Fig. 4.

Oxidative polymerization of cardiolipin: physiological versus pathological oxidation. Oxidative polymerization of cardiolipin facilitates the creation of a covalently linked, mechanically robust structure (B) than without it (A). However, excessive or pathological oxidation of cardiolipin can result in the breakage of acyl chains, leading to the release of toxic lipid peroxidation products (C). The loss and externalization of cardiolipin can serve as a death signal, contributing to programmed cell death (apoptosis) and other forms of cellular demise. Proper regulation of cardiolipin oxidation may be crucial for maintaining mitochondria integrity. Other membrane components are omitted for simplicity.