CX43 hemichannel engineering enables size-selective mitochondrial transfer

**Molecular Mechanism and Rationale** The proposed therapeutic approach centers on engineering connexin-43 (Cx43) hemichannels, encoded by the GJA1 gene, to create selective conduits for mitochondrial transfer between cells. Connexin-43 forms gap junctions through the assembly of two hemichannels (connexons), each composed of six Cx43 subunits arranged around a central pore. Under normal physiological conditions, these pores have a diameter of approximately 1.2-2.0 nanometers, permitting passag...