Department of Neurosurgery, Ningbo First Hospital, Ningbo Hospital, Zhejiang University, Ningbo, Zhejiang, China.
Department of Neurosurgery, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
Front Immunol. 2023 May 17;14:1191826. doi: 10.3389/fimmu.2023.1191826. eCollection 2023.
Subarachnoid hemorrhage (SAH) is a cerebrovascular accident with an acute onset, severe disease characteristics, and poor prognosis. Within 72 hours after the occurrence of SAH, a sequence of pathological changes occur in the body including blood-brain barrier breakdown, cerebral edema, and reduced cerebrovascular flow that are defined as early brain injury (EBI), and it has been demonstrated that EBI exhibits an obvious correlation with poor prognosis. Ferroptosis is a novel programmed cell death mode. Ferroptosis is induced by the iron-dependent accumulation of lipid peroxides and reactive oxygen species (ROS). Ferroptosis involves abnormal iron metabolism, glutathione depletion, and lipid peroxidation. Recent study revealed that ferroptosis is involved in EBI and is significantly correlated with poor prognosis. With the gradual realization of the importance of ferroptosis, an increasing number of studies have been conducted to examine this process. This review summarizes the latest work in this field and tracks current research progress. We focused on iron metabolism, lipid metabolism, reduction systems centered on the GSH/GPX4 system, other newly discovered GSH/GPX4-independent antioxidant systems, and their related targets in the context of early brain injury. Additionally, we examined certain ferroptosis regulatory mechanisms that have been studied in other fields but not in SAH. A link between death and oxidative stress has been described. Additionally, we highlight the future research direction of ferroptosis in EBI of SAH, and this provides new ideas for follow-up research.
蛛网膜下腔出血（SAH）是一种发病急骤、病情严重、预后不良的脑血管意外。在 SAH 发生后 72 小时内，机体发生一系列的病理变化，包括血脑屏障破坏、脑水肿和脑血流量减少，被定义为早期脑损伤（EBI），研究表明 EBI 与预后不良明显相关。铁死亡是一种新的细胞程序性死亡方式。铁死亡是由铁依赖性脂质过氧化物和活性氧（ROS）的积累引起的。铁死亡涉及异常的铁代谢、谷胱甘肽耗竭和脂质过氧化。最近的研究表明，铁死亡参与 EBI 并与预后不良显著相关。随着对铁死亡重要性的逐步认识，越来越多的研究对其进行了研究。本综述总结了该领域的最新工作，并跟踪了当前的研究进展。我们集中讨论了铁代谢、脂质代谢、以 GSH/GPX4 系统为中心的还原系统、其他新发现的 GSH/GPX4 非依赖性抗氧化系统及其在早期脑损伤中的相关靶点。此外，我们还研究了其他领域研究过但在 SAH 中未研究过的某些铁死亡调控机制。氧化应激与死亡之间存在关联。此外，我们强调了 SAH 中 EBI 中铁死亡的未来研究方向，这为后续研究提供了新的思路。
