Mitochondria: Our Other 'Patient'

From Ep 180 on the ECC feed. With Dr Laurence St Pierre.

The pearls from this one are (for now) fairly academic, but I found it really interesting. Dr St Pierre is a geek for all things mitochondria, and in this chat, we were reintroduced to the mitochondria. Here are some of my 🤯 moments:

• I was reminded that mitochondria are almost like an entirely different organism from us and our patients, living their best little lives in a crucial symbiotic relationship inside their ‘host’ cells.

• What I’d never considered is that when those host cells become very inhospitable—such as during critical disease or shock—the mitochondria suffer their own injuries and have their own survival strategies. AND that…

• Even when we fix the host cell—i.e., we restore perfusion and oxygen status—the mitochondria might not be so quick to get fully back online. Ever treated a very sick patient, doing all the right things, only to find that they just aren’t responding as well as expected? That might be because the mitochondria are still sick.

• This has widespread clinical implications, which are beyond the scope of this newsletter, but we cover it well in the episode.

• Why does it matter? Well, people like Laurence are working hard on finding therapies that can specifically support the mitochondria. We’ll share a few ideas next time. But for now, I find some comfort in having a potential explanation for those ‘what the hell went wrong there?!’ patients. (It’s a good story to tell yourself!)

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