Abstract

BackgroundIschemic stroke is the main cause of disability worldwide, leading to a serious socioeconomic burden. Ferroptosis is a non-apoptotic form of programmed cell death and is related to various diseases. Acyl-CoA synthetase long-chain family member 4 (ACSL4) is considered a target of ferroptosis, but its specific role in ischemic stroke remains unclear. In this study, we investigate whether the inhibition of ACSL4 promotes the recovery of neurological function in a way that prevents ferroptosis.MethodsA transient cerebral ischemia model was established for mice by middle cerebral artery occlusion (MCAO); glutathione peroxidase 4 (GPx4), ACSL4 and cyclooxygenase 2 (COX2) were detected by Western blot, and changes to mitochondria were observed by a transmission electron microscope. A kit was used to determine iron levels and lipid peroxide indicators, such as glutathione peroxidase (GPx), reduced glutathione (GSH), total glutathione/oxidized glutathione (GSH/GSSG), lipid peroxidation, reactive oxygen species, superoxide and malonaldehyde. Following MCAO, a ferroptosis inhibitor, liproxstatin-1, was administered intranasally immediately at a concentration of 10 mg/kg. Rosiglitazone was used to inhibit ACSL4 and was administered intravenously 1 h before MCAO at a concentration of 0.4 mg/kg. Brain injury was determined by neurological deficit scores, neuroscore (28-point), corner test and gait analyses, at 24 and 72 h after stroke. Brain infarct volume was determined by 2, 3, 5-Triphenyltetrazolium chloride (TTC) staining at 72 h after stroke.ResultsAfter MCAO, GPx4 protein expression decreased, ACSL4 and COX2 protein expression increased, GPx activity decreased and iron accumulation. Transmission electron microscopy confirmed that the outer mitochondrial membrane of neurons had ruptured and mitochondrial cristae had decreased or disappeared. Liproxstatin-1 could significantly attenuate the decrease of GPx4 and the increase of COX2 after MCAO, dramatically reducing iron accumulation and decreasing GPx activity, accompanied by a marked reduction in changes in lipid peroxidation indicators. The use of rosiglitazone to inhibit ACSL4 could significantly improve neurological function and reduce the brain infarct volume at 72 h after stroke. Importantly, inhibiting ACSL4 could significantly attenuate the decline of GPx4 after MCAO and markedly attenuate iron accumulation and a decrease in GPx activity. Additionally, changes in lipid peroxidation indicators were also significantly inhibited.ConclusionThis study indicates that inhibiting ACSL4 can promote the recovery of neurological function after stroke by suppression of ferroptosis.

Highlights

  • Ischemic stroke is a leading cause of death and disability worldwide, causing severe health and socioeconomic burdens (Benjamin et al, 2019)

  • Compared with the sham group, the middle cerebral artery occlusion (MCAO) group significantly increased the Acyl-CoA synthetase long-chain family member 4 (ACSL4) protein levels of mice (0.30 ± 0.02 vs 0.40 ± 0.02, p ≤ 0.05; n = 5, Student’s t-test, Figures 1A,B), suggesting that ACSL4 may serve as a key target after cerebral infarction

  • Ferroptosis is a novel mode of cell death that is caused by irondependent accumulation that is driven by lipid peroxidation, which differs significantly from apoptosis and autophagy in morphology, biochemistry and genetics (Dixon et al, 2012)

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Summary

Introduction

Ischemic stroke is a leading cause of death and disability worldwide, causing severe health and socioeconomic burdens (Benjamin et al, 2019). Intravenous thrombolysis and endovascular therapy have been used for clinical intervention. Regulating the pathogenesis of brain injury after stroke has established roles for multiple processes including oxidative stress, inflammation, excitotoxicity and apoptosis (Tuo et al, 2017). Ferroptosis, a new form of cell death related to oxidative stress, has attracted increasing attention. Comprehensively elucidating the molecular mechanism of ferroptosis in ischemic stroke and finding key signal pathways and protein molecules for ferroptosis are of great significance in terms of guiding the clinical practice of ischemic stroke (Dong et al, 2018). Ischemic stroke is the main cause of disability worldwide, leading to a serious socioeconomic burden. Ferroptosis is a non-apoptotic form of programmed cell death and is related to various diseases. We investigate whether the inhibition of ACSL4 promotes the recovery of neurological function in a way that prevents ferroptosis

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