Why should neuroscientists worry about iron? The emerging role of ferroptosis in the pathophysiology of neuroprogressive diseases

• Published in: Behavioural brain research Vol. 341; pp. 154 - 175
• Main Authors: Morris, Gerwyn, Berk, Michael, Carvalho, André F., Maes, Michael, Walker, Adam J., Puri, Basant K.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 02.04.2018
• Subjects: Animals; Cell Death - physiology; Ferroptosis; Glutathione and glutathione peroxidases; Humans; Iron - metabolism; Iron homeostasis; Lipid peroxidation; Mitochondrial function; Nervous System Diseases - drug therapy; Nervous System Diseases - metabolism; Oxidative and nitrosative stress; BCEC; Lipid peroxidation; MDA; Xc; DFO; AP-1; DFP; RNS; DFX; STAT-3; Iron homeostasis; AD; PUFA; Nrf-2; IMM; NTBI; ACSL4; LPOs; DMT-1; IL-6; TCA; ARE; LOX; NOX; HSP27; ROS; IRE; NADPH; Oxidative and nitrosative stress; Fe-S; GPx4; HHE; MRI; IRP; ANT; CoQ10; CNS; Ferroptosis; DHN; Glutathione and glutathione peroxidases; CREB; SLC25A28; Mitochondrial function; tBid; GSH; GSSG; MFRN1; MFRN2; cPLA2; SOD; VDAC-1; GR; PIC; Bak; YY-1; NAC; SLC25A37; PD; TNF-α; Keap1; HNA; ATP; HNE
• ISSN: 0166-4328; 1872-7549
• DOI: 10.1016/j.bbr.2017.12.036

•Ferroptosis is a major driver of cell death in neurodegenerative diseases e.g. AD.•Oxidative and nitrosative stress adversely affect cellular iron homeostasis.•Ferroptosis entails membrane lipid peroxidation and mitochondria involvement.•Neuroinflammation and high NTBI levels make neuroglia sensitive to iron overload.•Deferiprone with N-acetylcysteine offers a rational therapeutic approach. Ferroptosis is a unique form of programmed death, characterised by cytosolic accumulation of iron, lipid hydroperoxides and their metabolites, and effected by the fatal peroxidation of polyunsaturated fatty acids in the plasma membrane. It is a major driver of cell death in neurodegenerative neurological diseases. Moreover, cascades underpinning ferroptosis could be active drivers of neuropathology in major psychiatric disorders. Oxidative and nitrosative stress can adversely affect mechanisms and proteins governing cellular iron homeostasis, such as the iron regulatory protein/iron response element system, and can ultimately be a source of abnormally high levels of iron and a source of lethal levels of lipid membrane peroxidation. Furthermore, neuroinflammation leads to the upregulation of divalent metal transporter1 on the surface of astrocytes, microglia and neurones, making them highly sensitive to iron overload in the presence of high levels of non-transferrin-bound iron, thereby affording such levels a dominant role in respect of the induction of iron-mediated neuropathology. Mechanisms governing systemic and cellular iron homeostasis, and the related roles of ferritin and mitochondria are detailed, as are mechanisms explaining the negative regulation of ferroptosis by glutathione, glutathione peroxidase 4, the cysteine/glutamate antiporter system, heat shock protein 27 and nuclear factor erythroid 2-related factor 2. The potential role of DJ-1 inactivation in the precipitation of ferroptosis and the assessment of lipid peroxidation are described. Finally, a rational approach to therapy is considered, with a discussion on the roles of coenzyme Q10, iron chelation therapy, in the form of deferiprone, deferoxamine (desferrioxamine) and deferasirox, and N-acetylcysteine.