Low‐intensity pulsed ultrasound improves myocardial ischaemia‒reperfusion injury via migrasome‐mediated mitocytosis

Abstract During myocardial ischaemia‒reperfusion injury (MIRI), the accumulation of damaged mitochondria could pose serious threats to the heart. The migrasomes, newly discovered mitocytosis‐mediating organelles, selectively remove damaged mitochondria to provide mitochondrial quality control. Here, we utilised low‐intensity pulsed ultrasound (LIPUS) on MIRI mice model and demonstrated that LIPUS reduced the infarcted area and improved cardiac dysfunction. Additionally, we found that LIPUS alleviated MIRI‐induced mitochondrial dysfunction. We provided new evidence that LIPUS mechanical stimulation facilitated damaged mitochondrial excretion via migrasome‐dependent mitocytosis. Inhibition the formation of migrasomes abolished the protective effect of LIPUS on MIRI. Mechanistically, LIPUS induced the formation of migrasomes by evoking the RhoA/Myosin II/F‐actin pathway. Meanwhile, F‐actin activated YAP nuclear translocation to transcriptionally activate the mitochondrial motor protein KIF5B and Drp1, which are indispensable for LIPUS‐induced mitocytosis. These results revealed that LIPUS activates mitocytosis, a migrasome‐dependent mitochondrial quality control mechanism, to protect against MIRI, underlining LIPUS as a safe and potentially non‐invasive treatment for MIRI.