Abstract

Iron is an essential trace mineral element in almost all living cells and organisms. However, cellular iron metabolism pathways are disturbed in most cancer cell types. Cancer cells have a high demand of iron. To maintain rapid growth and proliferation, cancer cells absorb large amounts of iron by altering expression of iron metabolism related proteins. However, iron can catalyze the production of reactive oxygen species (ROS) through Fenton reaction. Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is an important player in the resistance to oxidative damage by inducing the transcription of antioxidant genes. Aberrant activation of Nrf2 is observed in most cancer cell types. It has been revealed that the over-activation of Nrf2 promotes cell proliferation, suppresses cell apoptosis, enhances the self-renewal capability of cancer stem cells, and even increases the chemoresistance and radioresistance of cancer cells. Recently, several genes involving cellular iron homeostasis are identified under the control of Nrf2. Since cancer cells require amounts of iron and Nrf2 plays pivotal roles in oxidative defense and iron metabolism, it is highly probable that Nrf2 is a potential modulator orchestrating iron homeostasis and redox balance in cancer cells. In this hypothesis, we summarize the recent findings of the role of iron and Nrf2 in cancer cells and demonstrate how Nrf2 balances the oxidative stress induced by iron through regulating antioxidant enzymes and iron metabolism. This hypothesis provides new insights into the role of Nrf2 in cancer progression. Since ferroptosis is dependent on lipid peroxide and iron accumulation, Nrf2 inhibition may dramatically increase sensitivity to ferroptosis. The combination of Nrf2 inhibitors with ferroptosis inducers may exert greater efficacy on cancer therapy.

Highlights

  • Iron is an essential trace mineral element in the body and is engaged in a wide range of biological processes, such as oxygen transport, electron transport, energy metabolism, DNA synthesis and repair, etc. (Torti et al, 2018)

  • Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) knockout enhances ferritin expression in aging mice. These results suggest that ferritin, FPN1, DMT1, and transferrin receptor 1 (TfR1) may be regulated by IRP-iron responsive element (IRE) system in Nrf2 deficiency mice

  • We highlight the role of Nrf2 in ferroptosis through regulating iron and reactive oxygen species (ROS) homeostasis

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Summary

INTRODUCTION

Iron is an essential trace mineral element in the body and is engaged in a wide range of biological processes, such as oxygen transport, electron transport, energy metabolism, DNA synthesis and repair, etc. (Torti et al, 2018). Oxidative stress can be induced by the high levels of iron accumulation in cancer cells and activates the Nrf pathway (Bellezza et al, 2018; Nakamura et al, 2019). Ferroptosis is a type of iron dependent oxidative cell death caused by the accumulation of ROS from the Fenton reaction and iron-mediated lipid peroxidation (Chen et al, 2020). Hepcidin downregulates FPN1 as an autocrine hormone, increases intracellular iron, and contributes to cancer cell progression (Pinnix et al, 2010; Tesfay et al, 2015) These results suggest that the measurement of proteins involved in cellular iron homeostasis could be helpful in cancer prognosis.

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