Abstract
Mitochondria are the energy factories, signaling hubs, and metabolic regulatory centers of cells, and their structural and functional integrity is essential for maintaining tissue homeostasis. Recent studies have revealed that mitochondria can be actively transferred between cells, which may play a key role in various physiological and pathological processes. In respiratory diseases, mitochondrial transfer is involved in alveolar epithelial repair, resistance to oxidative stress, modulation of the immune response, suppression of inflammation, and vascular remodeling, but the specific mechanisms and potential therapeutic value remain to be explored. This paper will systematically review the research progress in this field, focusing on the dual role of mitochondrial transfer in pulmonary diseases and the clinical translation prospects of mitochondrial transplantation. We aimed to provide new insights for precision intervention in respiratory diseases. A deeper understanding of the molecular network regulating mitochondrial transfer in lung diseases not only helps elucidate disease heterogeneity but also can advance therapeutic strategies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12931-025-03408-1.