{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:14:07Z","timestamp":1793121247222,"version":"4.5.0"},"reference-count":65,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Sepsis is a life-threatening syndrome characterized by a dysregulated host response to infection and progressive organ dysfunction. Although early antimicrobial therapy, source control, hemodynamic resuscitation, and organ support remain the foundations of care, these approaches do not directly reverse the cellular mechanisms that connect systemic inflammation to multi-organ failure. Mitochondrial dysfunction has emerged as a central mechanism linking impaired oxygen utilization, oxidative and nitrosative stress, immune-cell metabolic reprogramming, inflammatory amplification, and organ injury. During sepsis, inflammatory mediators, nitric oxide, microcirculatory abnormalities, calcium dysregulation, and metabolic stress converge on mitochondria, impairing oxidative phosphorylation and promoting mitochondrial reactive oxygen species\/reactive nitrogen species (ROS\/RNS) generation. When mitochondrial quality-control programs, including fission, fusion, mitophagy, and mitochondrial biogenesis, fail to restore network integrity, damaged mitochondria accumulate and become persistent sources of oxidative stress and danger signals. Mitochondrial damage-associated molecular patterns, particularly mitochondrial DNA, oxidized mitochondrial DNA, cardiolipin, ATP, and N-formyl peptides, activate innate immune pathways such as TLR9-MyD88-NF-kappaB, the NLRP3 inflammasome, and cGAS-STING signaling. In parallel, mitochondrial metabolism shapes macrophage activation, neutrophil function, T-cell competence, pyruvate-lactate handling through the pyruvate dehydrogenase complex, and the transition between hyperinflammation and immunosuppression. Clinical translation remains challenging because sepsis is biologically heterogeneous and mitochondrial dysfunction is dynamic, tissue-specific, and influenced by disease stage. This review synthesizes current knowledge on mitochondrial dysfunction in sepsis, emphasizing oxidative and nitrosative stress, mitochondrial quality control, mitochondrial damage-associated molecular pattern (DAMP) signaling, immunometabolism, organ-specific injury, candidate biomarkers, clinical translational strategies for mitochondria-targeted therapy, and future approaches based on multi-omics and artificial intelligence-assisted patient stratification. We argue that future therapeutic development should move beyond nonspecific antioxidant supplementation toward time-sensitive, phenotype-informed, and biomarker-guided mitochondrial medicine.<\/jats:p>","DOI":"10.3390\/ijms27135918","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:50:37Z","timestamp":1782867037000},"page":"5918","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Mitochondrial Immunometabolism in Sepsis: From Oxidative Stress and mtDAMP Signaling to Biomarker-Guided Therapy"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0246-4169","authenticated-orcid":false,"given":"Minsoo","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Physiology & Medical Science, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyu Phyu","family":"Khin","sequence":"additional","affiliation":[{"name":"Department of Physiology & Medical Science, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2428-2677","authenticated-orcid":false,"given":"Hyeran","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Physiology & Medical Science, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Woo","family":"Chae","sequence":"additional","affiliation":[{"name":"Department of Physiology & Medical Science, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3347-2739","authenticated-orcid":false,"given":"Byeong Hwa","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Physiology & Medical Science, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7647-6089","authenticated-orcid":false,"given":"Cuk-Seong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Physiology & Medical Science, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1001\/jama.2016.0288","article-title":"Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Seymour","year":"2016","journal-title":"JAMA"},{"key":"ref_3","unstructured":"(2025). GBD 2021 Global Sepsis Collaborators. Global, regional, and national sepsis incidence and mortality, 1990\u20132021: A systematic analysis. Lancet Glob. Health, 13, e2013\u2013e2026."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990\u20132017: Analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1007\/s00134-026-08361-1","article-title":"Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026","volume":"52","author":"Prescott","year":"2026","journal-title":"Intensive Care Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00134-021-06506-y","article-title":"Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021","volume":"47","author":"Evans","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1056\/NEJMra1208623","article-title":"Severe sepsis and septic shock","volume":"369","author":"Angus","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"16045","DOI":"10.1038\/nrdp.2016.45","article-title":"Sepsis and septic shock","volume":"2","author":"Hotchkiss","year":"2016","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/S0140-6736(04)16815-3","article-title":"Multiorgan failure is an adaptive, endocrine-mediated, metabolic response to overwhelming systemic inflammation","volume":"364","author":"Singer","year":"2004","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/S0140-6736(02)09459-X","article-title":"Association between mitochondrial dysfunction and severity and outcome of septic shock","volume":"360","author":"Brealey","year":"2002","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.mito.2004.07.023","article-title":"Mitochondrial dysfunction in septic shock and multiple organ dysfunction syndrome","volume":"4","author":"Crouser","year":"2004","journal-title":"Mitochondrion"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1097\/00003246-200202000-00002","article-title":"Endotoxin-induced mitochondrial damage correlates with impaired respiratory activity","volume":"30","author":"Crouser","year":"2002","journal-title":"Crit. Care Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1093\/bja\/aer093","article-title":"Oxidative stress and mitochondrial dysfunction in sepsis","volume":"107","author":"Galley","year":"2011","journal-title":"Br. J. Anaesth."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"5985209","DOI":"10.1155\/2017\/5985209","article-title":"Role of Oxidative Stress and Mitochondrial Dysfunction in Sepsis and Potential Therapies","volume":"2017","author":"Mantzarlis","year":"2017","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1186\/s13054-024-05069-w","article-title":"Mitochondrial dysfunction in sepsis: Mechanisms and therapeutic perspectives","volume":"28","author":"Hu","year":"2024","journal-title":"Crit. Care"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1186\/s40635-024-00694-9","article-title":"Assessment of mitochondrial function and its prognostic role in sepsis: A literature review","volume":"12","author":"Nedel","year":"2024","journal-title":"Intensive Care Med. Exp."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"8828","DOI":"10.1038\/s41598-026-39202-2","article-title":"Progression of peripheral blood mononuclear cell mitochondrial function during the early phase of sepsis in intensive care unit patients","volume":"16","author":"Moonen","year":"2026","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1152\/physrev.00026.2013","article-title":"Mitochondrial reactive oxygen species (ROS) and ROS-induced ROS release","volume":"94","author":"Zorov","year":"2014","journal-title":"Physiol. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.freeradbiomed.2016.04.001","article-title":"Mitochondrial generation of superoxide and hydrogen peroxide as the source of mitochondrial redox signaling","volume":"100","author":"Brand","year":"2016","journal-title":"Free Radic. Biol. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1042\/BJ20081386","article-title":"How mitochondria produce reactive oxygen species","volume":"417","author":"Murphy","year":"2009","journal-title":"Biochem. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"26464","DOI":"10.1074\/jbc.R113.472936","article-title":"Peroxynitrite, a stealthy biological oxidant","volume":"288","author":"Radi","year":"2013","journal-title":"J. Biol. Chem."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/nrm3028","article-title":"Mechanisms of mitophagy","volume":"12","author":"Youle","year":"2011","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1038\/s41556-018-0176-2","article-title":"Mechanisms of mitophagy in cellular homeostasis, physiology and pathology","volume":"20","author":"Palikaras","year":"2018","journal-title":"Nat. Cell Biol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"R170","DOI":"10.1016\/j.cub.2018.01.004","article-title":"Mitophagy and Quality Control Mechanisms in Mitochondrial Maintenance","volume":"28","author":"Pickles","year":"2018","journal-title":"Curr. Biol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1038\/nrm.2017.95","article-title":"AMPK: Guardian of metabolism and mitochondrial homeostasis","volume":"19","author":"Herzig","year":"2018","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1152\/physrev.00025.2007","article-title":"Transcriptional paradigms in mammalian mitochondrial biogenesis and function","volume":"88","author":"Scarpulla","year":"2008","journal-title":"Physiol. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1146\/annurev.pharmtox.47.120505.105122","article-title":"Mitochondrial oxidative stress: Implications for cell death","volume":"47","author":"Orrenius","year":"2007","journal-title":"Annu. Rev. Pharmacol. Toxicol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1038\/ni.1980","article-title":"Autophagy proteins regulate innate immune responses by inhibiting the release of mitochondrial DNA mediated by the NALP3 inflammasome","volume":"12","author":"Nakahira","year":"2011","journal-title":"Nat. Immunol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.immuni.2012.01.009","article-title":"Oxidized mitochondrial DNA activates the NLRP3 inflammasome during apoptosis","volume":"36","author":"Shimada","year":"2012","journal-title":"Immunity"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Fredriksson, K., Tj\u00e4der, I., Keller, P., Petrovic, N., Ahlman, B., Sch\u00e9ele, C., Wernerman, J., Timmons, J.A., and Rooyackers, O. (2008). Dysregulation of mitochondrial dynamics and the muscle transcriptome in ICU patients suffering from sepsis induced multiple organ failure. PLoS ONE, 3, Erratum in PLoS ONE 2008, 3, e3686. https:\/\/doi.org\/10.1371\/annotation\/68d951f9-a236-472f-98af-24e4cc4c1a20.","DOI":"10.1371\/journal.pone.0003686"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1038\/nature09973","article-title":"TLR signalling augments macrophage bactericidal activity through mitochondrial ROS","volume":"472","author":"West","year":"2011","journal-title":"Nature"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1038\/nature08780","article-title":"Circulating mitochondrial DAMPs cause inflammatory responses to injury","volume":"464","author":"Zhang","year":"2010","journal-title":"Nature"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e49799","DOI":"10.15252\/embr.201949799","article-title":"Mitochondrial DNA in inflammation and immunity","volume":"21","author":"Riley","year":"2020","journal-title":"EMBO Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"eaat8657","DOI":"10.1126\/science.aat8657","article-title":"cGAS in action: Expanding roles in immunity and inflammation","volume":"363","author":"Ablasser","year":"2019","journal-title":"Science"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1038\/s41577-021-00524-z","article-title":"The cGAS-STING pathway as a therapeutic target in inflammatory diseases","volume":"21","author":"Decout","year":"2021","journal-title":"Nat. Rev. Immunol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1038\/35047123","article-title":"A Toll-like receptor recognizes bacterial DNA","volume":"408","author":"Hemmi","year":"2000","journal-title":"Nature"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3047","DOI":"10.4049\/jimmunol.1701723","article-title":"Cutting Edge: Mitochondrial Assembly of the NLRP3 Inflammasome Complex Is Initiated at Priming","volume":"200","author":"Elliott","year":"2018","journal-title":"J. Immunol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1126\/science.1092385","article-title":"Neutrophil extracellular traps kill bacteria","volume":"303","author":"Brinkmann","year":"2004","journal-title":"Science"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Denning, N.-L., Aziz, M., Gurien, S.D., and Wang, P. (2019). DAMPs and NETs in Sepsis. Front. Immunol., 10.","DOI":"10.3389\/fimmu.2019.02536"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s40001-025-03590-4","article-title":"Mitochondrial immunometabolism in sepsis: Orchestrating macrophage polarization and dysfunction","volume":"31","author":"Yang","year":"2026","journal-title":"Eur. J. Med. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1084\/jem.20151570","article-title":"Immunometabolism governs dendritic cell and macrophage function","volume":"213","author":"Pearce","year":"2016","journal-title":"J. Exp. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1038\/ni.3704","article-title":"Mitochondria are the powerhouses of immunity","volume":"18","author":"Mills","year":"2017","journal-title":"Nat. Immunol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1038\/nri3552","article-title":"Sepsis-induced immunosuppression: From cellular dysfunctions to immunotherapy","volume":"13","author":"Hotchkiss","year":"2013","journal-title":"Nat. Rev. Immunol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1038\/nri.2017.36","article-title":"The immunopathology of sepsis and potential therapeutic targets","volume":"17","author":"Scicluna","year":"2017","journal-title":"Nat. Rev. Immunol."},{"key":"ref_45","first-page":"2883","article-title":"Circulating mitochondrial DNA levels are associated with early diagnosis and prognosis in sepsis","volume":"135","author":"Zhou","year":"2022","journal-title":"Crit. Care"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Wang, L., Zhou, W., Wang, K., He, S., and Chen, Y. (2020). Predictive value of circulating plasma mitochondrial DNA for sepsis in the emergency department: Observational study based on the Sepsis-3 definition. BMC Emerg. Med., 20.","DOI":"10.1186\/s12873-020-00320-3"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/s00068-025-03058-4","article-title":"Assessment of circulating cell-free mitochondrial DNA as a damage associated molecular pattern in predicting severity and mortality of sepsis and septic shock patients","volume":"52","author":"Begum","year":"2026","journal-title":"Eur. J. Trauma. Emerg. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Zeng, Z., Huang, Q., Mao, L., Wu, J., An, S., Chen, Z., and Zhang, W. (2021). The Pyruvate Dehydrogenase Complex in Sepsis: Metabolic Regulation and Targeted Therapy. Front. Nutr., 8.","DOI":"10.3389\/fnut.2021.783164"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1002\/JLB.3MR0322-692RR","article-title":"Sepsis, pyruvate, and mitochondria energy supply chain shortage","volume":"112","author":"McCall","year":"2022","journal-title":"J. Leukoc. Biol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.chom.2025.02.003","article-title":"Mitochondria sense bacterial lactate and drive release of neutrophil extracellular traps","volume":"33","author":"Wise","year":"2025","journal-title":"Cell Host Microbe"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s40560-016-0148-1","article-title":"Sepsis-induced myocardial dysfunction: Pathophysiology and management","volume":"4","author":"Kakihana","year":"2016","journal-title":"J. Intensive Care"},{"key":"ref_52","first-page":"546","article-title":"Sepsis-induced acute kidney injury","volume":"22","author":"Kellum","year":"2016","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1001\/jama.1996.03530300054040","article-title":"The spectrum of septic encephalopathy. Definitions, etiologies, and mortalities","volume":"275","author":"Eidelman","year":"1996","journal-title":"JAMA"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"33572","DOI":"10.1038\/s41598-025-18650-2","article-title":"Integrated multi omics and machine learning reveal mitochondrial immunometabolic networks in sepsis associated encephalopathy","volume":"15","author":"Zhang","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1152\/japplphysiol.01053.2020","article-title":"Mitoquinone mesylate (MitoQ) prevents sepsis-induced diaphragm dysfunction","volume":"131","author":"Supinski","year":"2021","journal-title":"J. Appl. Physiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.1056\/NEJMoa2200644","article-title":"Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit","volume":"386","author":"Lamontagne","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1111\/aas.14311","article-title":"Intravenous vitamin C therapy in adult patients with sepsis: A rapid practice guideline","volume":"67","author":"Blaser","year":"2023","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.1007\/s00210-025-04526-9","article-title":"A pilot double-blind, placebo-controlled, randomized clinical trial of MitoQ in the treatment of septic shock: Evaluating its effects on clinical outcomes and oxidative stress biomarker","volume":"399","author":"Moradbaki","year":"2026","journal-title":"Naunyn-Schmiedebergs Arch. Pharmacol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1016\/j.freeradbiomed.2008.09.003","article-title":"The mitochondria-targeted antioxidant MitoQ protects against organ damage in a lipopolysaccharide-peptidoglycan model of sepsis","volume":"45","author":"Lowes","year":"2008","journal-title":"Free Radic. Biol. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1093\/bja\/aes577","article-title":"Antioxidants that protect mitochondria reduce interleukin-6 and oxidative stress, improve mitochondrial function, and reduce biochemical markers of organ dysfunction in a rat model of acute sepsis","volume":"110","author":"Lowes","year":"2013","journal-title":"Br. J. Anaesth."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"R1095","DOI":"10.1152\/ajpregu.90902.2008","article-title":"MitoQ administration prevents endotoxin-induced cardiac dysfunction","volume":"297","author":"Supinski","year":"2009","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.bja.2021.05.036","article-title":"Selective mitochondrial antioxidant MitoTEMPO reduces renal dysfunction and systemic inflammation in experimental sepsis in rats","volume":"127","author":"Arulkumaran","year":"2021","journal-title":"Br. J. Anaesth."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"E277","DOI":"10.1007\/BF02854898","article-title":"Cell-permeable, mitochondrial-targeted, peptide antioxidants","volume":"8","author":"Szeto","year":"2006","journal-title":"AAPS J."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1089\/ars.2014.5952","article-title":"Molecular strategies for targeting antioxidants to mitochondria: Therapeutic implications","volume":"22","author":"Apostolova","year":"2015","journal-title":"Antioxid. Redox Signal"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1046\/j.1432-1327.1999.00543.x","article-title":"Selective targeting of an antioxidant to mitochondria","volume":"263","author":"Smith","year":"1999","journal-title":"Eur. J. Biochem."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/13\/5918\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:23:50Z","timestamp":1783484630000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/13\/5918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":65,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["ijms27135918"],"URL":"https:\/\/doi.org\/10.3390\/ijms27135918","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]}}}