Beyond oxidative stress: Ferroptosis as a novel orchestrator in neurodegenerative disorders.

Frontiers in immunology 2025
Open on PubMed

Neurodegenerative diseases are a group of disorders characterized by progressive loss of neuronal function due to degenerative damage to neural cells. Ferroptosis, a newly identified form of regulated cell death, is pathologically defined by iron-dependent accumulation of lipid peroxides, mitochondrial shrinkage, and increased mitochondrial membrane density. Unlike apoptosis or necrosis, ferroptosis is driven by a combination of factors, including excessive lipid peroxidation, disruption of iron homeostasis, and depletion of antioxidant defenses such as glutathione (GSH) and glutathione peroxidase 4 (GPX4). The ferroptotic process engages multiple biological functions-such as iron metabolism, lipid metabolism, oxidative stress, mevalonate signaling, transsulfuration pathways, heat shock protein activation, glutamate/cystine transport, and GSH biosynthesis. While initial studies focused on its role in cancer, accumulating evidence now links ferroptosis to neurological disorders. Ferroptosis has been implicated in the pathophysiology of stroke, traumatic brain injury, and major neurodegenerative diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), and Huntington's disease (HD). Several small-molecule inhibitors-including ferrostatin-1, liproxstatin-1, and iron chelators such as deferoxamine (DFO)-have demonstrated efficacy in animal models by attenuating neuronal damage and improving behavioral outcomes through the suppression of ferroptosis. In addition, natural compounds have emerged as promising candidates for targeting ferroptosis due to their structural diversity, low toxicity, and multitarget regulatory properties. These agents offer potential leads for developing novel neuroprotective therapeutics. Neurodegenerative diseases remain a significant global health burden, with limited effective treatments available to date. Modulation of ferroptosis presents a new conceptual framework for therapeutic intervention, offering hope for disease-modifying strategies. This review summarizes recent advances in understanding the role of ferroptosis in neurodegenerative disease mechanisms, focusing on its contribution to pathological progression, molecular regulation, and therapeutic interventions. By integrating current findings, we aim to provide theoretical insights into novel pathogenic mechanisms and scientific guidance for the development of targeted therapies that modulate ferroptosis to slow or halt disease progression.

10 Figures Extracted
Figure 1
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Molecular mechanisms of ferroptosis in neurodegenerative diseases. From left to right: The diagram illustrates ferroptosis mechanisms induced by disti...
Figure 2
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Pathways regulating ferroptosis. Different molecules regulate lipid peroxidation in multiple ways. BH4, tetrahydrobiopterin; GCH1, recombinant GTP cyc...
Figure 3
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Summary of the mechanisms of ferroptosis in cerebral ischemia. Following cerebral ischemia, energy depletion impairs the clearance of excitatory neuro...
Figure 4
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Summary of the mechanisms of ferroptosis in intracerebral hemorrhage (ICH). ICH leads to the extravasation of RBCs into brain tissue. Upon lysis, RBCs...
Figure 5
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Summary of the mechanisms of ferroptosis in PD. Activation of microglia and astrocytes upregulates DMT1 and downregulates FPN1, leading to iron accumu...
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Summary of the mechanisms of ferroptosis in AD. In the pathological context of AD, glial cells are exposed to elevated levels of iron, LPS, and extrac...
Figure 7
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Inhibitory agents targeting ferroptosis-induced oxidative stress. Ferroptosis is closely associated with ROS levels; thus, maintaining redox homeostas...
Figure 8
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Summary of the mechanisms of ferroptosis in ALS and ferroptosis as a therapeutic target for ALS. Riluzole, a glutamate antagonist, alleviates mitochon...
Figure 9
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Summary of the mechanisms of ferroptosis in HD and ferroptosis as a therapeutic target for HD. Frequent cleavage of mHTT leads to the formation of tox...
Figure 10
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A common ferroptosis network in neurodegenerative diseases.