Mitochondrial Transfer: A Novel Mechanism in the Development of Obesity and Obesity-Related Metabolic Diseases

Obesity and its related metabolic diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD), represent a major global health challenge. Mitochondrial dysfunction is a key driver in their pathogenesis. This review explores the emerging role of mitochondrial transfer, a novel mode of cellular communication that can occur via tunneling nanotubes, extracellular vesicles, or as free mitochondria, in these conditions. Increasing evidence suggests that mitochondrial transfer may contribute to tissue homeostasis and metabolic adaptation, and that disruption of this process may participate in the pathogenesis of obesity and MASLD. In parallel, therapeutic strategies aimed at restoring mitochondrial function by enhancing endogenous mitochondrial transfer or through mitochondrial transplantation are beginning to emerge. This review summarizes current knowledge of the mechanisms underlying mitochondrial transfer, discusses roles in obesity and MASLD, and evaluates the therapeutic potential and translational challenges of targeting mitochondrial transfer in obesity and obesity-related metabolic disease.