Neural Regeneration Research ›› 2026, Vol. 21 ›› Issue (4): 1396-1408.doi: 10.4103/NRR.NRR-D-24-01029

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Mitophagy: A key regulator in the pathophysiology and treatment of spinal cord injury

Qiuyang Gu1, 2, #, Shengye Yuan1, 2, #, Yumei An2, #, Wenyue Sun2 , Mingyuan Xu2 , Mengchun Xue2 , Xianzhe Li2 , Chao Liu1 , Haiyan Shan3, *, Mingyang Zhang1, 2, *   

  1. 1 Department of Orthopedics, Suzhou BenQ Medical Center, Suzhou, Jiangsu Province, China;  2 Institute of Forensic Sciences, Suzhou Medical College, Suzhou, Jiangsu Province, China;  3 Department of Obstetrics and Gynecology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, China
  • Online:2026-04-15 Published:2025-07-25
  • Contact: Mingyang Zhang, MD, PhD, mingyangzhang@suda.edu.cn; Haiyan Shan MD, PhD, ghostqth@163.com.
  • Supported by:
    This work was supported by the National Natural Science Foundation of China, Nos. 82371389, 82071382 (to MZ); the Priority Academic Program Development of Jiangsu Higher Education Institutions, PAPD (to MZ); Jiangsu Maternal and Child Health Research Key Project, No. F202013 (to HS); Jiangsu 333 High Level Talent Training Project, 2022 (to HS); Gusu District Health Talent Training Project, No. 2024145 (to HS); Suzhou BenQ Medical Center Project, No. H220918 (to MZ); Undergraduate Training Program for Innovation and Entrepreneurship, Soochow University, No. 202410285091Z (to MZ).

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Abstract: Mitophagy is closely associated with the pathogenesis of secondary spinal cord injury. Abnormal mitophagy may contribute significantly to secondary spinal cord injury, leading to the impaired production of adenosine triphosphate, ion imbalance, the excessive production of reactive oxygen species, neuroinflammation, and neuronal cell death. Therefore, maintaining an appropriate balance of mitophagy is crucial when treating spinal cord injury, as both excessive and insufficient mitophagy can impede recovery. In this review, we summarize the pathological changes associated with spinal cord injury, the mechanisms of mitophagy, and the direct and indirect relationships between mitophagy and spinal cord injury. We also consider therapeutic approaches that target mitophagy for the treatment of spinal cord injury, including ongoing clinical trials and other innovative therapies, such as use of stem cells, nanomaterials, and small molecule polymers. Finally, we highlight the current challenges facing this field and suggest potential directions for future research. The aim of our review is to provide a theoretical reference for future studies targeting mitophagy in the treatment of spinal cord injury.

Key words: ATP production disorders, cell death, mitochondria, mitophagy, neuroinflammation, neuroprotection, oxidative stress, secondary injury, spinal cord injury, treatment