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Here, we present a biomimetically engineered carrier material using mitochondria as \u201cliving materials\u201d to restore cell homeostasis in RA. The dual action carrier consists of a folic acid\u2010modified macrophage membrane targeting activated M1 macrophages in RA joints, and it enables in situ mitochondrial transfer with more than twofold increase of delivery efficiency, which is a critical limitation of current approaches. By facilitating precise intracellular transfer of healthy mitochondria, and incorporating autophagy targeting chimera 4 (AUTAC4) in order to selectively destroy dysfunctional mitochondria, this design achieves complete mitochondrial renewal, increasing energy metabolism and homeostasis. In an RA model, the Dual\u2010Action Mitochondrial Renewal Therapy (DAMRT) showed significant therapeutic potential. It could be used as a novel platform for treatment for RA and other mitochondrial dysfunction.<\/jats:p>","DOI":"10.1002\/adma.202514070","type":"journal-article","created":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T08:48:55Z","timestamp":1771145335000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["High\u2010Efficiency Targeted Mitochondrial Transfer and AUTAC4\u2010Enhanced Dual Renewal Strategy for Rheumatoid Arthritis"],"prefix":"10.1002","volume":"38","author":[{"given":"Fuxiao","family":"Wang","sequence":"first","affiliation":[{"name":"Organoid Research Center Institute of Translational Medicine Shanghai University  Shanghai P. R. China"},{"name":"National Center for Translational Medicine (Shanghai) SHU Branch Shanghai University  Shanghai P. R. 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