Modulation of mitochondrial quality control in sepsis by traditional Chinese medicine: mechanistic insights and translational perspectives

Abstract

Sepsis is a life-threatening syndrome caused by a dysregulated host response to infection and represents a major challenge in critical care medicine due to its high global mortality. Mitochondrial quality control (MQC) denotes the regulatory network essential for maintaining mitochondrial homeostasis, encompassing processes including mitochondrial biogenesis, mitophagy, and mitochondrial dynamics. Impaired MQC leads to the accumulation of damaged mitochondria and constitutes a core pathological mechanism underlying sepsis-induced multiorgan dysfunction. Recent studies have demonstrated that various bioactive components of traditional Chinese medicine (TCM) can facilitate the restoration of the MQC network under septic conditions by modulating distinct signaling pathways, thereby attenuating cytokine storms, mitigating oxidative stress, and preserving organ function. Owing to their multicomponent and multitarget characteristics, TCM interventions offer promising therapeutic potential for sepsis. However, a systematic understanding of how these agents coordinately regulate MQC remains limited. In this review, we aim to elucidate the pharmacological roles and underlying molecular mechanisms of TCM in modulating mitochondrial quality during sepsis, and we also discuss future research directions in this field.