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针对 Nrf2 的铁死亡治疗策略:克服癌症中铁死亡逃避和治疗抵抗的意义。

Targeting Nrf2 for ferroptosis-based therapy: Implications for overcoming ferroptosis evasion and therapy resistance in cancer.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea; Department of Biomedical Science, General Graduate School, CHA University, Seongnam, Republic of Korea.

Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea; Department of Biomedical Science, General Graduate School, CHA University, Seongnam, Republic of Korea.

出版信息

Biochim Biophys Acta Mol Basis Dis. 2023 Oct;1869(7):166788. doi: 10.1016/j.bbadis.2023.166788. Epub 2023 Jun 10.


DOI:10.1016/j.bbadis.2023.166788
PMID:37302427
Abstract

Ferroptosis is a newly discovered form of programmed cell death caused by redox-active iron-mediated lipid peroxidation. Ferroptosis exhibits a unique morphological phenotype resulting from oxidative damage to membrane lipids. Ferroptosis induction has been shown to be effective in treating human cancers that rely on lipid peroxidation repair pathways. Nuclear factor erythroid 2-related factor 2 (Nrf2) can control the regulatory pathways of ferroptosis, which involve genes associated with glutathione biosynthesis, antioxidant responses, and lipid and iron metabolism. Resistant cancer cells often utilize Nrf2 stabilization by Keap1 inactivation or other somatic alterations in the genes from the Nrf2 pathway, which can confer resistance to ferroptosis induction and other therapies. However, pharmacological inactivation of the Nrf2 pathway can sensitize cancer cells to ferroptosis induction. Inducing lipid peroxidation and ferroptosis through regulating the Nrf2 pathway is a promising strategy for enhancing the anticancer effects of chemotherapy and radiation therapy in therapy-resistant human cancers. Despite promising preliminary studies, clinical trials in human cancer therapy have not yet been realized. A deeper understanding of their exact processes and efficacies in various cancers remains unsolved. Therefore, this article aims to summarize the regulatory mechanisms of ferroptosis, their modulation by Nrf2, and the potential of targeting Nrf2 for ferroptosis-based cancer therapy.

摘要

铁死亡是一种新发现的细胞程序性死亡形式,由氧化还原活性铁介导的脂质过氧化引起。铁死亡表现出独特的形态表型,是由于膜脂质的氧化损伤所致。铁死亡诱导已被证明在治疗依赖脂质过氧化修复途径的人类癌症方面是有效的。核因子红细胞 2 相关因子 2(Nrf2)可以控制铁死亡的调节途径,其中涉及与谷胱甘肽生物合成、抗氧化反应以及脂质和铁代谢相关的基因。耐药癌细胞通常利用 Keap1 失活或 Nrf2 途径中其他体细胞改变来稳定 Nrf2,这可以赋予对铁死亡诱导和其他治疗的耐药性。然而,Nrf2 途径的药理学失活可以使癌细胞对铁死亡诱导敏感。通过调节 Nrf2 途径诱导脂质过氧化和铁死亡是增强化疗和放疗在耐药性人类癌症中抗癌作用的有前途的策略。尽管有初步的研究结果,但在人类癌症治疗中的临床试验尚未实现。对其在各种癌症中的确切过程和疗效的更深入了解仍然没有解决。因此,本文旨在总结铁死亡的调节机制、Nrf2 对其的调节以及针对 Nrf2 进行铁死亡为基础的癌症治疗的潜力。

相似文献

[1]
Targeting Nrf2 for ferroptosis-based therapy: Implications for overcoming ferroptosis evasion and therapy resistance in cancer.

Biochim Biophys Acta Mol Basis Dis. 2023-10

[2]
Nrf2 targeting in overcoming ferroptosis evasion in head and neck cancer.

Biochem Biophys Res Commun. 2023-9-3

[3]
A targetable CoQ-FSP1 axis drives ferroptosis- and radiation-resistance in KEAP1 inactive lung cancers.

Nat Commun. 2022-4-22

[4]
Nrf2 inhibition reverses the resistance of cisplatin-resistant head and neck cancer cells to artesunate-induced ferroptosis.

Redox Biol. 2017-4

[5]
FSP1 confers ferroptosis resistance in KEAP1 mutant non-small cell lung carcinoma in NRF2-dependent and -independent manner.

Cell Death Dis. 2023-8-26

[6]
Nrf2 inhibition reverses resistance to GPX4 inhibitor-induced ferroptosis in head and neck cancer.

Free Radic Biol Med. 2018-10-16

[7]
, a novel KEAP1/NRF2 target gene regulating ferroptosis and radioresistance in lung cancers.

Oncotarget. 2022-10-19

[8]
[Kelch-like ech-associated protein 1/nuclear factor E2-related factor 2/antioxidant response element pathway alleviates ferroptosis in sepsis by regulating oxidative stress].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021-7

[9]
Molecular mechanism of paraquat-induced ferroptosis leading to pulmonary fibrosis mediated by Keap1/Nrf2 signaling pathway.

Mol Biol Rep. 2023-11

[10]
The crosstalk between classic cell signaling pathways, non-coding RNAs and ferroptosis in drug resistance of tumors.

Cell Signal. 2023-2

引用本文的文献

[1]
Targeting the Keap1/Nrf2 axis in cancer: molecular mechanisms and pharmacological interventions.

Invest New Drugs. 2025-9-5

[2]
Transcriptional activation of PHKG2 by TP53 promotes ferroptosis through nuclear export of NRF2 in head and neck squamous cell carcinoma.

Cell Death Dis. 2025-8-30

[3]
Epigenetic Mechanisms Governing Nrf2 Expression and Its Role in Ferroptosis.

Biomedicines. 2025-8-5

[4]
Ferroptosis and Nrf2 Signaling in Head and Neck Cancer: Resistance Mechanisms and Therapeutic Prospects.

Antioxidants (Basel). 2025-8-13

[5]
Ferroptosis as a therapeutic target in glioblastoma: Mechanisms and emerging strategies.

Mol Ther Nucleic Acids. 2025-7-30

[6]
Salvianolic Acid A Activates Nrf2-Related Signaling Pathways to Inhibit Ferroptosis to Improve Ischemic Stroke.

Molecules. 2025-8-4

[7]
Effect of natural compounds on NRF2/KEAP1 signaling in periodontitis: a potential use to prevent age-related disorders.

Mol Biol Rep. 2025-7-30

[8]
Ferroptosis and Metabolic Dysregulation: Emerging Chemical Targets in Cancer and Infection.

Molecules. 2025-7-18

[9]
Emerging Therapeutic Strategies Targeting GPX4-Mediated Ferroptosis in Head and Neck Cancer.

Int J Mol Sci. 2025-7-4

[10]
Dysregulated lipids homeostasis disrupts CHAC1-mediated ferroptosis driving fibroblast growth factor receptor tyrosine kinase inhibitor AZD4547 resistance in gastric cancer.

Redox Biol. 2025-7

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