Xia Shenglin, Li Li, Shi Zhexiong, Sun Nianyi, He Yu
Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Rehabilitation, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Immunol. 2025 Jun 6;16:1604652. doi: 10.3389/fimmu.2025.1604652. eCollection 2025.
Osteoarthritis is a common degenerative joint disease characterized by progressive cartilage loss, bone remodeling, and chronic joint inflammation, yet its underlying mechanisms remain incompletely understood. Disrupted iron metabolism, particularly iron accumulation in joint tissues, contributes to oxidative damage and inflammation, suggesting a potential link to disease progression. This review focuses on ferroptosis, a regulated form of cell death driven by iron-dependent lipid peroxidation, as a key pathological mechanism in osteoarthritis. We summarize current evidence showing how impaired iron homeostasis, weakened antioxidant defenses, and metabolic alterations make chondrocytes and other joint cells vulnerable to ferroptotic injury. We further describe how inflammatory and metabolic signals interact to amplify ferroptosis, creating a self-reinforcing cycle of tissue damage. Finally, we explore emerging strategies to target ferroptosis, including iron chelation, antioxidant therapy, inhibition of lipid peroxidation, and gene or cell-based interventions. By integrating these findings, this review offers new insights into the role of ferroptosis in joint degeneration and highlights its potential as a therapeutic target in osteoarthritis.
骨关节炎是一种常见的退行性关节疾病,其特征为进行性软骨丧失、骨重塑和慢性关节炎症,但其潜在机制仍未完全明确。铁代谢紊乱,尤其是关节组织中的铁蓄积,会导致氧化损伤和炎症,提示其与疾病进展存在潜在联系。本综述聚焦于铁死亡,这是一种由铁依赖性脂质过氧化驱动的程序性细胞死亡形式,是骨关节炎的关键病理机制。我们总结了当前的证据,展示了铁稳态受损、抗氧化防御减弱和代谢改变如何使软骨细胞及其他关节细胞易受铁死亡损伤。我们进一步描述了炎症和代谢信号如何相互作用以放大铁死亡,从而形成一个自我强化的组织损伤循环。最后,我们探讨了针对铁死亡的新兴策略,包括铁螯合、抗氧化治疗、抑制脂质过氧化以及基因或基于细胞的干预措施。通过整合这些发现,本综述为铁死亡在关节退变中的作用提供了新见解,并突出了其作为骨关节炎治疗靶点的潜力。
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