AKI.
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Reference
Yajie Hao, Fahui Chen, Xiya Ren, Xiu Huang, Xiaoshuang Zhou, Harnessing mitochondrial biogenesis to combat acute kidney injury: Current insights and futuredirections, Genes & Diseases, Volume 12, Issue 6, 2025, 101645,
https://doi.org/10.1016/j.gendis.2025.101645