Targeted Drug Delivery for Precision Mitochondrial Therapy in Osteoporosis: Therapeutic Strategies and Advances

: Osteoporosis (OP) remains a significant global health challenge, marked by high prevalence and considerable economic burden, yet effective therapeutic options remain limited. Central to the pathogenesis of OP is mitochondrial dysfunction, which adversely impacts bone formation and resorption. This review provides an in-depth analysis of the complex relationship between mitochondrial function and OP, elucidating critical molecular mechanisms and identifying promising therapeutic agents. Among these, zoledronic acid and resveratrol stand out, demonstrating significant efficacy in enhancing mitochondrial functions and enhancing bone density in both preclinical models and clinical trials. Moreover, innovative drug delivery systems, such as mitochondrial-targeted nanodelivery systems and localized delivery methods, have been developed to ensure precise targeting and reduce systemic side effects, thereby enhancing bioavailability and therapeutic outcomes. By delving into these advancements, this review seeks to facilitate the translation of mitochondrial-targeted therapies from preclinical research to clinical application, ultimately advancing OP management and improving patient outcomes.