Ferroptosis in acute liver Failure: Unraveling the hepcidin-ferroportin axis and therapeutic interventions

Acute liver failure (ALF) represents a critical clinical syndrome marked by massive hepatocyte death and severe functional deterioration. While metabolic dysregulation is a recognized hallmark, the pathophysiological implications of iron metabolism disturbance in ALF progression remain poorly unders...

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Main Authors: Jinyong He, Cong Du, Cuiping Li, Wei Li, Jinlan Qiu, Mingpeng Ma, Yunhao Chen, Qi Zhang
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Redox Biology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213231725001703
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author Jinyong He
Cong Du
Cuiping Li
Wei Li
Jinlan Qiu
Mingpeng Ma
Yunhao Chen
Qi Zhang
author_facet Jinyong He
Cong Du
Cuiping Li
Wei Li
Jinlan Qiu
Mingpeng Ma
Yunhao Chen
Qi Zhang
author_sort Jinyong He
collection DOAJ
description Acute liver failure (ALF) represents a critical clinical syndrome marked by massive hepatocyte death and severe functional deterioration. While metabolic dysregulation is a recognized hallmark, the pathophysiological implications of iron metabolism disturbance in ALF progression remain poorly understood, which may unveil novel therapeutic targets. Using clinical samples and preclinical murine models, we identified ferroptosis as a predominant pathological feature in ALF-affected livers. Notably, pharmacological inhibition of ferroptosis significantly attenuated disease progression in experimental ALF. Mechanistically, dysregulation of the hepcidin-ferroportin (FPN) axis drives hepatic iron overload, precipitating ferroptotic cell death in ALF. The anti-rheumatoid arthritis drug auranofin restored hepcidin-FPN axis homeostasis and mitigated liver injury, though concomitant upregulation of proinflammatory cytokines limited its therapeutic potential. Strikingly, mesenchymal stromal cells (MSCs) demonstrated superior therapeutic efficacy, coordinately modulating the hepcidin-FPN axis while suppressing ferroptosis through PI3K/Akt/Nrf2 pathway activation. Our findings not only establish the causal relationship between hepcidin-FPN axis dysfunction and ferroptosis-driven liver injury, but also propose MSC-based therapy as a multifaceted strategy targeting both iron homeostasis and ferroptosis for ALF management.
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spelling doaj-art-56057727e0164f4e8b0e0d4cd84ff5592025-08-20T01:55:21ZengElsevierRedox Biology2213-23172025-07-018410365710.1016/j.redox.2025.103657Ferroptosis in acute liver Failure: Unraveling the hepcidin-ferroportin axis and therapeutic interventionsJinyong He0Cong Du1Cuiping Li2Wei Li3Jinlan Qiu4Mingpeng Ma5Yunhao Chen6Qi Zhang7Cell-gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Biotherapy Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Province Key Laboratory of Liver Disease Research, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaCell-gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Biotherapy Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Province Key Laboratory of Liver Disease Research, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Corresponding author. Biotherapy Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510630, China.Cell-gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Biotherapy Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaCell-gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Biotherapy Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Province Key Laboratory of Liver Disease Research, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaCell-gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Biotherapy Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Province Key Laboratory of Liver Disease Research, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaCell-gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Biotherapy Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Province Key Laboratory of Liver Disease Research, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBiotherapy Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaCell-gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Biotherapy Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Province Key Laboratory of Liver Disease Research, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Corresponding author. Biotherapy Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510630, China.Acute liver failure (ALF) represents a critical clinical syndrome marked by massive hepatocyte death and severe functional deterioration. While metabolic dysregulation is a recognized hallmark, the pathophysiological implications of iron metabolism disturbance in ALF progression remain poorly understood, which may unveil novel therapeutic targets. Using clinical samples and preclinical murine models, we identified ferroptosis as a predominant pathological feature in ALF-affected livers. Notably, pharmacological inhibition of ferroptosis significantly attenuated disease progression in experimental ALF. Mechanistically, dysregulation of the hepcidin-ferroportin (FPN) axis drives hepatic iron overload, precipitating ferroptotic cell death in ALF. The anti-rheumatoid arthritis drug auranofin restored hepcidin-FPN axis homeostasis and mitigated liver injury, though concomitant upregulation of proinflammatory cytokines limited its therapeutic potential. Strikingly, mesenchymal stromal cells (MSCs) demonstrated superior therapeutic efficacy, coordinately modulating the hepcidin-FPN axis while suppressing ferroptosis through PI3K/Akt/Nrf2 pathway activation. Our findings not only establish the causal relationship between hepcidin-FPN axis dysfunction and ferroptosis-driven liver injury, but also propose MSC-based therapy as a multifaceted strategy targeting both iron homeostasis and ferroptosis for ALF management.http://www.sciencedirect.com/science/article/pii/S2213231725001703Acute liver failureMesenchymal stromal cellsFerroptosisIron metabolismHepcidin-ferroportin axis
spellingShingle Jinyong He
Cong Du
Cuiping Li
Wei Li
Jinlan Qiu
Mingpeng Ma
Yunhao Chen
Qi Zhang
Ferroptosis in acute liver Failure: Unraveling the hepcidin-ferroportin axis and therapeutic interventions
Redox Biology
Acute liver failure
Mesenchymal stromal cells
Ferroptosis
Iron metabolism
Hepcidin-ferroportin axis
title Ferroptosis in acute liver Failure: Unraveling the hepcidin-ferroportin axis and therapeutic interventions
title_full Ferroptosis in acute liver Failure: Unraveling the hepcidin-ferroportin axis and therapeutic interventions
title_fullStr Ferroptosis in acute liver Failure: Unraveling the hepcidin-ferroportin axis and therapeutic interventions
title_full_unstemmed Ferroptosis in acute liver Failure: Unraveling the hepcidin-ferroportin axis and therapeutic interventions
title_short Ferroptosis in acute liver Failure: Unraveling the hepcidin-ferroportin axis and therapeutic interventions
title_sort ferroptosis in acute liver failure unraveling the hepcidin ferroportin axis and therapeutic interventions
topic Acute liver failure
Mesenchymal stromal cells
Ferroptosis
Iron metabolism
Hepcidin-ferroportin axis
url http://www.sciencedirect.com/science/article/pii/S2213231725001703
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