Ferroptosis: a key driver and therapeutic target in the pathogenesis of acute respiratory distress syndrome

Acute Respiratory Distress Syndrome (ARDS) is a severe inflammatory lung condition often triggered by infections or sepsis, characterized by diffuse alveolar damage, pulmonary edema, and impaired gas exchange. Despite advances in supportive care, ARDS continues to have a high mortality rate. The pat...

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Main Authors: Mingjun Yao, Jinfeng Liao, Zheng Liu, Wei Zhao, Siyuan Song, Xiaobo Huang, Yi Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1567980/full
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author Mingjun Yao
Jinfeng Liao
Zheng Liu
Wei Zhao
Siyuan Song
Xiaobo Huang
Yi Wang
Yi Wang
author_facet Mingjun Yao
Jinfeng Liao
Zheng Liu
Wei Zhao
Siyuan Song
Xiaobo Huang
Yi Wang
Yi Wang
author_sort Mingjun Yao
collection DOAJ
description Acute Respiratory Distress Syndrome (ARDS) is a severe inflammatory lung condition often triggered by infections or sepsis, characterized by diffuse alveolar damage, pulmonary edema, and impaired gas exchange. Despite advances in supportive care, ARDS continues to have a high mortality rate. The pathogenesis of ARDS involves an exaggerated immune response leading to tissue damage and inflammation. Regulatory cell death pathways, particularly ferroptosis, an iron-dependent form of cell death driven by lipid peroxidation and oxidative stress, play a critical role in ARDS progression. Ferroptosis is characterized by the accumulation of lipid peroxides and is regulated by enzymes such as glutathione peroxidase 4 (GPX4) and the system Xc- antiporter. Dysregulation of these pathways exacerbates oxidative stress and tissue damage in ARDS. In the context of ARDS, ferroptosis contributes to the destruction of alveolar and endothelial cells, leading to increased vascular permeability, pulmonary edema, and impaired gas exchange. Immune cells like macrophages and neutrophils, while essential for pathogen clearance, can also contribute to lung injury when overactivated, highlighting the need for therapeutic strategies to modulate ferroptosis. Therapeutic targeting of ferroptosis in ARDS includes the use of antioxidants, GPX4 activators, iron chelators, and inhibitors of lipid peroxidation. These approaches aim to reduce oxidative stress, restore antioxidant defenses, and prevent iron-driven cell death. Future research must address challenges in identifying reliable biomarkers, understanding subphenotype-specific mechanisms, and integrating ferroptosis inhibitors into existing therapeutic frameworks. By targeting ferroptosis, it may be possible to mitigate ARDS severity and improve patient outcomes, offering new hope for the management of this devastating condition.
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spelling doaj-art-d02567de599d42a99f81c01f01c05ea92025-08-20T03:51:08ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.15679801567980Ferroptosis: a key driver and therapeutic target in the pathogenesis of acute respiratory distress syndromeMingjun Yao0Jinfeng Liao1Zheng Liu2Wei Zhao3Siyuan Song4Xiaobo Huang5Yi Wang6Yi Wang7School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Dermatology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, ChinaDepartment of Neuroscience, Baylor College of Medicine, Houston, TX, United StatesSchool of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Neuroscience, Baylor College of Medicine, Houston, TX, United StatesDepartment of Critical Care Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, ChinaDepartment of Critical Care Medicine, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, ChinaTranslational Clinical Immunology Medicine Key Laboratory of Sichuan Province, Center of Organ Transplantation, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, Chengdu, Sichuan, ChinaAcute Respiratory Distress Syndrome (ARDS) is a severe inflammatory lung condition often triggered by infections or sepsis, characterized by diffuse alveolar damage, pulmonary edema, and impaired gas exchange. Despite advances in supportive care, ARDS continues to have a high mortality rate. The pathogenesis of ARDS involves an exaggerated immune response leading to tissue damage and inflammation. Regulatory cell death pathways, particularly ferroptosis, an iron-dependent form of cell death driven by lipid peroxidation and oxidative stress, play a critical role in ARDS progression. Ferroptosis is characterized by the accumulation of lipid peroxides and is regulated by enzymes such as glutathione peroxidase 4 (GPX4) and the system Xc- antiporter. Dysregulation of these pathways exacerbates oxidative stress and tissue damage in ARDS. In the context of ARDS, ferroptosis contributes to the destruction of alveolar and endothelial cells, leading to increased vascular permeability, pulmonary edema, and impaired gas exchange. Immune cells like macrophages and neutrophils, while essential for pathogen clearance, can also contribute to lung injury when overactivated, highlighting the need for therapeutic strategies to modulate ferroptosis. Therapeutic targeting of ferroptosis in ARDS includes the use of antioxidants, GPX4 activators, iron chelators, and inhibitors of lipid peroxidation. These approaches aim to reduce oxidative stress, restore antioxidant defenses, and prevent iron-driven cell death. Future research must address challenges in identifying reliable biomarkers, understanding subphenotype-specific mechanisms, and integrating ferroptosis inhibitors into existing therapeutic frameworks. By targeting ferroptosis, it may be possible to mitigate ARDS severity and improve patient outcomes, offering new hope for the management of this devastating condition.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1567980/fullcell death pathwaysimmune homeostasisacute respiratory distress syndromeferroptosisimmune cytokines
spellingShingle Mingjun Yao
Jinfeng Liao
Zheng Liu
Wei Zhao
Siyuan Song
Xiaobo Huang
Yi Wang
Yi Wang
Ferroptosis: a key driver and therapeutic target in the pathogenesis of acute respiratory distress syndrome
Frontiers in Immunology
cell death pathways
immune homeostasis
acute respiratory distress syndrome
ferroptosis
immune cytokines
title Ferroptosis: a key driver and therapeutic target in the pathogenesis of acute respiratory distress syndrome
title_full Ferroptosis: a key driver and therapeutic target in the pathogenesis of acute respiratory distress syndrome
title_fullStr Ferroptosis: a key driver and therapeutic target in the pathogenesis of acute respiratory distress syndrome
title_full_unstemmed Ferroptosis: a key driver and therapeutic target in the pathogenesis of acute respiratory distress syndrome
title_short Ferroptosis: a key driver and therapeutic target in the pathogenesis of acute respiratory distress syndrome
title_sort ferroptosis a key driver and therapeutic target in the pathogenesis of acute respiratory distress syndrome
topic cell death pathways
immune homeostasis
acute respiratory distress syndrome
ferroptosis
immune cytokines
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1567980/full
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