While the mitochondrion has long fascinated biologists and the sheer diversity of druggable targets has made it attractive for potential drug development, there has been little success translatable to the clinic. Given the diversity of inborn errors of metabolism and mitochondrial diseases, mitochondrially mediated oxidative stress (myopathies, reperfusion injury, Parkinson’s disease, ageing) and the consequences of disturbed energetics (circulatory shock, diabetes, cancer), the potential for meaningful gain with novel drugs targeting mitochondrial mechanisms is huge both in terms of patient quality of life and health care costs. In this themed issue of the British Journal of Pharmacology, we highlight the key directions of the contemporary advances in the field of mitochondrial biology, emerging drug targets and new molecules which are close to clinical application. Authors’ contributions are diverse both in terms of species and organs in which the mitochondrially related studies are performed, and from the perspectives of mechanisms under study. Defined roles of mitochondria in disease are updated and previously unknown contributions to disease are described in terms of the interface between basic science and pathological relevance.

Getting older is a fact of life. As we age, we can grow bigger, smarter and stronger. But at a certain point, our bodies often start to slow down. The idea behind why we age and why our bodies slow down is that we start to lose the ability to make enough energy to support all the different functions that our body carries out.

Hazel H. Szeto, MD, PhD, is a medical doctor and a research scientist. She may have found the answer to reversing the aging process by restoring a person’s ability to make energy. Szeto presented her work last month at Experimental Biology 2021.

To better understand Szeto’s discovery, we must first understand how the body makes energy. We produce energy in the form of a small molecule called adenosine triphosphate, or ATP. When ATP is broken down, it releases energy that allows our bodies to do work, such as contracting the muscles in our arms and legs so we can lift a box. Mitochondria are small structures in the cells that make ATP from the food we eat.