铁死亡在帕金森病发病机制中的作用研究进展
Research Progress on the Role of Ferroptosis in the Pathogenesis of Parkinson’s Disease
DOI: 10.12677/acm.2026.1693164, PDF,   
作者: 折 洁*, 华晓彤, 王佳璇:西安医学院研究生院,陕西 西安;徐瑞芬#:陕西省人民医院麻醉科,陕西 西安
关键词: 帕金森病;铁死亡;发病机制;治疗;Parkinson’s Disease; Ferroptosis; Pathogenesis; Therapy
摘要: 帕金森病(Parkinson’s Disease, PD)是全球第二大中枢神经系统退行性疾病,核心病理为中脑黑质多巴胺能神经元进行性丢失和α-突触核蛋白(α-Synuclein, α-SYN)异常聚集。铁死亡作为铁依赖性非凋亡性程序性细胞死亡,是PD神经元退变的关键机制。本文阐述铁死亡的核心调控通路,以及其与PD的交互作用,总结靶向铁死亡的干预策略及研究进展,指出当前研究不足,为PD疾病疗法的研发提供新靶点与理论依据。
Abstract: Parkinson’s disease (PD) is the second‑most prevalent neurodegenerative disorder of the central nervous system worldwide. Its core pathological hallmarks include progressive loss of dopaminergic neurons in the substantia nigra pars compacta of the midbrain and aberrant aggregation of α‑synuclein (α‑SYN). Ferroptosis, an iron‑dependent non‑apoptotic form of programmed cell death, constitutes a pivotal mechanism underlying neuronal degeneration in PD. This review elaborates on the core regulatory pathways of ferroptosis and its crosstalk with PD, summarizes intervention strategies targeting ferroptosis together with relevant research advances, and highlights existing limitations in current studies, so as to provide novel targets and theoretical evidence for the development of therapeutic approaches against PD.
文章引用:折洁, 华晓彤, 王佳璇, 徐瑞芬. 铁死亡在帕金森病发病机制中的作用研究进展[J]. 临床医学进展, 2026, 16(9): 1286-1296. https://doi.org/10.12677/acm.2026.1693164

参考文献

[1] Postuma, R.B., Berg, D., Stern, M., Poewe, W., Olanow, C.W., Oertel, W., et al. (2015) MDS Clinical Diagnostic Criteria for Parkinson’s Disease. Movement Disorders, 30, 1591-1601.
https://doi.org/10.1002/mds.26424
[2] 王刚, 徐刚, 谢心怡, 等. 中国帕金森病报告2025 [J]. 神经病学与神经康复学杂志, 2025, 21(2): 63-98.
[3] Spillantini, M.G., Schmidt, M.L., Lee, V.M., Trojanowski, J.Q., Jakes, R. and Goedert, M. (1997) α-Synuclein in Lewy Bodies. Nature, 388, 839-840.
https://doi.org/10.1038/42166
[4] 中华医学会神经病学分会帕金森病及运动障碍学组, 中国医师协会神经内科医师分会帕金森病及运动障碍专业委员会. 中国帕金森病的诊断标准(2016版) [J]. 中华神经科杂志, 2016, 49(4): 268-271.
[5] Espay, A.J., Vizcarra, J.A., Marsili, L., Lang, A.E., Simon, D.K., Merola, A., et al. (2019) Revisiting Protein Aggregation as Pathogenic in Sporadic Parkinson and Alzheimer Diseases. Neurology, 92, 329-337.
https://doi.org/10.1212/wnl.0000000000006926
[6] Dixon, S.J., Lemberg, K.M., Lamprecht, M.R., Skouta, R., Zaitsev, E.M., Gleason, C.E., et al. (2012) Ferroptosis: An Iron-Dependent Form of Nonapoptotic Cell Death. Cell, 149, 1060-1072.
https://doi.org/10.1016/j.cell.2012.03.042
[7] Yang, W.S., SriRamaratnam, R., Welsch, M.E., Shimada, K., Skouta, R., Viswanathan, V.S., et al. (2014) Regulation of Ferroptotic Cancer Cell Death by GPX4. Cell, 156, 317-331.
https://doi.org/10.1016/j.cell.2013.12.010
[8] Koppula, P., Zhuang, L. and Gan, B. (2020) Cystine Transporter SLC7A11/xCT in Cancer: Ferroptosis, Nutrient Dependency, and Cancer Therapy. Protein & Cell, 12, 599-620.
https://doi.org/10.1007/s13238-020-00789-5
[9] Chen, X., Li, J., Kang, R., Klionsky, D.J. and Tang, D. (2021) Ferroptosis: Machinery and Regulation. Autophagy, 17, 2054-2081.
https://doi.org/10.1080/15548627.2020.1810918
[10] Ursini, F., Maiorino, M., Valente, M., Ferri, L. and Gregolin, C. (1982) Purification from Pig Liver of a Protein Which Protects Liposomes and Biomembranes from Peroxidative Degradation and Exhibits Glutathione Peroxidase Activity on Phosphatidylcholine Hydroperoxides. Biochimica et Biophysica Acta—Lipids and Lipid Metabolism, 710, 197-211.
https://doi.org/10.1016/0005-2760(82)90150-3
[11] Jiang, L., Kon, N., Li, T., Wang, S., Su, T., Hibshoosh, H., et al. (2015) Ferroptosis as a P53-Mediated Activity during Tumour Suppression. Nature, 520, 57-62.
https://doi.org/10.1038/nature14344
[12] Dodson, M., Castro-Portuguez, R. and Zhang, D.D. (2019) NRF2 Plays a Critical Role in Mitigating Lipid Peroxidation and Ferroptosis. Redox Biology, 23, Article 101107.
https://doi.org/10.1016/j.redox.2019.101107
[13] Hassannia, B., Vandenabeele, P. and Vanden Berghe, T. (2019) Targeting Ferroptosis to Iron Out Cancer. Cancer Cell, 35, 830-849.
https://doi.org/10.1016/j.ccell.2019.04.002
[14] Xie, Y., Hou, W., Song, X., Yu, Y., Huang, J., Sun, X., et al. (2016) Ferroptosis: Process and Function. Cell Death & Differentiation, 23, 369-379.
https://doi.org/10.1038/cdd.2015.158
[15] Galluzzi, L., Vitale, I., Aaronson, S.A., Abrams, J.M., Adam, D., Agostinis, P., et al. (2018) Molecular Mechanisms of Cell Death: Recommendations of the Nomenclature Committee on Cell Death 2018. Cell Death & Differentiation, 25, 486-541.
https://doi.org/10.1038/s41418-017-0012-4
[16] Mou, Y., Wang, J., Wu, J., He, D., Zhang, C., Duan, C., et al. (2019) Ferroptosis, a New Form of Cell Death: Opportunities and Challenges in Cancer. Journal of Hematology & Oncology, 12, Article No. 34.
https://doi.org/10.1186/s13045-019-0720-y
[17] Tian, Y., Lu, J., Hao, X., Li, H., Zhang, G., Liu, X., et al. (2020) FTH1 Inhibits Ferroptosis through Ferritinophagy in the 6-OHDA Model of Parkinson’s Disease. Neurotherapeutics, 17, 1796-1812.
https://doi.org/10.1007/s13311-020-00929-z
[18] Do Van, B., Gouel, F., Jonneaux, A., Timmerman, K., Gelé, P., Pétrault, M., et al. (2016) Ferroptosis, a Newly Characterized Form of Cell Death in Parkinson’s Disease That Is Regulated by PKC. Neurobiology of Disease, 94, 169-178.
https://doi.org/10.1016/j.nbd.2016.05.011
[19] Sun, Y., He, L., Wang, T., Hua, W., Qin, H., Wang, J., et al. (2020) Activation of p62-Keap1-Nrf2 Pathway Protects 6-Hydroxydopamine-Induced Ferroptosis in Dopaminergic Cells. Molecular Neurobiology, 57, 4628-4641.
https://doi.org/10.1007/s12035-020-02049-3
[20] Ito, K., Eguchi, Y., Imagawa, Y., Akai, S., Mochizuki, H. and Tsujimoto, Y. (2017) MPP+ Induces Necrostatin-1-and Ferrostatin-1-Sensitive Necrotic Death of Neuronal SH-SY5Y Cells. Cell Death Discovery, 3, Article No. 17013.
https://doi.org/10.1038/cddiscovery.2017.13
[21] Zeng, X., An, H., Yu, F., Wang, K., Zheng, L., Zhou, W., et al. (2021) Benefits of Iron Chelators in the Treatment of Parkinson’s Disease. Neurochemical Research, 46, 1239-1251.
https://doi.org/10.1007/s11064-021-03262-9
[22] Tang, F., Zhou, L., Li, P., Jiao, L., Chen, K., Guo, Y., et al. (2023) Inhibition of ACSL4 Alleviates Parkinsonism Phenotypes by Reduction of Lipid Reactive Oxygen Species. Neurotherapeutics, 20, 1154-1166.
https://doi.org/10.1007/s13311-023-01382-4
[23] Zilka, O., Shah, R., Li, B., Friedmann Angeli, J.P., Griesser, M., Conrad, M., et al. (2017) On the Mechanism of Cytoprotection by Ferrostatin-1 and Liproxstatin-1 and the Role of Lipid Peroxidation in Ferroptotic Cell Death. ACS Central Science, 3, 232-243.
https://doi.org/10.1021/acscentsci.7b00028
[24] Ayton, S. and Lei, P. (2014) Nigral Iron Elevation Is an Invariable Feature of Parkinson’s Disease and Is a Sufficient Cause of Neurodegeneration. BioMed Research International, 2014, 1-9.
https://doi.org/10.1155/2014/581256
[25] Guo, J.J., Yue, F., Song, D.Y., et al. (2021) Intranasal Administration of Α-Synuclein Preformed Fibrils Triggers Microglial Iron Deposition in the Substantia Nigra of Macaca Fascicularis. Cell Death & Disease, 12, Article No. 81.
https://doi.org/10.1038/s41419-020-03369-x
[26] Li, Y., Yang, C., Wang, S., Yang, D., Zhang, Y., Xu, L., et al. (2020) Copper and Iron Ions Accelerate the Prion-Like Propagation of α-Synuclein: A Vicious Cycle in Parkinson’s Disease. International Journal of Biological Macromolecules, 163, 562-573.
https://doi.org/10.1016/j.ijbiomac.2020.06.274
[27] Bai, L., Yan, F., Deng, R., Gu, R., Zhang, X. and Bai, J. (2021) Thioredoxin-1 Rescues MPP+/MPTP-Induced Ferroptosis by Increasing Glutathione Peroxidase 4. Molecular Neurobiology, 58, 3187-3197.
https://doi.org/10.1007/s12035-021-02320-1
[28] Mochizuki, H., Choong, C. and Baba, K. (2020) Parkinson’s Disease and Iron. Journal of Neural Transmission, 127, 181-187.
https://doi.org/10.1007/s00702-020-02149-3
[29] Zheng, Z., Zhang, S., Liu, X., Wang, X., Xue, C., Wu, X., et al. (2024) LRRK2 Regulates Ferroptosis through the System Xc-GSH-GPX4 Pathway in the Neuroinflammatory Mechanism of Parkinson’s Disease. Journal of Cellular Physiology, 239, e31250.
https://doi.org/10.1002/jcp.31250
[30] Bellinger, F.P., Bellinger, M.T., Seale, L.A., Takemoto, A.S., Raman, A.V., Miki, T., et al. (2011) Glutathione Peroxidase 4 Is Associated with Neuromelanin in Substantia Nigra and Dystrophic Axons in Putamen of Parkinson’s Brain. Molecular Neurodegeneration, 6, Article No. 8.
https://doi.org/10.1186/1750-1326-6-8
[31] Liu, Z., Wang, R., Shen, M., Lan, X., Yan, W., Wang, S., et al. (2026) A LNK-CBL-HNRPA2B1-GPX4 Signaling Axis Mediates Dopaminergic Neuron Vulnerability to Ferroptosis in Parkinson’s Disease. Redox Biology, 90, Article 104039.
https://doi.org/10.1016/j.redox.2026.104039
[32] Antonini, A., Leenders, K.L., Meier, D., Oertel, W.H., Boesiger, P. and Anliker, M. (1993) T2 Relaxation Time in Patients with Parkinson’s Disease. Neurology, 43, 697-697.
https://doi.org/10.1212/wnl.43.4.697
[33] Gong, Z., Guo, D., Lin, Y., Liu, Z., Lv, M., Liu, X., et al. (2025) Deciphering Ferroptosis-Related Astrocyte Subpopulations and Diagnostic Biomarkers in Parkinson’s Disease through RNA Transcriptomics. Molecular Neurobiology, 63, Article No. 221.
https://doi.org/10.1007/s12035-025-05542-9
[34] Mahoney-Sanchez, L., Bouchaoui, H., Boussaad, I., Jonneaux, A., Timmerman, K., Berdeaux, O., et al. (2022) Alpha Synuclein Determines Ferroptosis Sensitivity in Dopaminergic Neurons via Modulation of Ether-Phospholipid Membrane Composition. Cell Reports, 40, Article 111231.
https://doi.org/10.1016/j.celrep.2022.111231
[35] Wang, L., Zhang, Y. and Guo, L. (2026) Ferroptosis in Parkinson’s Disease: A Review of Molecular Mechanisms and Emerging Therapeutic Strategies. Frontiers in Neuroscience, 20, Article 1780573.
https://doi.org/10.3389/fnins.2026.1780573
[36] Chen, L., Shen, Q., Liu, Y., Zhang, Y., Sun, L., Ma, X., et al. (2025) Homeostasis and Metabolism of Iron and Other Metal Ions in Neurodegenerative Diseases. Signal Transduction and Targeted Therapy, 10, Article No. 31.
https://doi.org/10.1038/s41392-024-02071-0
[37] Thomas, G.E.C., Zarkali, A., Ryten, M., Shmueli, K., Gil-Martinez, A.L., Leyland, L., et al. (2021) Regional Brain Iron and Gene Expression Provide Insights into Neurodegeneration in Parkinson’s Disease. Brain, 144, 1787-1798.
https://doi.org/10.1093/brain/awab084
[38] Hare, D.J. and Double, K.L. (2016) Iron and Dopamine: A Toxic Couple. Brain, 139, 1026-1035.
https://doi.org/10.1093/brain/aww022
[39] Wu, L., Liu, M., Liang, J., Li, N., Yang, D., Cai, J., et al. (2021) Ferroptosis as a New Mechanism in Parkinson’s Disease Therapy Using Traditional Chinese Medicine. Frontiers in Pharmacology, 12, Article 659584.
https://doi.org/10.3389/fphar.2021.659584
[40] Ganguly, U., Singh, S., Bir, A., Ghosh, A., Chakrabarti, S.S., Saini, R.V., et al. (2024) Alpha-Synuclein Interaction with Mitochondria Is the Final Mechanism of Ferroptotic Death Induced by Erastin in SH-SY5Y Cells. Free Radical Research, 58, 217-228.
https://doi.org/10.1080/10715762.2024.2336563
[41] Shamoto-Nagai, M., Hisaka, S., Naoi, M. and Maruyama, W. (2018) Modification of α-Synuclein by Lipid Peroxidation Products Derived from Polyunsaturated Fatty Acids Promotes Toxic Oligomerization: Its Relevance to Parkinson Disease. Journal of Clinical Biochemistry and Nutrition, 62, 207-212.
https://doi.org/10.3164/jcbn.18-25
[42] Götz, M.E., Gerstner, A., Harth, R., Dirr, A., Janetzky, B., Kuhn, W., et al. (2000) Altered Redox State of Platelet Coenzyme Q10 in Parkinson’s Disease. Journal of Neural Transmission, 107, 41-48.
https://doi.org/10.1007/s007020050003
[43] Cleren, C., Yang, L., Lorenzo, B., Calingasan, N.Y., Schomer, A., Sireci, A., et al. (2008) Therapeutic Effects of Coenzyme Q10 (CoQ 10) and Reduced Coq 10 in the MPTP Model of Parkinsonism. Journal of Neurochemistry, 104, 1613-1621.
https://doi.org/10.1111/j.1471-4159.2007.05097.x
[44] Nagatsu, T. (2024) Catecholamines and Parkinson’s Disease: Tyrosine Hydroxylase (TH) over Tetrahydrobiopterin (BH4) and GTP Cyclohydrolase I (GCH1) to Cytokines, Neuromelanin, and Gene Therapy: A Historical Overview. Journal of Neural Transmission, 131, 617-630.
https://doi.org/10.1007/s00702-023-02673-y
[45] Orrù, V., Marongiu, M., Steri, M., Marongiu, M., Sidore, C., Serra, V., et al. (2026) Genetic Co-Regulation of Neopterin and Parkinson’s Disease. npj Parkinson’s Disease, 12, Article No. 69.
https://doi.org/10.1038/s41531-026-01279-x
[46] You, L., Wang, J., Liu, T., Zhang, Y., Han, X., Wang, T., et al. (2018) Targeted Brain Delivery of Rabies Virus Glycoprotein 29-Modified Deferoxamine-Loaded Nanoparticles Reverses Functional Deficits in Parkinsonian Mice. ACS Nano, 12, 4123-4139.
https://doi.org/10.1021/acsnano.7b08172
[47] Devos, D., Moreau, C., Devedjian, J.C., Kluza, J., Petrault, M., Laloux, C., et al. (2014) Targeting Chelatable Iron as a Therapeutic Modality in Parkinson’s Disease. Antioxidants & Redox Signaling, 21, 195-210.
https://doi.org/10.1089/ars.2013.5593
[48] Finkelstein, D.I., Billings, J.L., Adlard, P.A., Ayton, S., Sedjahtera, A., Masters, C.L., et al. (2017) The Novel Compound PBT434 Prevents Iron Mediated Neurodegeneration and Alpha-Synuclein Toxicity in Multiple Models of Parkinson’s Disease. Acta Neuropathologica Communications, 5, Article No. 53.
https://doi.org/10.1186/s40478-017-0456-2
[49] Chen, L., Xue, L., Zheng, J., Tian, X., Zhang, Y. and Tong, Q. (2019) PPARß/δ Agonist Alleviates NLRP3 Inflammasome-Mediated Neuroinflammation in the MPTP Mouse Model of Parkinson’s Disease. Behavioural Brain Research, 356, 483-489.
https://doi.org/10.1016/j.bbr.2018.06.005
[50] Kupershmidt, L., Weinreb, O., Amit, T., Mandel, S., Bar-Am, O. and Youdim, M.B.H. (2011) Novel Molecular Targets of the Neuroprotective/Neurorescue Multimodal Iron Chelating Drug M30 in the Mouse Brain. Neuroscience, 189, 345-358.
https://doi.org/10.1016/j.neuroscience.2011.03.040
[51] Pechlivani, L., Giannakis, A., Sioka, C., Alexiou, G.A., Konitsiotis, S. and Kyritsis, A.P. (2025) Therapeutic Potential of Flavonoids in Parkinson’s Disease. The Journal of Nutrition, 155, 3618-3641.
https://doi.org/10.1016/j.tjnut.2025.09.022
[52] Hung, L.W., Villemagne, V.L., Cheng, L., Sherratt, N.A., Ayton, S., White, A.R., et al. (2012) The Hypoxia Imaging Agent CuII(atsm) Is Neuroprotective and Improves Motor and Cognitive Functions in Multiple Animal Models of Parkinson’s Disease. Journal of Experimental Medicine, 209, 837-854.
https://doi.org/10.1084/jem.20112285
[53] Cramer, S.L., Saha, A., Liu, J., Tadi, S., Tiziani, S., Yan, W., et al. (2017) Systemic Depletion of L-Cyst(e)ine with Cyst(e)inase Increases Reactive Oxygen Species and Suppresses Tumor Growth. Nature Medicine, 23, 120-127.
https://doi.org/10.1038/nm.4232
[54] Lv, Q.K., Tao, K.X., Yao, X.Y., et al. (2024) Melatonin MT1 Receptors Regulate the Sirt1/Nrf2/Ho-1/GPX4 Pathway to Prevent α-Synuclein-Induced Ferroptosis in Parkinson’s Disease. Journal of Pineal Research, 76, e12948.
https://doi.org/10.1111/jpi.12948
[55] Wang, J., Geng, T., Yao, X. and Liu, Y. (2025) GDF15 Attenuates Parkinson’s Disease Progression via Suppressing the Activation of cGAS-STING Pathway. Molecular and Cellular Biochemistry, 480, 4449-4466.
https://doi.org/10.1007/s11010-025-05265-4
[56] Liu, H., Zhang, T.A., Zhang, W.Y., et al. (2023) Rhein Attenuates Cerebral Ischemia-Reperfusion Injury via Inhibition of Ferroptosis through NRF2/SLC7A11/GPX4 Pathway. Experimental Neurology, 369, Article 114541.
https://doi.org/10.1016/j.expneurol.2023.114541
[57] Beal, M.F., Oakes, D., Shoulson, I., Henchcliffe, C., Galpern, W.R., Haas, R., et al. (2014) A Randomized Clinical Trial of High-Dosage Coenzyme Q10 in Early Parkinson Disease: No Evidence of Benefit. JAMA Neurology, 71, 543-552.
https://doi.org/10.1001/jamaneurol.2014.131
[58] Yan, J., Sun, W., Shen, M., Zhang, Y., Jiang, M., Liu, A., et al. (2022) Idebenone Improves Motor Dysfunction, Learning and Memory by Regulating Mitophagy in MPTP-Treated Mice. Cell Death Discovery, 8, Article No. 28.
https://doi.org/10.1038/s41420-022-00826-8
[59] Yue, M., Wei, J., Chen, W., Hong, D., Chen, T. and Fang, X. (2022) Neurotrophic Role of the Next-Generation Probiotic Strain L. Lactis MG1363-pMG36e-GLP-1 on Parkinson’s Disease via Inhibiting Ferroptosis. Nutrients, 14, Article 4886.
https://doi.org/10.3390/nu14224886
[60] Tian, Y., Wang, F., Ma, J., Huang, W., Zhang, X., Du, C., et al. (2025) Targeting Ferroptosis and Mitophagy with Neutrophil-Inspired Nanozyme for Parkinson’s Disease Therapy. Journal of Controlled Release, 384, Article 113950.
https://doi.org/10.1016/j.jconrel.2025.113950
[61] Gao, T., Wei, H., Ju, Q., Lin, Y., Yin, X., Liu, X., et al. (2025) HSPA4 Restrains Transferrin in Dopaminergic Neurons to Attenuate Ferroptosis in a Parkinson’s Disease Model. Communications Biology, 8, Article No. 1453.
https://doi.org/10.1038/s42003-025-08854-7
[62] Ercin, N., Besli, N., Beker, M. and Celik, U. (2026) Non-Canonical Cell Death in Neurodegeneration: Emerging Mechanisms and Therapeutic Frontiers. Apoptosis, 31, Article No. 72.
https://doi.org/10.1007/s10495-026-02260-y
[63] Majerníková, N., Caiado, M.J., Seinstra, R.I., Couzijn, S., Goya, M.E., Salinas, C.S., et al. (2025) Ferroptosis Inhibition Protects against α-Synuclein-Related Neuronal Cell Death. Cell Death & Disease, 17, Article No. 78.
https://doi.org/10.1038/s41419-025-08319-z
[64] Wang, W., Thomas, E.R., Xiao, R., Chen, T., Guo, Q., Liu, K., et al. (2025) Targeting Mitochondria-Regulated Ferroptosis: A New Frontier in Parkinson’s Disease Therapy. Neuropharmacology, 274, Article 110439.
https://doi.org/10.1016/j.neuropharm.2025.110439
[65] Singh, S.K., Dutta, A. and Modi, G. (2017) α-Synuclein Aggregation Modulation: An Emerging Approach for the Treatment of Parkinson’s Disease. Future Medicinal Chemistry, 9, 1039-1053.
https://doi.org/10.4155/fmc-2017-0016
[66] Devos, D., Labreuche, J., Rascol, O., Corvol, J., Duhamel, A., Guyon Delannoy, P., et al. (2022) Trial of Deferiprone in Parkinson’s Disease. New England Journal of Medicine, 387, 2045-2055.
https://doi.org/10.1056/nejmoa2209254