Powering prescription: Mitochondria as “Living Drugs” – Definition, clinical applications, and industry advancements

Andrés Caicedo*, Emilia Morales, Aldana Moyano, Sebastian Peñaherrera, José Peña-Cisneros, Abigail Benavides-Almeida, Álvaro A. Pérez-Meza, Alissen Haro-Vinueza, Cristina Ruiz, Paola Robayo, Doménica Tenesaca, Diego Barba, Kevin Zambrano, Verónica Castañeda, Keshav K. Singh

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Mitochondria's role as engines and beacons of metabolism and determinants of cellular health is being redefined through their therapeutic application as “Living Drugs” (LDs). Artificial mitochondrial transfer/transplant (AMT/T), encompassing various techniques to modify, enrich, or restore mitochondria in cells and tissues, is revolutionizing acellular therapies and the future of medicine. This article proposes a necessary definition for LDs within the Advanced Therapeutic Medicinal Products (ATMPs) framework. While recognizing different types of LDs as ATMPs, such as mesenchymal stem cells (MSCs) and chimeric antigen receptor T (CAR T) cells, we focus on mitochondria due to their unique attributes that distinguish them from traditional cell therapies. These attributes include their inherent living nature, diverse sources, industry applicability, validation, customizability for therapeutic needs, and their capability to adapt and respond within recipient cells. We trace the journey from initial breakthroughs in AMT/T to the current state-of-the-art applications by emerging innovative companies, highlighting the need for manufacturing standards to navigate the transition of mitochondrial therapies from concept to clinical practice. By providing a comprehensive overview of the scientific, clinical, and commercial landscape of mitochondria as LDs, this article contributes to the essential dialogue among regulatory agencies, academia, and industry to shape their future in medicine.

Original languageEnglish
Article number107018
JournalPharmacological Research
StatePublished - Jan 2024

Bibliographical note

Publisher Copyright:
© 2023 The Authors


  • Acellular therapy
  • Advanced therapeutic medicinal products (ATMPs)
  • Artificial mitochondrial transfer transplant (AMT/T)
  • Cell therapy
  • Industry
  • Innovation
  • Living drugs (LDs)
  • Mitochondria


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