Advances in development of rechargeable mitochondrial antioxidants.

It has been about 15 years since the introduction of the rechargeable mitochondria-targeted antioxidants (RMA). Two major groups have been developing RMA of the MitoQ and SkQ types independently, and many additional trials have been done by other researchers. This has provided solid preclinical evidence of RMA efficacy in various models. Human trials of systemic MitoQ were not followed by further advances, but the safety of MitoQ and, most likely, other RMA in humans has been demonstrated. A prooxidant effect at higher concentrations of RMA was described. For RMA of the SkQ type, a large window between anti- and prooxidant concentrations was observed, which makes SkQs promising as potential medicines. Significant RMA-induced improvements in many diseases that do not have an accepted treatment have been described. This justifies further clinical trials of RMA.