Vilaplana-Lopera Nuria, Kim Jiyoung, Nam Gilyeong, Tullis Iain D C, Paillas Salome, Ruan Jia-Ling, Lee Pei Ju, Jiang Yanyan, Park Sohee, Hou Tianxu, Nasir Ayesha, Charlesworth Eve, Walker Ellie, Abu-Halawa Ammar, Hill Mark A, Choi Changhoon, Lee Ik Jae, Jeong Youngtae, Lakhal-Littleton Samira, Then Chee Kin, Shen Shing-Chuan, Giaccia Amato J, Petersson Kristoffer, Moon Eui Jung
Department of Oncology, University of Oxford, Oxford, UK.
Department of Radiation Oncology, Severance Hospital, Yonsei University Medical School, Seoul, Republic of Korea.
Cell Death Dis. 2025 Sep 2;16(1):668. doi: 10.1038/s41419-025-07988-0.
Iron is vital to living cells, playing a key role in cellular respiration, DNA synthesis, and various metabolic functions. Importantly, cancer cells have a higher dependency on iron compared to normal cells to support their rapid growth and survival. Due to this fact, tumors are more vulnerable to ferroptosis, an iron-dependent form of regulated cell death. Radiation therapy (RT), a standard treatment for many cancer patients, is known to induce ferroptosis. Ultra-high dose rate FLASH RT offers an improved therapeutic window by minimizing damage to normal tissues while preserving tumor control. However, the precise biological mechanisms behind the protective effects of FLASH RT on normal tissues remain unclear. In this study, we propose that variations in lipid peroxidation and ferroptosis, driven by intrinsic differences in iron levels between normal and cancerous tissues, contribute to this effect. Our findings show that FLASH RT increases lipid peroxidation and induces ferroptosis in tumor cells but does not significantly elevate lipid peroxidation and ferroptosis in normal tissues compared to conventional RT. To determine whether raising iron levels in normal tissues could abrogate the protective effects of FLASH, mice were fed a high-iron diet before RT. A high-iron diet before and after RT reversed the protective effect of FLASH, resulting in increased intestinal damage and lipid peroxidation. This suggests that baseline iron levels and iron-driven lipid peroxidation are critical factors in mediating the protective outcomes of FLASH RT. Overall, our study sheds light on the role of iron in modulating RT responses and provides new mechanistic insights into how FLASH RT influences normal and cancerous tissues.
铁对活细胞至关重要,在细胞呼吸、DNA合成及各种代谢功能中发挥关键作用。重要的是,与正常细胞相比,癌细胞对铁的依赖性更高,以支持其快速生长和存活。由于这一事实,肿瘤更容易发生铁死亡,这是一种铁依赖性的程序性细胞死亡形式。放射治疗(RT)是许多癌症患者的标准治疗方法,已知其可诱导铁死亡。超高剂量率FLASH RT通过在保持肿瘤控制的同时将对正常组织的损伤降至最低,提供了一个更好的治疗窗口。然而,FLASH RT对正常组织保护作用背后的确切生物学机制仍不清楚。在本研究中,我们提出,正常组织和癌组织之间铁水平的内在差异驱动的脂质过氧化和铁死亡变化促成了这种效应。我们的研究结果表明,与传统RT相比,FLASH RT增加了肿瘤细胞中的脂质过氧化并诱导了铁死亡,但在正常组织中并未显著提高脂质过氧化和铁死亡水平。为了确定提高正常组织中的铁水平是否会消除FLASH的保护作用,在放疗前给小鼠喂食高铁饮食。放疗前后的高铁饮食逆转了FLASH的保护作用,导致肠道损伤和脂质过氧化增加。这表明基线铁水平和铁驱动的脂质过氧化是介导FLASH RT保护效果的关键因素。总体而言,我们的研究揭示了铁在调节放疗反应中的作用,并为FLASH RT如何影响正常组织和癌组织提供了新的机制见解。
Cell Death Dis. 2025-9-2
Electromagn Biol Med. 2025-8-19
Cancer Immunol Immunother. 2025-8-4
Mol Cancer Ther. 2025-5-2
Annu Rev Cancer Biol. 2023-4
Front Oncol. 2024-7-3
Clin Transl Radiat Oncol. 2022-11-9
Br J Radiol. 2022-12-1