Ferroptosis is an iron-dependent form of programmed cell death defined by the lethal accumulation of lipid peroxides. Accumulating evidence indicates that ferroptosis plays a critical role in a wide range of pathological processes, including tumor progression, ischemia-reperfusion injury, and neurodegenerative diseases. The key determinants of cellular susceptibility to ferroptosis are the homeostasis of iron and lipid metabolism, whose maintenance relies heavily on the precise regulation of inter-organelle communication networks. In this review, we focus on the spatial biology of ferroptosis regulation. From three core dimensions, iron homeostasis modulation, lipid metabolism remodeling, and redox balance maintenance, we systematically dissect the mechanisms by which signal crosstalk and functional coordination among multiple organelles (lysosomes, endoplasmic reticulum, mitochondria, plasma membrane, nucleus, lipid droplets, Golgi apparatus and peroxisome) govern ferroptosis initiation, signal amplification, and cellular defense responses. Comprehensive elucidation of this multi-organellar coordinated regulatory network will not only advance our fundamental understanding of ferroptosis execution but also provide a holistic perspective for the development of organelle-targeted therapeutic strategies against human diseases.

Ferroptosis is a form of regulated cell death driven by iron-dependent lipid peroxidation, and is therefore intrinsically coupled to cellular redox metabolism. Progression of ferroptosis is regulated by an integrated network of metabolic signaling pathways that involve inter-organellar communication. In this Review, we synthesize recent progress in the field that has advanced our understanding of the metabolic determinants of ferroptosis. We discuss key metabolites which participate in the execution and prevention of ferroptosis, describe major signaling axes that impinge on regulating these metabolic activities to determine cellular ferroptosis sensitivity, and highlight how compartmentalized metabolism within and across distinct intracellular organelles collectively shape ferroptosis progression. Together, this Review aims to provide a framework that unifies metabolic state, signaling plasticity and organellar cooperation as a mechanistic basis of ferroptosis, underscoring its implications in the pathogenesis of various diseases including cancer.

Ferroptosis is a form of programmed cell death driven by iron-dependent lipid peroxidation. Inducing ferroptosis in tumor cells has emerged as a crucial strategy for cancer treatment and overcoming therapeutic resistance. Ferroptosis suppressor protein 1 (FSP1), identified in recent years, is a key ferroptosis-inhibitory factor that operates independently of glutathione peroxidase 4 (GPX4). FSP1 is highly expressed in multiple malignant tumors, and its expression levels are tightly associated with unfavorable patient prognosis, treatment resistance, and tumor progression. Specific stresses within the tumor microenvironment, including hypoxia, metabolic stress, and the development of drug resistance, can drive a shift in ferroptosis resistance mechanisms from GPX4-dependent to FSP1-dependent pathways. Such plasticity renders FSP1 a druggable target in specific cancer genotypes or at particular stages of tumor progression. Indeed, genetic or pharmacological inhibition of FSP1 has yielded potent antitumor effects across diverse preclinical models. This review systematically summarizes the structural characteristics of FSP1, the molecular mechanisms through which it suppresses ferroptosis, the multilayered regulatory networks controlling its activity, and its roles in different malignancies. We deeply analyze the plasticity of FSP1 dependency in tumor cells in vivo and comprehensively review the latest preclinical progress on small-molecule FSP1 inhibitors and related combinatorial therapeutic strategies. This review aims to establish a theoretical framework to support the clinical translation of FSP1-targeted antitumor strategies.

Selenium is an essential trace element that maintains cellular redox homeostasis through its incorporation into selenoproteins, including glutathione peroxidase 4, a key regulator of ferroptosis. Although selenium deficiency has long been linked to oxidative stress and lipid peroxidation, its significance in the context of ferroptosis has not been fully appreciated. In this review, building on our previous studies, we revisit selenium deficiency and impaired selenoprotein biosynthesis through the lens of ferroptosis. We summarize our findings that selenium deficiency induces a non-apoptotic, vitamin E- and deferoxamine-sensitive form of cell death associated with lipid peroxidation, and that selenium-deficient cells accumulate not only phospholipid oxidation products but also cholesterol oxidation products. We also discuss the possibility that cholesterol oxidation may represent a broader feature of membrane lipid peroxidation, as similar products are observed in cells exposed to the radical initiator. In addition, we highlight SECIS-binding protein 2 deficiency as a human model of impaired selenoprotein biosynthesis, in which increased linoleic acid and cholesterol oxidation products, together with their responsiveness to vitamin E, indicate progressive lipid oxidative damage in vivo. Finally, we discuss recent findings on peroxiredoxin 6 and arsenite, which suggest that toxicological disruption of selenium metabolism can suppress selenoprotein biosynthesis and increase ferroptosis sensitivity. By integrating these findings with recent advances in ferroptosis research, this review provides a perspective on how impaired selenium metabolism contributes to lipid oxidative damage and ferroptotic vulnerability.

Z-nucleic acid-binding protein 1 (ZBP1) is a cytosolic innate immune sensor that detects left-handed Z-DNA and Z-RNA, structures arising from endogenous retroelements, splicing stress, R-loops, viruses, or viral mimicry. Originally viewed as an antiviral receptor, ZBP1 has emerged as a sentinel of genomic and transcriptomic instability. Upon ligand binding, ZBP1 recruits receptor-interacting serine/threonine-protein kinase 1 (RIPK1) and receptor-interacting serine/threonine-protein kinase 3 (RIPK3) via RIP homotypic interaction motif domains; in humans, RIPK1 acts as an essential scaffold to form the necrosome, which phosphorylates mixed lineage kinase domain-like pseudokinase (MLKL) and triggers necroptosis, a lytic, immunogenic cell death. This pathway is intimately regulated by reactive oxygen species (ROS): oxidative stress promotes RIPK1 activation, and necroptosis further drives a mitochondrial ROS burst, establishing a feed-forward amplification loop. In cancer, therapeutic induction of viral mimicry (e.g., using curaxins or splicing inhibitors) combined with tumor-localized ROS generation activates ZBP1-driven necroptosis, leading to the release of damage-associated molecular patterns and tumor antigens. This process converts immunosuppressive “cold” tumors into inflamed “hot” tumors, enhancing dendritic cell maturation, CD8⁺ T cell infiltration, and sensitivity to immune checkpoint blockade. Integrating epigenetic priming, nanomedicine, and patient stratification according to ZBP1/RIPK3/MLKL pathway status holds promise for overcoming therapeutic resistance. Thus, ZBP1-mediated nucleic acid surveillance represents a central innate checkpoint bridging genomic stress to antitumor immunity.

Ferroptosis, an iron-dependent form of regulated cell death characterised by lipid peroxidation, has emerged as a critical pathway in cancer, neurodegeneration, and ischaemia-reperfusion injury. While reverse genetic approaches have dominated ferroptosis research, forward genetic strategies offer unique advantages for discovering novel regulatory mechanisms without prior knowledge of pathway components. This perspective explores how classical forward genetic methodologies, including chemical mutagenesis screens, genetic modifier studies, and quantitative trait locus mapping, can be adapted to systematically identify ferroptosis regulators. We focus on employing the nematode model, Caenorhabditis elegans, and discuss the inherent advantages and disadvantages of this system. Technical considerations for designing phenotype-based screens are discussed, highlighting successful examples from related cell death pathways. Experimental frameworks for leveraging alternate model organisms to uncover conserved ferroptosis mechanisms are also explored. Forward genetics promises to reveal unexpected connections between ferroptosis and cellular processes, potentially identifying new therapeutic targets and biomarkers for ferroptosis-related diseases.

Aims: Brown adipose tissue (BAT) relies heavily on mitochondrial activity and reactive oxygen species homeostasis to regulate thermogenesis and metabolic balance. However, the specific role of glutathione peroxidase 4 (GPX4), a critical antioxidant enzyme and central regulator of ferroptosis, in BAT remains unclear. This study aims to investigate the necessity of GPX4 for the functional integrity and thermogenic capacity of BAT.

Methods: Initially, we employed pharmacological inhibition of GPX4 in vitro using differentiated brown adipocytes. To investigate its role in vivo, we generated a BAT-specific Gpx4 knockout mouse model. The physiological and metabolic impacts of GPX4 deficiency were evaluated across three different conditions: cold exposure, high-fat diet, and vitamin E-deficient diet. Comprehensive evaluations were conducted using metabolic, histological, ultrastructural, and transcriptomic (RNA-seq) analyses.

Results: In vitro, pharmacological inhibition of GPX4 induced ferroptosis in differentiated brown adipocytes, suggesting its potential regulatory role. Strikingly, in vivo histological, ultrastructural, and metabolic analyses indicated that the genetic deletion of GPX4 does not impair BAT morphology or thermogenic function under any of the tested conditions. Consistent with these physiological findings, RNA-seq revealed that GPX4 deficiency did not significantly alter the expression of genes associated with ferroptosis or thermogenic pathways.

Conclusion: Although pharmacological inhibition of GPX4 triggers ferroptosis in brown adipocytes in vitro, GPX4 is not essential for maintaining the morphological integrity and thermogenic capacity of BAT in vivo under the specific experimental conditions tested.

Ferroptosis, a distinct form of cell death driven by lipid peroxidation, holds considerable potential as a therapeutic strategy for cancer. Its unique mechanisms, centered on the disruption of cellular systems that protect against phospholipid peroxidation, distinguish ferroptosis from apoptosis and other well-characterized forms of cell death. This creates a novel therapeutic opportunity; however, it also presents challenges, as non-cancerous cells likewise depend to some extent on ferroptosis-regulating pathways. Consequently, extensive research efforts have focused on identifying suitable molecular targets, developing targeted drug delivery strategies, defining cancer types that are particularly dependent on ferroptosis-regulatory components, and establishing effective patient stratification approaches. Furthermore, exploring combination therapies may further enhance therapeutic efficacy through additive or synergistic effects. This review highlights the potential synergistic effects of combining ferroptosis induction with conventional cancer therapies, including chemotherapy, immunotherapy, and radiation therapy. Preclinical studies indicate that promoting ferroptosis may help overcome drug resistance, a major barrier that often limits the efficacy of existing treatments. Nevertheless, the successful development of ferroptosis-based therapies will require overcoming several challenges through innovative therapeutic strategies.

Friedreich’s ataxia (FRDA) is a rare neurodegenerative condition driven by a severe deficiency of the mitochondrial protein frataxin (FXN). This depletion impairs mitochondrial iron-sulfur cluster biogenesis and disrupts intracellular iron homeostasis, ultimately promoting oxidative stress. Driven by localized iron overload and the continuous generation of reactive oxygen species, the resulting metabolic dysfunction renders vulnerable tissues highly susceptible to ferroptosis. This iron-dependent form of regulated cell death, executed through excessive lipid peroxidation, is now widely acknowledged as an important contributor to the neurodegeneration and hypertrophic cardiomyopathy that characterize FRDA. In the present review, we explore how FXN loss undermines cellular defenses against oxidative damage, placing a specific focus on the regulation of the lipid redox landscape. We detail the breakdown of glutathione (GSH)-dependent mechanisms, specifically highlighting the blunted Nrf2 antioxidant response and the subsequent reduced capacity of glutathione peroxidase 4. Alongside these deficits, we investigate the compensatory roles of GSH-independent rescue networks, namely ferroptosis suppressor protein 1 and mitochondrial dihydroorotate dehydrogenase. Looking toward clinical translation, we critically assess emerging pharmacological interventions designed to target these ferroptotic nodes. The potential of mitochondria-targeted iron chelators, lipoxygenase inhibitors, lipophilic radical-trapping antioxidants, and novel Nrf2 activators is evaluated to determine whether inhibiting ferroptosis can serve as a viable disease-modifying strategy. Moving forward, combinatorial “protect and restore” approaches will likely prove essential for maximizing therapeutic efficacy in FRDA.

Ferroptosis, a lipid peroxidation-driven form of regulated cell death, has emerged as a central mechanism in neurological disease. While most studies have focused on neuronal vulnerability, non-neuronal cells, including oligodendrocytes, astrocytes, microglia, brain endothelial cells, and central nervous system (CNS) infiltrating T cells, play equally critical roles in shaping disease progression. These cell types regulate iron homeostasis, lipid metabolism, antioxidant defenses, and inflammatory signaling, thereby establishing the microenvironmental conditions that determine ferroptotic susceptibility within the CNS. Accumulating evidence demonstrates lipid peroxidation and ferroptosis-related signaling in demyelinating disorders, ischemic injury, small vessel disease, Alzheimer’s disease, Parkinson’s disease, and spinal cord injury. However, the contribution of non-neuronal cells to ferroptotic stress and execution remains comparatively underexplored. In this review, we synthesize emerging data highlighting cell type-specific dependencies on glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), ferroptosis suppressor protein 1 (FSP1), nuclear factor erythroid 2-related factor 2 (NRF2), peroxiredoxin (PRDX), thioredoxin (TRX), iron-handling proteins, and lipid remodeling pathways, and discuss how these regulatory networks differ across CNS-resident and CNS infiltrating T cells. We propose that ferroptosis in neurological disease is not solely a neuron-autonomous event, but a tissue-level process orchestrated by non-neuronal cells with distinct metabolic and immunological programs. Understanding these cell type-specific vulnerabilities and regulatory mechanisms will be essential for the development of targeted therapeutic strategies aimed at modulating ferroptotic stress in neuroinflammatory and neurodegenerative disorders.

Iron is indispensable for cellular metabolism yet potentially cytotoxic, making its intracellular handling a fundamental determinant of cell fate decisions. The endo-lysosomal system has recently emerged as a central iron rheostat that integrates transferrin uptake, ferritinophagy, and lysosomal iron export to control iron bioavailability for mitochondria and other iron-dependent pathways. Growing studies further show that lysosomal iron is not merely permissive for ferroptosis but can directly initiate lipid damage through localized iron activation, lysosomal lipid peroxidation, and lysosomal membrane permeabilization. At the same time, emerging studies on organelle contact sites reveal that ferroptosis arises from the failure of a coordinated multi-organellar communication system, in which lysosomes, the endoplasmic reticulum, and mitochondria exchange iron, lipids, and redox signals in an effort to metabolically adapt to stress. This perspective is particularly relevant to drug-tolerant persisters and mesenchymal cancer cell states, which rely on rewired lysosomal iron trafficking to sustain plasticity while becoming highly susceptible to ferroptosis. In this minireview, we discuss emerging insights into the spatial organization of iron metabolism and propose a model in which ferroptosis sensitivity depends on the intracellular routing, chemical reactivity, and release dynamics of iron, highlighting lysosomal iron handling as a key therapeutic vulnerability in minimal residual disease.

Ferroptosis is an oxidative form of non-apoptotic cell death that is important for human biology. This process can be induced in cultured cells by at least four structurally and mechanistically distinct classes of ferroptosis inducing (FIN) small molecules. These four classes of FINs are distinguished based on molecular target and mechanism of action. The lethal mechanism of the prototypic oxime-containing class III FIN, FIN56, is unique and poorly understood. FIN56 is proposed to cause ferroptosis by depleting coenzyme Q10 and degrading glutathione peroxidase 4 (GPX4). Curiously, the FIN56 analogs caspase independent lethal 56 (CIL56) and tegavivint also trigger non-apoptotic cell death but not ferroptosis. Tegavivint is a drug candidate currently being tested in humans for the treatment of cancer. Here, we review our understanding of the FIN56 lethal mechanism with a view to guiding future investigations into a privileged chemical scaffold that possesses unusual lethal activity in cancer cells.