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Selective ferroptosis vulnerability due to familial Alzheimer’s disease presenilin mutations
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Mutations in presenilin 1 and 2 ( PS1 and PS2 ) cause autosomal dominant familial Alzheimer’s disease (FAD). Ferroptosis has been implicated as a mechanism of neurodegeneration in AD since neocortical iron burden predicts Alzheimer’s disease (AD) progression. We found that loss of the presenilins dramatically sensitizes multiple cell types to ferroptosis, but not apoptosis. FAD causal mutations of presenilins similarly sensitizes cells to ferroptosis. The presenilins promote the expression of GPX4, the selenoprotein checkpoint enzyme that blocks ferroptosis by quenching the membrane propagation of lethal hydroperoxyl radicals. Presenilin γ-secretase activity cleaves Notch-1 to signal LRP8 expression, which then controls GPX4 expression by regulating the supply of selenium into the cell since LRP8 is the uptake receptor for selenoprotein P. Selenium uptake is thus disrupted by presenilin FAD mutations, suppressing GPX4 expression. Therefore, presenilin mutations may promote neurodegeneration by derepressing ferroptosis, which has implications for disease-modifying therapeutics.
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![Fig. 1 Presenilin confers resistance to ferroptosis in multiple cell types and is affected by familial Alzheimer’s disease causative mutations. Cell viability analyses performed using the MTT assay to compare ferroptosis resistance in mouse embryonic fibroblasts (MEFs), primary human fibroblasts and HT22 mouse hippocampal neurons to RSL3 (a, c, e, g, i) or erastin (b, d, f, h, j) at the concentrations shown, following 24 h incubation. Note: In i and j, “control” refers to matched negative-control HT22 cells transfected with non-targeting sgRNA contemporaneously with the generation of the PS1 KO and PS dKO HT22 cells, while “control*” is the contemporaneous and matched HT22 control for the subsequently created PS2 KO HT22 cells. Hence, PS1 KO and PS dKO HT22 should be compared to “control”, while PS2 KO should be compared to “control*”. Abbreviations: wildtype (WT), presenilin 1 knockout (PS1 KO), presenilin 2 knockout (PS2 KO), presenilin double-knockout (PS dKO), wild-type human sequence presenilin 1 (wt hPS1), L166P familial Alzheimer’s disease mutant human sequence presenilin 1 (L166P hPS1), I213T familial Alzheimer’s disease mutant human sequence presenilin 1 (I213T hPS1), healthy control human fibroblast (HC), A246E familial Alzheimer’s disease mutant presenilin 1 human fibroblast (PS1A246E FAD), N-[N-(3,5-Difluorophenacetyl)-L-alanyl]-S-phenylglycine t-butyl ester (DAPT, 10 μM, γ-secretase inhibitor). Data points represent mean percentage survival relative to respective controls ± SEM, N = 12–16 from 3 to 4 independent experiments.](/paper-figures/240513dcaf9a4e83919acb3bad3d42e5/selective-ferroptosis-vulnerability-due-to-familial-alzheimers-disease-figure-1.jpg)



![Fig. 5 A hypothesis of how loss of γ-secretase function causes ferroptotic stress. a (1) Presenilins combine with other proteins of the γ-secretase complex to (2) cleave Notch-1, releasing the intracellular domain of Notch-1 (NICD). (3) NICD translocates to the nucleus and binds the co-activator, RBPJκ, to transcribe LRP8. (4) LRP8 is the neuronal receptor for the selenium transport protein, SELENOP. (5) Following internalization, SELENOP is degraded in the lysosome, releasing selenocysteine (Sec). Sec is decomposed to selenide by Sec lyase (SCLY), which is used to synthesize Sec-tRNA[Ser]Sec in a pathway involving selenophosphate synthetase 2 (SEPHS2), ultimately incorporating Sec into de novo translated Glutathione Peroxidase 4 (GPX4). (6) GPX4, which detoxifies lethal iron-catalyzed lipid hydroperoxides (LOOH), is a critical checkpoint in the ferroptosis pathway. Diminished GPX4 activity causes ferroptosis. Created with BioRender.com. b Model for ferroptosis causing AD. Brain iron levels rise needlessly but universally with aging. The burden of brain iron increases the chance of ferroptosis occurring, held in better check by wild type PS than mutant PS. As a result, neuroferroptosis commences at an earlier age in people expressing mutant PS (familial AD) than the typical age of onset of non-familial AD in people expressing wild type PS. The insert shows the canonical ferroptosis events: cytoplasmic Fe2+ reacts with polyunsaturated fatty acids (PUFAs) to generate lipid peroxides, which, beyond a certain threshold, can disrupt the cell membrane. PS mutations suppress the expression of GPX4, which is a major checkpoint enzyme that prevent lipid peroxide accumulation from reaching lethal levels.](/paper-figures/a76ed4eb6d384b6eaec2a5d6727de6b1/selective-ferroptosis-vulnerability-due-to-familial-alzheimers-disease-figure-5.jpg)
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“LRP8 has been recently shown to affect ferroptosis by regulating the level of selenoprotein GPX4 in cancer cells (54–56).”
From Secreted Apoe rewires melanoma cell state vulnerability to ferroptosis (2024) · cites this paper as [55]
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Cites
Ferroptosis: An Iron-Dependent Form of Nonapoptotic Cell Death
Dixon, S. J., Lemberg, K. M., Lamprecht, M. R., Skouta, R., Zaitsev, E. M., Gleason, C. E., Patel, D. N., Bauer, A. J., Cantley, A. M., Yang, W. S., et al. (2012) · Cell · doi:10.1016/j.cell.2012.03.042 · Cited by 18,691
Regulation of Ferroptotic Cancer Cell Death by GPX4
Yang, W. S., SriRamaratnam, R., Welsch, M. E., Shimada, K., Skouta, R., Viswanathan, V. S., Cheah, J. H., Clemons, P. A., Shamji, A. F., Clish, C. B., et al. (2014) · Cell · doi:10.1016/j.cell.2013.12.010 · Cited by 7,713
Ferroptosis: A Regulated Cell Death Nexus Linking Metabolism, Redox Biology, and Disease
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Self-citationThe amyloid hypothesis of Alzheimer's disease at 25 years
Selkoe, D. J., & Hardy, J. (2016) · EMBO Molecular Medicine · doi:10.15252/emmm.201606210 · Cited by 6,164
Inactivation of the ferroptosis regulator Gpx4 triggers acute renal failure in mice
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., et al. (2014) · Nature Cell Biology · doi:10.1038/ncb3064 · Cited by 3,732
A presenilin-1-dependent γ-secretase-like protease mediates release of Notch intracellular domain
De Strooper, B., Annaert, W., Cupers, P., Saftig, P., Craessaerts, K., Mumm, J. S., Schroeter, E. H., Schrijvers, V., Wolfe, M. S., Ray, W. J., et al. (1999) · Nature · doi:10.1038/19083 · Cited by 2,100
Dependency of a therapy-resistant state of cancer cells on a lipid peroxidase pathway
Viswanathan, V. S., Ryan, M. J., Dhruv, H. D., Gill, S., Eichhoff, O. M., Seashore-Ludlow, B., Kaffenberger, S. D., Eaton, J. K., Shimada, K., Aguirre, A. J., et al. (2017) · Nature · doi:10.1038/nature23007 · Cited by 2,011
The role of iron in brain ageing and neurodegenerative disorders
Ward, R. J., Zucca, F. A., Duyn, J. H., Crichton, R. R., & Zecca, L. (2014) · The Lancet Neurology · doi:10.1016/s1474-4422(14)70117-6 · Cited by 1,819
Selenium Utilization by GPX4 Is Required to Prevent Hydroperoxide-Induced Ferroptosis
Ingold, I., Berndt, C., Schmitt, S., Doll, S. G., Poschmann, G., Buday, K., Roveri, A., Peng, X., Freitas, F. P., Seibt, T., et al. (2017) · Cell · doi:10.1016/j.cell.2017.11.048 · Cited by 1,712
Ferroptosis: Mechanisms and links with diseases
Yan, H.-F., Zou, T., Tuo, Q.-Z., Xu, S., Li, H., Belaidi, A. A., & Lei, P. (2021) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-020-00428-9 · Cited by 1,471
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Ferroptosis in health and disease
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Metadata
- Authors
- Greenough, M. A., Lane, D. J. R., Balez, R., Anastacio, H. T. D., Zeng, Z., Ganio, K., McDevitt, C. A., Acevedo, K., Belaidi, A. A., Koistinaho, J., Ooi, L., Ayton, S., & Bush, A. I.
- Affiliations
- The University of Melbourne (AU)
- University of Wollongong (AU)
- Shenzhen KangNing Hospital (CN)
- Corresponding author
- Ayton, Scott
- Bush, Ashley I.
- ORCID
- Venue
- Cell Death & Differentiation
- Published
- 2022-04-21
- Volume
- 29
- Issue
- 11
- Pages
- 2123-2136
- ISSN
- 1350-9047 (ISSN-L)
- 1476-5403
- PMC
- PMC9613996
- OpenAlex
- W4224302612
- Cited by
- 102
- References
- 96
- Citations by year
- 2026: 20 · 2025: 26 · 2024: 28 · 2023: 26 · 2022: 2
- FWCI
- 12.85
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Cell Death and Differentiation (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Online (University of Wollongong) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- Työväentutkimus Vuosikirja (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Funders
- Itä-Suomen Yliopisto
- University College London
- KU Leuven
- National Health and Medical Research Council
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Ferroptosis and cancer prognosis
- Life Sciences › Neuroscience › Neurology › Neurological diseases and metabolism
- Keywords
- ferroptosis, familial Alzheimer's disease, presenilin 1, presenilin 2, GPX4, Notch1, LRP8, selenoprotein P, selenium uptake, gamma-secretase, neurodegeneration, iron accumulation, apoptosis
- MeSH terms
- Ferroptosis, Alzheimer Disease, Humans, Mutation, Selenium, Presenilins, Presenilin-1, Amyloid Precursor Protein Secretases
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