Bench to bedside: the role of mitochondrial medicine in the pathogenesis and treatment of cellular injury.

Interest in the study of mitochondria has undergone a revival. The term mitochondrial medicine developed around evidence pointing to the mitochondria as a logical target for therapy. This article reviews the normal functions of mitochondria and integration of mitochondrial processes in cells. Changes in mitochondria that occur in ischemia and reperfusion, production of reactive oxygen species by mitochondria, stimulation of apoptosis, and roles of mitochondria in sepsis also are reviewed. The authors also review therapies that are based on targeting drugs to mitochondria, regulating calcium availability, substrate preferences, and activation of poly (ADP-ribose) polymerase and apoptosis. The purpose of this article is to provide a framework for emergency medicine academicians to understand the roles of mitochondria in pathology and to facilitate the transition of this information into therapeutic strategies based on mitochondrial medicine. For individuals interested in the biochemistry of mitochondria, knowledge of this fundamental organelle is expanding at a rapid rate.