Inactivation of the ferroptosis regulator Gpx4 triggers acute renal failure in mice
Open accessAbstract
Ferroptosis is a non-apoptotic form of cell death induced by small molecules in specific tumour types, and in engineered cells overexpressing oncogenic RAS. Yet, its relevance in non-transformed cells and tissues is unexplored and remains enigmatic. Here, we provide direct genetic evidence that the knockout of glutathione peroxidase 4 (Gpx4) causes cell death in a pathologically relevant form of ferroptosis. Using inducible Gpx4(-/-) mice, we elucidate an essential role for the glutathione/Gpx4 axis in preventing lipid-oxidation-induced acute renal failure and associated death. We furthermore systematically evaluated a library of small molecules for possible ferroptosis inhibitors, leading to the discovery of a potent spiroquinoxalinamine derivative called Liproxstatin-1, which is able to suppress ferroptosis in cells, in Gpx4(-/-) mice, and in a pre-clinical model of ischaemia/reperfusion-induced hepatic damage. In sum, we demonstrate that ferroptosis is a pervasive and dynamic form of cell death, which, when impeded, promises substantial cytoprotection.
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Depletion of intracellular glutathione reduces GPX functionality.
“Under normal circumstances, glutathione peroxidase (GPX) neutralizes lipid peroxide to lipid alcohols, but the depletion of intracellular glutathione (GSH, GPX substrate) reduces GPX functionality (Yang and Stockwell, 2008; Friedmann Angeli et al., 2014).”
From Toxic Concentrations of Glutamate Induce Ferroptosis without Affecting Mitochondrial Respiration in Rodent Brain Slice Cultures (2026) · cites this paper as Friedmann Angeli et al., 2014
Depleting GSH with BSO can induce ferroptotic RCD at least in some cases.
“depleting GSH with L-buthionine sulfoximine (BSO)—an inhibitor of the glutamate–cysteine ligase complex—can induce ferroptotic RCD (at least in some cases) [547].”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [547]
GPX4 has emerged as the main endogenous inhibitor of ferroptosis by limiting lipid peroxidation through GSH-dependent reduction of lipid hydroperoxides to lipid alcohols.
“the reduced glutathione (GSH)-dependent enzyme glutathione peroxidase 4 (GPX4)—which is directly targeted by RSL3—has emerged as the main endogenous inhibitor of ferroptosis by virtue of its ability to limit lipid peroxidation by catalyzing the GSH-dependent reduction of lipid hydroperoxides to lipid alcohols [547–550].”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [547]
Gpx4−/− mice display embryonic lethality with complete penetrance.
“Gpx4−/− mice display embryonic lethality with complete penetrance [547, 550, 587, 588].”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [547]
Deletion of Alox15 fails to rescue the renal phenotype imposed by the Gpx4−/− genotype.
“the deletion of Alox15 fails to rescue the renal phenotype imposed by the Gpx4−/− genotype (see below) [547]”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [547]
Oxidized PUFAs accumulate upon GPX4 inactivation and can result in PUFA fragmentation and ferroptosis.
“oxidized PUFAs accumulate upon GPX4 inactivation and this can result in PUFA fragmentation and ferroptosis [539, 547].”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [547]
Inducible or tissue-specific ablation of Gpx4 in mice provokes acute renal or hepatic injury, neurodegeneration, and defective immunity to infection, all preventable or mitigated by ferroptosis-inhibiting strategies.
“the inducible or tissue-specific ablation of Gpx4 in mice provokes a variety of pathological conditions, including acute renal or hepatic injury [547, 563, 589], neurodegeneration [550, 590, 591], and defective immunity to infection [567], all of which can be prevented or mitigated by ferroptosis-inhibiting strategies.”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [547]
Multiple LOXs are involved in PUFA peroxidation and consequent ferroptosis in some mouse tissues.
“suggesting that multiple LOXs are involved in PUFA peroxidation and consequent ferroptosis in some mouse tissues.”
From Molecular mechanisms of cell death: recommendations of the nomenclature committee on cell death 2018. (2018) · cites this paper as [547]
Erastin-induced death still occurs when RIPK1/RIPK3 are knocked down or RIPK1 is inhibited, so it does not require known necroptosis components.
“Although non-apoptotic, erastin-induced cell death proceeds normally upon knockdown of RIPK1/RIPK3, or pharmacological inhibition of RIPK1 [10, 15, our unpublished data], known components of necroptosis [16].”
From Ferroptosis: Death by Lipid Peroxidation (2016) · cites this paper as [15]
Kidney tubular cells are especially susceptible to ferroptosis induction by Gpx4 deletion in vivo.
“Tubular cells in the kidney are also particularly susceptible to ferroptosis induction by Gpx4 deletion in vivo [15], which is intriguing in light of the enhanced sensitivity of renal cell carcinoma cell lines in culture to erastin [24].”
From Ferroptosis: Death by Lipid Peroxidation (2016) · cites this paper as [15]
In mice with inducible Gpx4 loss, liproxstatin-1 delays acute renal failure and extends survival compared with vehicle.
“When liprostatin-1 was administered to mice with inducible loss of Gpx4 protein, it delayed the acute renal failure caused by Gpx4 depletion, and extended survival of mice compared to a vehicle-treated group [15].”
From Ferroptosis: Death by Lipid Peroxidation (2016) · cites this paper as [15]
Ferroptosis-derived dead cells can release damage-associated molecular patterns (DAMPs) and lipid metabolites that can cause an elevation of inflammation.
“Ferroptosis-derived dead cells can release damage-associated molecular patterns (DAMPs) and lipid metabolites that can cause an elevation of inflammation [76,77].”
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- Authors
- Friedmann Angeli, J. P., Schneider, M., Proneth, B., Tyurina, Y. Y., Tyurin, V. A., Hammond, V. J., Herbach, N., Aichler, M., Walch, A., Eggenhofer, E., Basavarajappa, D., Rådmark, O., Kobayashi, S., Seibt, T., Beck, H., Neff, F., Esposito, I., Wanke, R., Förster, H., Yefremova, O., Heinrichmeyer, M., Bornkamm, G. W., Geissler, E. K., Thomas, S. B., Stockwell, B. R., O’Donnell, V. B., Kagan, V. E., Schick, J. A., & Conrad, M.
- Affiliations
- LMU Klinikum (DE)
- Helmholtz Munich (DE)
- University of Pittsburgh (US)
- Cardiff University (GB)
- Ludwig-Maximilians-Universität München (DE)
- University Hospital Regensburg (DE)
- Karolinska Institutet (SE)
- Yamagata University (JP)
- Institut für Chirurgische Forschung (DE)
- Howard Hughes Medical Institute (US)
- Corresponding author
- Conrad, Marcus
- ORCID
- Schneider, Manuela
- Proneth, Bettina
- Tyurina, Yulia Y.
- Tyurin, Vladimir A.
- Herbach, Nadja
- Walch, Axel
- Eggenhofer, Elke
- Basavarajappa, Devaraj
- Rådmark, Olof
- Kobayashi, Sho
- Seibt, Tobias
- Beck, Heike
- Wanke, Rüdiger
- Geissler, Edward K.
- Stockwell, Brent R.
- O’Donnell, Valerie B.
- Kagan, Valerian E.
- Schick, Joel A.
- Conrad, Marcus
- Venue
- Nature Cell Biology
- Published
- 2014-11-17
- Volume
- 16
- Issue
- 12
- Pages
- 1180-1191
- ISSN
- 1465-7392 (ISSN-L)
- 1476-4679
- PMC
- PMC4894846
- OpenAlex
- W2035898183
- Cited by
- 3,732
- References
- 46
- Citations by year
- 2026: 425 · 2025: 505 · 2024: 615 · 2023: 571 · 2022: 526 · 2021: 389 · 2020: 243 · 2019: 169 · 2018: 103 · 2017: 82 · 2016: 63 · 2015: 36 · 2014: 1
- FWCI
- 48.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Cell Biology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- University of Regensburg Publication Server (University of Regensburg) (submittedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (P01HL114453)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Ferroptosis and cancer prognosis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cell death mechanisms and regulation
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Keywords
- ferroptosis, GPX4, acute kidney injury, lipid peroxidation, glutathione, ferroptosis inhibitors, liproxstatin-1, ischemia-reperfusion injury, liver injury, non-apoptotic cell death
- MeSH terms
- Phospholipid Hydroperoxide Glutathione Peroxidase, Animals, Arachidonate 12-Lipoxygenase, Arachidonate 15-Lipoxygenase, Cardiolipins, Cell Line, Glutathione Peroxidase, Humans, Imidazoles, Indoles, Kidney, Male, Mice, Inbred C57BL, Mitochondria, Peroxidases, Phosphatidylcholines, Phosphatidylethanolamines, Quinoxalines, Spiro Compounds, Lipid Peroxidation, Reperfusion Injury, Apoptosis, Mice, Knockout, In Situ Nick-End Labeling, Mice, Acute Kidney Injury
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