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Table 2 Small molecule drugs targeting mitochondrial quality control

From: Targeting mitochondrial quality control: new therapeutic strategies for major diseases

Small molecule drug

Targeted protein

Targeting step

Research state

Reported disease models

References

Mdivi-1

DRP1

Fission

Preclinical phase

Cardiac arrest, heart failure, myocardial infarction, neurodegenerative diseases, acute kidney injury, and cerebral ischemia–reperfusion

[166,167,168,169,170,171,172]

P110

DRP1

Fission

Preclinical phase

Myocardial ischemia–reperfusion, sepsis-induced myocardial disease, PAH, sepsis-induced brain dysfunction, neurodegenerative diseases, and ALS

[25, 172,173,174,175,176,177,178]

Dynasore

DRP1

Fission

Preclinical phase

Spinal cord injury, myocardial ischemia–reperfusion, type 2 diabetes, and PD

[166, 179,180,181,182]

15-oxospiramilactone (S3)

MFN1/2

Fusion

Preclinical phase

Type 2 diabetes

[183, 184]

S89

MFN1

Fusion

Preclinical phase

Myocardial ischemia–reperfusion

[185]

MASM7

MFN2

Fusion

Preclinical phase

Spinal cord injury

[186, 187]

Paeonol (Pae)

OPA1

Fusion

Preclinical phase

Inflammation, pain-related diseases, oxidative damage, diabetic cardiomyopathy, cardiovascular diseases, PAH, AD, dentine hypersensitivity, and soft tissue injury

[188,189,190,191,192]

ZLN005

PGC-1α

Biogenesis

Preclinical phase

Diabetes, neuroprotection, retinal protection, renal ischemia–reperfusion, and high glucose-induced cardiomyopathy

[193,194,195,196,197]

Kinetin

PINK1

Mitophagy

Phase I clinical trial (NCT02274051)

Familial dysautonomia

[198]

Phase IV clinical trial (NCT01898182)

Skin photoaging

Kaempferol

PINK1

Mitophagy

Phase I clinical trial (NCT06060691)

Female arousal disorder and sexual dysfunction

[199]

Preclinical phase

AD

Rhapontigenin

PINK1

Mitophagy

Preclinical phase

AD

[199]

SR3677

PARKIN

Mitophagy

Preclinical phase

Paraquat poisoning

[200]

Cyclosporin A (CsA)

/

mPTP channel

Phase II clinical trial (NCT01650662)

Reperfused acute myocardial infarction

[201,202,203,204,205]

Preclinical phase

Pulmonary ischemia–reperfusion, hemorrhagic shock, and solid organ transplantation

Ru360

/

Calcium ion channel

Preclinical phase

Myocardial ischemia–reperfusion, traumatic brain injury

[206, 207]

MCU-i4

/

Calcium ion channel

Preclinical phase

Cancer, pancreatitis, and heart failure

[208]

N-acetyl-L-cysteine (NAC)

/

ROS generation

Approved for listing

Dietary supplement

[209,210,211]

Preclinical phase

Drug-induced liver injury, COVID-19, and PD

Genipin

/

ROS generation

Phase III clinical trial (NCT05755750)

Horses with tendon injuries

[212, 213]

Preclinical phase

Breast cancer, gastric cancer, liver cancer, and other tumor models, and tendon injuries

Vitamins C and E

/

ROS generation

Approved for listing

Dietary supplement

[214, 215]

Preclinical phase

Peripheral nerve damage, dysmenorrhea, and pelvic pain

Resveratrol

/

ROS generation

Approved for listing

Dietary supplement

[216, 217]

Preclinical phase

Hypertension, diabetes, and tumor

BAY 87–2243

/

OXPHOS

Phase I clinical trial (NCT01297530)

Advanced malignancies

[218, 219]

Preclinical phase

Lung cancer and melanoma

Antimycin A

/

OXPHOS

Preclinical phase

Cervical carcinoma

[220]

Tetrathiomolybdate

/

OXPHOS

Phase II clinical trial (NCT00195091)

Breast cancer

[221]

Preclinical phase

Ovarian cancer, endometrial cancer, and non-small cell lung cancer

CPI-613 (devimistat)

/

TCA cycle

Phase I/II clinical trial (NCT04593758)

Relapsed or refractory clear cell sarcoma of soft tissue

[222, 223]

Phase II clinical trial (NCT05733000)

Advanced chemorefractory solid tumors

Phase II clinical trial (NCT05854966)

Relapsed or refractory acute myeloid leukemia (AML)

Phase III clinical trial (NCT03504410)

Phase II clinical trial (NCT04217317)

Refractory T-cell non-hodgkin lymphoma

Phase I/II clinical trial (NCT04203160)

Advanced unresectable biliary tract cancer (Bilt-04)

Elamipretide

/

Phospholipid synthesis

Phase III clinical trial (NCT05162768)

Primary mitochondrial disease from nuclear DNA mutations (Npmd) (Nupower)

[224,225,226]

Preclinical phase

Primary mitochondrial myopathy, traumatic brain injury

Ketogenic agents

/

Ketone metabolism

—

Cardiovascular disease

[15]

L-carnitine

/

Fatty acid β-oxidation

Approved for listing

Dietary supplement

[227, 228]

Preclinical phase

Cardiovascular diseases, hypertension, hyperlipidemia, type 2 diabetes, and obesity

NMS-873

/

MAD

Preclinical phase

Ovarian cancer

[17, 18, 229]

CB-5083

/

MAD

Phase I clinical trial (NCT02243917)

Advanced solid tumors

[17, 18, 229]

Preclinical phase

Lymphoid system malignancies

SKPin C1

/

UPS

Preclinical phase

Melanoma and myeloma

[230, 231]

SZL P1-41

/

UPS

Preclinical phase

Renal cancer, leukemia, glioma, and lung tissue fibrosis

[232,233,234,235]

PROTACs

/

UPS

—

Cancer, diabetic cardiomyopathy, and chronic myeloid leukemia

[236,237,238,239]

ARV-766

/

UPS

Phase II clinical trial (NCT05067140)

Prostate cancer

[240]

BT317

/

Mitoproteases and chaperonin

Preclinical phase

Tumor

[241]

334

/

Mitoproteases and chaperonin

Preclinical phase

Leukemia

[242]

SD-169 (5-carbamoylindole)

/

Mitoproteases and chaperonin

Preclinical phase

Diabetes

[243]

C86 (chalcone)

/

Mitoproteases and chaperonin

Phase II clinical trial (NCT06063655)

Prostate cancer

[244]

JG98

/

Mitoproteases and chaperonin

Preclinical phase

Prostate cancer

[244]

CoQ

/

Mitochondrial signaling

Approved for listing

Dietary supplement

[245,246,247]

Preclinical phase

Acute kidney, lung, and septic liver injuries

α-lipoic acid

/

Mitochondrial signaling

Approved for listing

Dietary supplement

[248]

Preclinical phase

Sepsis

Nicotinic acid (vitamin B3)

/

Mitochondrial signaling

Approved for listing

Dietary supplement

[249]

Preclinical phase

Sepsis-induced liver injury

Mifepristone

/

Mitochondrial signaling

Approved for listing

Type 2 diabetes, Cushing’s syndrome, and adenomyosis

[250, 251]

17β-estradiol

/

Mitochondrial signaling

Approved for listing

Cerebral ischemia

[252]

Bicalutamide (Bic, ICI-176334)

/

Mitochondrial signaling

Approved for listing

Tumors, such as prostate cancer

[253, 254]

  1. AD Alzheimer’s disease, PD Parkinson’s disease, COVID-19 coronavirus disease 2019, ROS reactive oxygen species, mPTP mitochondrial permeability transition pore, OXPHOS oxidative phosphorylation, TCA tricarboxylic acid, MAD mitochondrial associated degradation, UPS ubiquitin–proteasome system, Mitoproteases mitochondrial protease system, Mdivi-1 mitochondrial division inhibitor-1, P110 a specific inhibitor of dynamin-related protein 1, S89 an agonist of mitofusin 1, MASM7 a serine protease activator, ZLN005 an agonist of PGC-1α, SR3677 Rho kinase inhibitor, Ru360 an oxygen-bridged dinuclear ruthenium amine complex, MCU-i4 mitochondrial calcium uniporter inhibitor, BAY 87–2243 an inhibitor of hypoxia-induced gene activation, NMS-873 an allosteric inhibitor of p97, CB-5083 an inhibitor of the p97 AAA ATPase, SKPin C1 a highly selective inhibitor of S-phase kinase associated protein 2, SZL P1-41 specific inhibitor of S-phase kinase-associated protein 2, PROTACs proteolysis-targeting chimeras, ARV-766 luxdegalutamide, BT317 a dual LONP1 and chymotrypsin-like proteasome inhibitor, 334 an AAA ATPase inhibitor, C86 and JG98 are allosteric modulators of heat shock protein 70, CoQ coenzyme Q, DRP1 dynamin-related protein 1, PAH pulmonary arterial hypertension, ALS amyotrophic lateral sclerosis, MFN mitofusin, OPA1 optic atrophy protein 1, PGC-1α peroxisome proliferator-activated receptor gamma coactivator-1α, PINK1 phosphatase and tensin homolog (PTEN)-induced kinase 1, PARKIN parkinson protein 2 E3 ubiquitin protein ligase. Dietary supplements have been approved by the U.S. Food and Drug Administration (FDA, https://www.fda.gov/)