Ferroptosis, a new form of regulated necrotic cell death, was recently described in RAS-transformed tumor cells when treated with a subset of lethal small molecules, called ferroptosis-inducing-agents (FINs). This form of regulated necrosis is characterized by the occurrence of high cellular levels of lipid hydroperoxides and iron overload, leading to caspase- and necrosome-independent cell death. In fact, iron-dependent lipid peroxidation is believed to be the main driver of ferroptosis that is counteracted by the selenoenzyme glutathione (GSH) peroxidase 4 (GPX4), which catalyzes the detoxification of peroxides specifically in lipid bilayers. However, there are many open questions about the execution mechanisms of ferroptosis, and in particular those downstream of GPX4 and lipid peroxidation. In this study, the GPX4 inhibitor (1S, 3R)-RSL3, along with the System xc- inhibitor Erastin, another FIN, were used in a recessive genetic screen to identify acyl-CoA synthetase long-chain family member 4 (Acsl4) as a very specific, crucial player of ferroptosis. Targeted knockout (KO) of Acsl4 in somatic cells by using the CRISPR/CAS technology not only rendered cells highly resistant to FINs, but also rescued ferroptotic cell death induced by Gpx4 deletion in double KO cells. Furthermore, it was demonstrated that forced re-expression of ACSL4 but not ACSL1 and ACSL3 could re-sensitize cells to undergo ferroptosis. The finding was expanded to a panel of triple-negative human breast cancer cells (difficult to treat by standard chemotherapy) to show that the presence of ACSL4 expression predicted the sensitivity to FIN induced ferroptotic cancer cell death. In an attempt to illuminate the mechanism of ferroptosis execution, it was shown that the protection against ferroptosis brought about by Acsl4 KO was due to the high resistance to lipid peroxidation. Specifically, Acsl4 was involved in shaping the phospholipid species containing polyunsaturated fatty acid groups in cells, the main targets of lipid peroxidation. In particular, the (oxi)-lipidome analysis of WT and Acsl4 KO cells during (1S, 3R)-RSL3 induced ferroptosis unraveled a yet unrecognized oxi-lipid signature, featuring double and triple oxygenated species of arachidonoyl- and adrenoyl-phosphatidylethanolamine (C18:0/20:4 and C18:0/22:4) as markers of ferroptosis. Pharmacological inhibition of Acsl4 using thiazolidinediones was shown to be a viable option to halt ferroptosis (independent of its effects on peroxisome proliferator-activated receptor-γ (PPAR-γ)) in vitro and to some extent in a mouse model of inducible Gpx4 deletion. Therefore, genetically modified mouse lines with a TAM-inducible KO of Acsl4 were generated and efforts are currently being made to generate inducible Acsl4/Gpx4 double KO mice that will serve as new tools to investigate the role of ferroptosis in vivo.
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Ferroptosis, a new form of regulated necrotic cell death, was recently described in RAS-transformed tumor cells when treated with a subset of lethal small molecules, called ferroptosis-inducing-agents (FINs). This form of regulated necrosis is characterized by the occurrence of high cellular levels of lipid hydroperoxides and iron overload, leading to caspase- and necrosome-independent cell death. In fact, iron-dependent lipid peroxidation is believed to be the main driver of ferroptosis that is...
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