General Information of the Ferroptosis Target (ID: TAR10038)
Target Name NADPH oxidase 4 (NOX4)
Synonyms
Kidney oxidase-1; Kidney superoxide-producing NADPH oxidase; Renal NAD(P)H-oxidase
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Gene Name NOX4
Sequence
MAVSWRSWLANEGVKHLCLFIWLSMNVLLFWKTFLLYNQGPEYHYLHQMLGLGLCLSRAS
ASVLNLNCSLILLPMCRTLLAYLRGSQKVPSRRTRRLLDKSRTFHITCGVTICIFSGVHV
AAHLVNALNFSVNYSEDFVELNAARYRDEDPRKLLFTTVPGLTGVCMVVVLFLMITASTY
AIRVSNYDIFWYTHNLFFVFYMLLTLHVSGGLLKYQTNLDTHPPGCISLNRTSSQNISLP
EYFSEHFHEPFPEGFSKPAEFTQHKFVKICMEEPRFQANFPQTWLWISGPLCLYCAERLY
RYIRSNKPVTIISVMSHPSDVMEIRMVKENFKARPGQYITLHCPSVSALENHPFTLTMCP
TETKATFGVHLKIVGDWTERFRDLLLPPSSQDSEILPFIQSRNYPKLYIDGPFGSPFEES
LNYEVSLCVAGGIGVTPFASILNTLLDDWKPYKLRRLYFIWVCRDIQSFRWFADLLCMLH
NKFWQENRPDYVNIQLYLSQTDGIQKIIGEKYHALNSRLFIGRPRWKLLFDEIAKYNRGK
TVGVFCCGPNSLSKTLHKLSNQNNSYGTRFEYNKESFS

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Function
Constitutive NADPH oxidase which generates superoxide intracellularly upon formation of a complex with CYBA/p22phox. Regulates signaling cascades probably through phosphatases inhibition. May function as an oxygen sensor regulating the KCNK3/TASK-1 potassium channel and HIF1A activity. May regulate insulin signaling cascade. May play a role in apoptosis, bone resorption and lipolysaccharide-mediated activation of NFKB. May produce superoxide in the nucleus and play a role in regulating gene expression upon cell stimulation. Isoform 3 is not functional. Isoform 5 and isoform 6 display reduced activity.; [Isoform 4]: Involved in redox signaling in vascular cells. Constitutively and NADPH-dependently generates reactive oxygen species (ROS). Modulates the nuclear activation of ERK1/2 and the ELK1 transcription factor, and is capable of inducing nuclear DNA damage. Displays an increased activity relative to isoform 1.

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Gene ID 50507
Uniprot ID
Q9NPH5
Target Type Driver Suppressor Marker
Mechanism Diagram Click to View the Original Diagram
Tissue Relative Abundances of This Target
Full List of Regulator(s) of This Ferroptosis Target and Corresponding Disease/Drug Response(s)
NOX4 can be involved in and affect the ferroptosis by the following regulators, and result in corresponding disease/drug response(s). You can browse corresponding disease or drug response(s) resulting from the regulation of certain regulators.
Browse Regulator related Disease
Browse Regulator related Drug
Mothers against decapentaplegic homolog 3 (SMAD3)
Unilateral ureteral obstruction [ICD-11: MG30]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [1]
Regulator for Ferroptosis Driver
Responsed Drug Tectorigenin Investigative
Pathway Response Fatty acid metabolism hsa01212
Cell Process Cell ferroptosis
In Vitro Model
mRTECs (Mouse renal tubular epithelial cells)
In Vivo Model
The male C57BL/6 mice (8 weeks old, 22-25 g body weight) used in this study were purchased from Dashuo Bio-Technique Co. Ltd. (Chengdu, China) and were maintained in 12 hr of light/12 hr of darkness. The mice were randomly divided into the following 4 groups (n = 8 per group): Sham, UUO, UUO with tectorigenin (20 mg/kg/day, dissolved in saline with 10% dimethyl sulfoxide [DMSO]) or irbesartan (IRB, a positive control, 20 mg/kg/day) treatment. After anesthesia with 1% pentobarbital, the left ureter was exposed through the lower left incision on the midline of the back and blocked by two-point ligation with 40 silk thread as previously described. The Sham-operated mice underwent the same operation but absence of ligation. The tectorigenin and IRB group were administered intraperitoneally with drug daily for 7 consecutive days since surgery. Sham-operated mice and UUO mice were received the equal volume of solvent.

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Response Description Tectorigenin exerts as a Smad3 inhibitor to suppress Smad3 activation through an Nox4-dependent mechanism. Tectorigenin protects against unilateral ureteral obstruction by inhibiting Smad3-mediated ferroptosis and fibrosis.
Cyclic AMP-dependent transcription factor ATF-3 (ATF3)
Glioblastoma [ICD-11: 2A00]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [2]
Regulator for Ferroptosis Driver
Responsed Drug Brucine Investigative
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
Cell proliferation
In Vitro Model
U118 cells Astrocytoma Homo sapiens CVCL_0633
U87 MG-Red-Fluc cells Glioblastoma Homo sapiens CVCL_5J12
U-251MG cells Astrocytoma Homo sapiens CVCL_0021
A-172 cells Glioblastoma Homo sapiens CVCL_0131
In Vivo Model
The athymic BALB/c nude mice (4 weeks; 20-22 g; Beijing Vital River Laboratory Animal Technology Company, China) were housed in a specific pathogen-free environment under a 12-h lightdark cycle with free access to food and water. The animals were allowed to acclimatize to their surroundings for 3 days. U87 cells (1 x 106) in the logarithmic growth phase in 100 uL PBS were subcutaneously injected into the right flank. Therapeutic experiments were started when the tumor reached around 150 mm3 after about 10 days. Mice were allocated to receive intraperitoneal injections of vehicle (control group, n = 6) or 40 mg/kg bodyweight (n = 6) in the same volume (50 uL) once a day for 13 times.

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Response Description Brucine inhibited glioma cell growth in vitro and in vivo, and brucine induced ATF3 upregulation and translocation into nuclei via activation of ER stress. ATF3 promoted brucine-induced H2O2 accumulation via upregulating NOX4 and SOD1 to generate H2O2 on one hand, and downregulating catalase and xCT to prevent H2O2 degradation on the other hand.
Toll-like receptor 4 (TLR4)
Congestive heart failure [ICD-11: BD10]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [3]
Regulator for Ferroptosis Driver
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Autophagy hsa04140
Cell Process Cell ferroptosis
Cell autophagy
In Vitro Model
rHTs (Rat hippocampal tissues)
In Vivo Model
Present animal studies used male Sprague Dawley rats (80-100 g) to create a HF model induced by the descending aortic banding (AB) procedure. The sham-operated (SO) group was defined as rats subjected to a similar procedure with the exception of arterial ligation. Echocardiography was applied to confirm the arterial banding immediately after the surgical procedure.

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Response Description TLR4 or NOX4 knock-down significantly improved left ventricular remodeling and reduced myocytes death. Simultaneously, activated autophagy and ferroptosis in rats with heart failure (HF) were remarkably retarded by either TLR4 and NOX4 knock-down, suggesting TLR4-NOX4 as a potential therapeutic target for HF through inhibiting autophagy- and ferroptosis-mediated cell death.
Ischemia/reperfusion injury [ICD-11: DB98]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [4]
Regulator for Ferroptosis Driver
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model
HK-2 cells Normal Homo sapiens CVCL_0302
In Vivo Model
Adult male C57BL6 (C57) mice (8-12 weeks, 20-25 g) were purchased from the Animal Experiment Center of Wuhan University. All 64 mice were randomly divided into various groups by different treatments (n = 8). In sham group, after the right kidney excised, the left renal pedicles were without any treatment. In IRI group, the pedicle of the left kidney was clamped for 30 min followed by various reperfusion periods (6, 12, 24 h). To study the effects of LSD1, TCP (MedChemExpress) was injected intraperitoneally at different doses (2.5, 5, 10 mg/kg) before IRI model establishment, once a day for 1 week. TCP powder was dissolved in dimethyl sulfoxide (DMSO). In the vehicle control group, equal amount of DMSO was injected intraperitoneally.

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Response Description LSD1 (KDM1A) inhibition blocked ferroptosis and oxidative stress caused by renal IRI through the TLR4/NOX4 pathway, indicating that LSD1 could be a potential therapeutic target for renal ischaemia reperfusion injury (IRI).
Tafazzin (TAFAZZIN)
Hereditary Leiomyomatosis [ICD-11: 2C90]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [5]
Regulator for Ferroptosis Driver
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Hippo signaling pathway hsa04390
Cell Process Cell ferroptosis
In Vitro Model
RCC4 cells Clear cell renal cell carcinoma Homo sapiens CVCL_0498
786-O cells Renal cell carcinoma Homo sapiens CVCL_1051
HEK-293T cells Normal Homo sapiens CVCL_0063
MDA-MB-231 cells Breast adenocarcinoma Homo sapiens CVCL_0062
In Vivo Model
One million 786O cells with or without shTAZ were implanted subcutaneously into the healthy 8-week-old JAX NOD.CB17-PrkdcSCID-J mice; both male and female mice were used. Once tumor volume reached 120 mm3, mice were randomized into control or erastin treatment group. The vehicle (ORA-plus) or erastin (0.1 ml of 4 mg/ml erastin) was administrated by oral gavage twice daily for 20 days.

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Response Description Cell density-regulated ferroptosis is mediated by TAZ through the regulation of EMP1-NOX4, suggesting its therapeutic potential for renal cell carcinoma (RCC) and other TAZ-activated tumors.
rno-miR-196c-3p (miRNA)
Cerebral ischemia [ICD-11: 8B10]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [6]
Regulator for Ferroptosis Suppressor
Pathway Response Fatty acid metabolism hsa01212
Cell Process Cell ferroptosis
In Vitro Model
CHO-S/H9C2 cells Normal Cricetulus griseus CVCL_A0TS
In Vivo Model
Wild-type SD rats were kept in the Animal Experiment Center of Southeast University. Experimental rats were divided into 4 groups (n = 6 per group). The method of establishing the I/R model was provided in supplementary material. Then, we covered the ligation with gel. In order to fully cover the infarcted area of the heart, we chose to inject about 300 uL of mimics + Gel at 23 mm below the left atrial appendage (about the ligation). In order to prevent excessive irradiation of tissue burns, we selected each irradiation for 2 min to control the body surface temperature for a total of 10 min of irradiation.

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Response Description The mir-196c-3p mimic (mimics) and photothermal nanoparticles (BTN) were co-encapsulated in an injectable Gel (mimics + Gel/BTN) with NIR-II light-triggered release. Consequently, declined ferroptosis in cardiomyocytes and improved cardiac function, survival rate in rats was achieved through the controlled release of Gel/BTN mimics in cerebral ischemia-reperfusion injury model to simultaneously inhibit ferroptosis hub genes NOX4, P53, and ALOX15 expression.
Lysine-specific histone demethylase 1A (KDM1A)
Ischemia/reperfusion injury [ICD-11: DB98]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [4]
Regulator for Ferroptosis Suppressor
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model
HK-2 cells Normal Homo sapiens CVCL_0302
In Vivo Model
Adult male C57BL6 (C57) mice (8-12 weeks, 20-25 g) were purchased from the Animal Experiment Center of Wuhan University. All 64 mice were randomly divided into various groups by different treatments (n = 8). In sham group, after the right kidney excised, the left renal pedicles were without any treatment. In IRI group, the pedicle of the left kidney was clamped for 30 min followed by various reperfusion periods (6, 12, 24 h). To study the effects of LSD1, TCP (MedChemExpress) was injected intraperitoneally at different doses (2.5, 5, 10 mg/kg) before IRI model establishment, once a day for 1 week. TCP powder was dissolved in dimethyl sulfoxide (DMSO). In the vehicle control group, equal amount of DMSO was injected intraperitoneally.

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Response Description LSD1 (KDM1A) inhibition blocked ferroptosis and oxidative stress caused by renal IRI through the TLR4/NOX4 pathway, indicating that LSD1 could be a potential therapeutic target for renal ischaemia reperfusion injury (IRI).
hsa-mir-132 (Precursor RNA)
Atherosclerosis [ICD-11: BD40]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [7]
Regulator for Ferroptosis Driver
Pathway Response Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model
HUVECs (Human umbilical vein endothelial cells)
Response Description MiR-132 promotes atherosclerosis by inducing mitochondrial oxidative stress-mediated ferroptosis, which may serve as a promising therapeutic target for atherosclerosis. The key iron death protein GPX4 was significantly down-regulated and the oxidized protein NOX4 was significantly increased in miR-132-overexpressing HUVECs (P < 0.001).
Forkhead box protein O4 (FOXO4)
Cardiomyopathy [ICD-11: BC43]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [8]
Regulator for Ferroptosis Driver
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Autophagy hsa04140
Cell Process Cell ferroptosis
Cell autophagy
In Vitro Model
CHO-S/H9C2 cells Normal Cricetulus griseus CVCL_A0TS
Response Description ENPP2 was transcriptionally regulated by FoxO4 to protect cardiomyocytes from Doxorubicininduced cardiotoxicity by inhibiting ferroptosis. In addition, the inhibitory effects of ENPP2 on Dox-induced ferroptosis were significantly reduced by FoxO4 overexpression, as demonstrated by increased Fe2+ and lipid ROS activity levels, decreased SLC7A11, GPX4 and FPN1 expression, and increased NOX4 expression, which were observed following FoxO4 overexpression.
Epithelial membrane protein 1 (EMP1)
Hereditary Leiomyomatosis [ICD-11: 2C90]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [5]
Regulator for Ferroptosis Driver
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Hippo signaling pathway hsa04390
Cell Process Cell ferroptosis
In Vitro Model
RCC4 cells Clear cell renal cell carcinoma Homo sapiens CVCL_0498
786-O cells Renal cell carcinoma Homo sapiens CVCL_1051
HEK-293T cells Normal Homo sapiens CVCL_0063
MDA-MB-231 cells Breast adenocarcinoma Homo sapiens CVCL_0062
In Vivo Model
One million 786O cells with or without shTAZ were implanted subcutaneously into the healthy 8-week-old JAX NOD.CB17-PrkdcSCID-J mice; both male and female mice were used. Once tumor volume reached 120 mm3, mice were randomized into control or erastin treatment group. The vehicle (ORA-plus) or erastin (0.1 ml of 4 mg/ml erastin) was administrated by oral gavage twice daily for 20 days.

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Response Description Cell density-regulated ferroptosis is mediated by TAZ through the regulation of EMP1-NOX4, suggesting its therapeutic potential for renal cell carcinoma (RCC) and other TAZ-activated tumors.
Epidermal growth factor receptor (EGFR)
Lung cancer [ICD-11: 2C25]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [9]
Regulator for Ferroptosis Driver
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
Cell proliferation
In Vitro Model
hTERT-HME1 cells Normal Homo sapiens CVCL_3383
H1650-ER1 cells Minimally invasive lung adenocarcinoma Homo sapiens CVCL_4V01
In Vivo Model
2.5 x 105 NCI-H1650 cells were inoculated 1:1 in Matrigel: PBS (100 mL) by subcutaneous injection into eight non-obese diabetic (NOD) severe combined immunodeficiency (SCID) gamma male mice. Tumors were allowed to engraft and grow for 30 days (tumor volume averaged ~200 mm3) and mice treated by intraperitoneal (i.p.) injection with 100 mg/kg cyst(e)inase or 100 mg/kg heat-inactivated cyst(e)inase (n = 4 ea.) on day 30, with a second dose given on day 33. Mice were necropsied 24 hr after the second dose.

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Response Description In non-small-cell lung cancer (NSCLC) cells, active MAPK signaling downstream of active EGFR can sensitize cells to ferroptosis upon cystine depletion. Sensitization involves both impaired detoxification of lipid peroxides, due to reduced expression of GPX4, and generation of hydrogen peroxide, via NOX4.
Unspecific Regulator
Glioblastoma [ICD-11: 2A00]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [10]
Responsed Drug Pseudolaric acid B Investigative
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
Cell proliferation
In Vitro Model
U-87MG cells Glioblastoma Homo sapiens CVCL_0022
U-251MG cells Astrocytoma Homo sapiens CVCL_0021
SHG-44 cells Astrocytoma Homo sapiens CVCL_6728
In Vivo Model
Twenty athymic BALB/c nude mice (aged 4 weeks, weight 20-22 g, from Shanghai laboratory animal Center, Shanghai, China) were housed in a specific pathogen-free environment. A total of 1 x 106 logarithmically growing C6 cells in 100 uL of PBS were subcutaneously injected into the right flank of each mouse. Therapeutic experiments were started when the tumor reached about 150 mm3 after about 7 days. The mice were allocated to receive intraperitoneal injections of vehicle (control group, n = 5/group), PAB at the dosage of 10 mg/kg body weight (n = 10/group) and 20 mg/kg body weight (n = 10/group) in the same volume 50 uL once a days for 8 times.

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Response Description Pseudolaric acid B (PAB) improved intracellular iron by upregulation of transferrin receptor. The increased iron activated Nox4, which resulted in overproduction of H2O2and lipid peroxides. Moreover, PAB depleted intracellular GSH via p53-mediated xCT pathway, which further exacerbated accumulation of H2O2and lipid peroxides. Thus, PAB triggers ferroptosis in glioma cells and is a potential medicine for glioma treatment.
Rhabdomyosarcoma [ICD-11: 2B55]
In total 2 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [11]
Responsed Drug Diphenyleneiodonium Investigative
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model
RD cells Rhabdomyosarcoma Homo sapiens CVCL_1649
Rh18 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_1659
Rh30 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_0041
Rh36 cells Embryonal rhabdomyosarcoma Homo sapiens CVCL_M599
Rh41 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_2176
T 174 cells Rhabdomyosarcoma Homo sapiens CVCL_U955
TE 381.T cells Rhabdomyosarcoma Homo sapiens CVCL_1751
KYM-1 cells Embryonal rhabdomyosarcoma Homo sapiens CVCL_3007
Response Description Rhabdomyosarcoma (RMS) cells might be vulnerable to oxidative stress-induced cell death. The broad-spectrum protein kinase C (PKC) inhibitor Bisindolylmaleimide I as well as the PKC- and -selective inhibitor G6976 significantly reduced Erastin-induced cell death. Furthermore, the broad-spectrum nicotinamide adenine dinucleotide phosphate-oxidase (NOX) inhibitor Diphenyleneiodonium and the selective NOX1/4 isoform inhibitor GKT137831 significantly decreased Erastin-stimulated ROS, lipid ROS and cell death.
Experiment 2 Reporting the Ferroptosis-centered Disease Response of This Regulator [11]
Responsed Drug GKT137831 Phase 2
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model
RD cells Rhabdomyosarcoma Homo sapiens CVCL_1649
Rh18 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_1659
Rh30 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_0041
Rh36 cells Embryonal rhabdomyosarcoma Homo sapiens CVCL_M599
Rh41 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_2176
T 174 cells Rhabdomyosarcoma Homo sapiens CVCL_U955
TE 381.T cells Rhabdomyosarcoma Homo sapiens CVCL_1751
KYM-1 cells Embryonal rhabdomyosarcoma Homo sapiens CVCL_3007
Response Description Rhabdomyosarcoma (RMS) cells might be vulnerable to oxidative stress-induced cell death. The broad-spectrum protein kinase C (PKC) inhibitor Bisindolylmaleimide I as well as the PKC- and -selective inhibitor G6976 significantly reduced Erastin-induced cell death. Furthermore, the broad-spectrum nicotinamide adenine dinucleotide phosphate-oxidase (NOX) inhibitor Diphenyleneiodonium and the selective NOX1/4 isoform inhibitor GKT137831 significantly decreased Erastin-stimulated ROS, lipid ROS and cell death.
Gastric cancer [ICD-11: 2B72]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [12]
Responsed Drug XN4 Investigative
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model
SGC-7901 cells Gastric carcinoma Homo sapiens CVCL_0520
BGC-823 cells Gastric carcinoma Homo sapiens CVCL_3360
GES-1 cells Normal Homo sapiens CVCL_EQ22
Response Description The pro-ferroptotic role of XN4 in gastric cancer (GC) might enable it to become a promising drug for GC treatment in the future despite the need for extensive research. Moreover, GPX4 levels decreased, but NOX4 and ferroptosis-related protein PTGS2 levels increased in GC cells following XN4 treatment, which was nullified by NOX4 knockdown.
Congestive heart failure [ICD-11: BD10]
In total 2 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [13]
Responsed Drug Atorvastatin Investigative
Pathway Response Ferroptosis hsa04216
Fatty acid metabolism hsa01212
Cell Process Cell ferroptosis
Cell autophagy
In Vitro Model
CHO-S/H9C2 cells Normal Cricetulus griseus CVCL_A0TS
In Vivo Model
8-week C57BL/6J male mice purchased from Comparative Medicine Center of Yangzhou University were retained with unrestricted access to sterilized diet and water at standard bio-clean laboratory settings (Experimental Animal Center of College of Veterinary Medicine of Yangzhou University). Animals were randomly divided into four groups(n = 6-8 mice per group): control group or ISO group: injected with saline or ISO (5 mg/kg) subcutaneously for 14 days and, meanwhile, received vehicle saline via gavage for 14 days respectively; ATV (Pfizer,USA) group or ISO + ATV group: injected with saline or 5 mg/kg ISO (Sigma, USA) subcutaneously for 14 days and, meanwhile, received 20 mg/kg ATV via gavage for 14 days respectively.

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Response Description Atorvastatin showed significantly protective effects through suppressing the activation of ferroptosis related signaling, as evidenced by decreasing the mRNA levels of PTGS2 (a marker of ferroptosis), contents of malonaldehyde and protein levels of NOX4 and increasing the contents of glutathione (GSH), the ratio of GSH/GSSG and protein levels of GPX4 and SLC7A11. ATV reduced cardiac hypertrophy and fibrosis and accumulation of iron in heart failure.
Experiment 2 Reporting the Ferroptosis-centered Disease Response of This Regulator [14]
Responsed Drug Puerarin Phase 2
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model
CHO-S/H9C2 cells Normal Cricetulus griseus CVCL_A0TS
In Vivo Model
Male Sprague Dawley ratsweighing 80-100 g were used to make the HF model induced by descending aortic banding (AB) procedure. Rats receiving a similar procedure except for the arterial ligation were defined as the sham-operated (SO) group. After the procedure, echocardiography was immediately applied to confirm the arterial banding. Rats receiving subcutaneous injections of low- or high-dose puerarin (100 mg/kg/day and 200 mg/kg/day, respectively) after the AB procedure were respectively defined as the Pue1 and Pue2 groups. An equal volume of normal saline was injected into the rats of the SO and AB groups.

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Response Description Ferroptosis is involved in the loss of myocytes during heart failure. Puerarin exerted protective effects against heart failure through inhibition of ferroptosis. And puerarin exerted protective effects against heart failure through inhibition of ferroptosis. Regulation of Nox4 signaling might be involved in puerarin inhibiting ferroptosis.
Left ventricular failure [ICD-11: BD11]
In total 1 item(s) under this disease
Experiment 1 Reporting the Ferroptosis-centered Disease Response of This Regulator [15]
Responsed Drug Levosimendan Approved
Pathway Response Glutathione metabolism hsa00480
Fatty acid metabolism hsa01212
Cell Process Cell ferroptosis
In Vitro Model
rHTs (Rat hippocampal tissues)
In Vivo Model
We purchased forty-eight 3-week-old male C57BL/6N mice from Beijing HFK Bioscience Co. Ltd. and gave a twelve-hour light and dark cycle starting from 06:00 (am) to 18:00 (pm). Mice were randomly assigned into three groups after 2 weeks of adaptive feeding as follows. (1) The control group (n = 16): mice were provided with normal drinking water, a normal diet and intraperitoneal administration of solvent (5% DMSO + 40% Peg300 + 5% Tween 80 + 50% ddH2O) 3 mL/kg once a week aged 13 to 17 weeks. (2) The HFpEF group (n = 16): a double-hit model was designed, in which metabolic and mechanical stress worked together and resulted in HFpEF. Briefly, C57BL/6N mice had unrestricted access to a high-fat diet (HFD, D12492, Research Diet) starting from 5 weeks old. Meanwhile, a nitric oxide synthase inhibitor, N (gamma)-nitro-L-arginine methyl ester (L-NAME) (N5751, Sigma) was supplied in drinking water (0.5 g/L) for HFpEF groups, and the pH of the drinking water was adjusted to 7.4. The above placebo solvent was administrated in the same manner. (3) The HFpEF + Levo group (n = 16): according to the previous study, HFpEF mice received 3 mg/kg levosimendan (S2446, Selleck) (Dissolve 1 mg of levosimendan in 50 uL of DMSO, subsequently dilute to 1 mg/mL with the above solvent) intraperitoneally once a week from week 13 to 17.

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Response Description Levosimendan reversed mitochondrial malfunction in heart failure with preserved ejection fraction (HFpEF) mice, as evidenced by increased mitofilin and decreased ROS, superoxide anion, NOX4, and cytochrome C levels. Interestingly, after levosimendan administration, myocardial tissue from HFpEF mice showed restricted ferroptosis, indicated by an increased GSH/GSSG ratio; upregulated GPX4, xCT, and FSP-1 expression; and reduced intracellular ferrous ion, MDA, and 4-HNE levels. Levosimendan reverses cardiac malfunction and cardiomyocyte ferroptosis during heart failure with preserved ejection fraction via connexin 43 signaling activation.
Mothers against decapentaplegic homolog 3 (SMAD3)
Tectorigenin [Investigative]
In total 1 item(s) under this drug
Experiment 1 Reporting the Ferroptosis-centered Drug Response of This Regulator [1]
Regulator for Ferroptosis Driver
Responsed Disease Unilateral ureteral obstruction [ICD-11: MG30]
Pathway Response Fatty acid metabolism hsa01212
Cell Process Cell ferroptosis
In Vitro Model mRTECs (Mouse renal tubular epithelial cells)
In Vivo Model
The male C57BL/6 mice (8 weeks old, 22-25 g body weight) used in this study were purchased from Dashuo Bio-Technique Co. Ltd. (Chengdu, China) and were maintained in 12 hr of light/12 hr of darkness. The mice were randomly divided into the following 4 groups (n = 8 per group): Sham, UUO, UUO with tectorigenin (20 mg/kg/day, dissolved in saline with 10% dimethyl sulfoxide [DMSO]) or irbesartan (IRB, a positive control, 20 mg/kg/day) treatment. After anesthesia with 1% pentobarbital, the left ureter was exposed through the lower left incision on the midline of the back and blocked by two-point ligation with 40 silk thread as previously described. The Sham-operated mice underwent the same operation but absence of ligation. The tectorigenin and IRB group were administered intraperitoneally with drug daily for 7 consecutive days since surgery. Sham-operated mice and UUO mice were received the equal volume of solvent.

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Response Description Tectorigenin exerts as a Smad3 inhibitor to suppress Smad3 activation through an Nox4-dependent mechanism. Tectorigenin protects against unilateral ureteral obstruction by inhibiting Smad3-mediated ferroptosis and fibrosis.
Cyclic AMP-dependent transcription factor ATF-3 (ATF3)
Brucine [Investigative]
In total 1 item(s) under this drug
Experiment 1 Reporting the Ferroptosis-centered Drug Response of This Regulator [2]
Regulator for Ferroptosis Driver
Responsed Disease Glioblastoma [ICD-11: 2A00]
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
Cell proliferation
In Vitro Model U118 cells Astrocytoma Homo sapiens CVCL_0633
U87 MG-Red-Fluc cells Glioblastoma Homo sapiens CVCL_5J12
U-251MG cells Astrocytoma Homo sapiens CVCL_0021
A-172 cells Glioblastoma Homo sapiens CVCL_0131
In Vivo Model
The athymic BALB/c nude mice (4 weeks; 20-22 g; Beijing Vital River Laboratory Animal Technology Company, China) were housed in a specific pathogen-free environment under a 12-h lightdark cycle with free access to food and water. The animals were allowed to acclimatize to their surroundings for 3 days. U87 cells (1 x 106) in the logarithmic growth phase in 100 uL PBS were subcutaneously injected into the right flank. Therapeutic experiments were started when the tumor reached around 150 mm3 after about 10 days. Mice were allocated to receive intraperitoneal injections of vehicle (control group, n = 6) or 40 mg/kg bodyweight (n = 6) in the same volume (50 uL) once a day for 13 times.

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Response Description Brucine inhibited glioma cell growth in vitro and in vivo, and brucine induced ATF3 upregulation and translocation into nuclei via activation of ER stress. ATF3 promoted brucine-induced H2O2 accumulation via upregulating NOX4 and SOD1 to generate H2O2 on one hand, and downregulating catalase and xCT to prevent H2O2 degradation on the other hand.
Unspecific Regulator
Pseudolaric acid B [Investigative]
In total 1 item(s) under this drug
Experiment 1 Reporting the Ferroptosis-centered Drug Response of This Regulator [10]
Responsed Disease Glioblastoma [ICD-11: 2A00]
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
Cell proliferation
In Vitro Model U-87MG cells Glioblastoma Homo sapiens CVCL_0022
U-251MG cells Astrocytoma Homo sapiens CVCL_0021
SHG-44 cells Astrocytoma Homo sapiens CVCL_6728
In Vivo Model
Twenty athymic BALB/c nude mice (aged 4 weeks, weight 20-22 g, from Shanghai laboratory animal Center, Shanghai, China) were housed in a specific pathogen-free environment. A total of 1 x 106 logarithmically growing C6 cells in 100 uL of PBS were subcutaneously injected into the right flank of each mouse. Therapeutic experiments were started when the tumor reached about 150 mm3 after about 7 days. The mice were allocated to receive intraperitoneal injections of vehicle (control group, n = 5/group), PAB at the dosage of 10 mg/kg body weight (n = 10/group) and 20 mg/kg body weight (n = 10/group) in the same volume 50 uL once a days for 8 times.

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Response Description Pseudolaric acid B (PAB) improved intracellular iron by upregulation of transferrin receptor. The increased iron activated Nox4, which resulted in overproduction of H2O2and lipid peroxides. Moreover, PAB depleted intracellular GSH via p53-mediated xCT pathway, which further exacerbated accumulation of H2O2and lipid peroxides. Thus, PAB triggers ferroptosis in glioma cells and is a potential medicine for glioma treatment.
Diphenyleneiodonium [Investigative]
In total 1 item(s) under this drug
Experiment 1 Reporting the Ferroptosis-centered Drug Response of This Regulator [11]
Responsed Disease Rhabdomyosarcoma [ICD-11: 2B55]
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model RD cells Rhabdomyosarcoma Homo sapiens CVCL_1649
Rh18 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_1659
Rh30 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_0041
Rh36 cells Embryonal rhabdomyosarcoma Homo sapiens CVCL_M599
Rh41 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_2176
T 174 cells Rhabdomyosarcoma Homo sapiens CVCL_U955
TE 381.T cells Rhabdomyosarcoma Homo sapiens CVCL_1751
KYM-1 cells Embryonal rhabdomyosarcoma Homo sapiens CVCL_3007
Response Description Rhabdomyosarcoma (RMS) cells might be vulnerable to oxidative stress-induced cell death. The broad-spectrum protein kinase C (PKC) inhibitor Bisindolylmaleimide I as well as the PKC- and -selective inhibitor G6976 significantly reduced Erastin-induced cell death. Furthermore, the broad-spectrum nicotinamide adenine dinucleotide phosphate-oxidase (NOX) inhibitor Diphenyleneiodonium and the selective NOX1/4 isoform inhibitor GKT137831 significantly decreased Erastin-stimulated ROS, lipid ROS and cell death.
GKT137831 [Phase 2]
In total 1 item(s) under this drug
Experiment 1 Reporting the Ferroptosis-centered Drug Response of This Regulator [11]
Responsed Disease Rhabdomyosarcoma [ICD-11: 2B55]
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model RD cells Rhabdomyosarcoma Homo sapiens CVCL_1649
Rh18 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_1659
Rh30 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_0041
Rh36 cells Embryonal rhabdomyosarcoma Homo sapiens CVCL_M599
Rh41 cells Alveolar rhabdomyosarcoma Homo sapiens CVCL_2176
T 174 cells Rhabdomyosarcoma Homo sapiens CVCL_U955
TE 381.T cells Rhabdomyosarcoma Homo sapiens CVCL_1751
KYM-1 cells Embryonal rhabdomyosarcoma Homo sapiens CVCL_3007
Response Description Rhabdomyosarcoma (RMS) cells might be vulnerable to oxidative stress-induced cell death. The broad-spectrum protein kinase C (PKC) inhibitor Bisindolylmaleimide I as well as the PKC- and -selective inhibitor G6976 significantly reduced Erastin-induced cell death. Furthermore, the broad-spectrum nicotinamide adenine dinucleotide phosphate-oxidase (NOX) inhibitor Diphenyleneiodonium and the selective NOX1/4 isoform inhibitor GKT137831 significantly decreased Erastin-stimulated ROS, lipid ROS and cell death.
XN4 [Investigative]
In total 1 item(s) under this drug
Experiment 1 Reporting the Ferroptosis-centered Drug Response of This Regulator [12]
Responsed Disease Gastric cancer [ICD-11: 2B72]
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model SGC-7901 cells Gastric carcinoma Homo sapiens CVCL_0520
BGC-823 cells Gastric carcinoma Homo sapiens CVCL_3360
GES-1 cells Normal Homo sapiens CVCL_EQ22
Response Description The pro-ferroptotic role of XN4 in gastric cancer (GC) might enable it to become a promising drug for GC treatment in the future despite the need for extensive research. Moreover, GPX4 levels decreased, but NOX4 and ferroptosis-related protein PTGS2 levels increased in GC cells following XN4 treatment, which was nullified by NOX4 knockdown.
Atorvastatin [Investigative]
In total 1 item(s) under this drug
Experiment 1 Reporting the Ferroptosis-centered Drug Response of This Regulator [13]
Responsed Disease Congestive heart failure [ICD-11: BD10]
Pathway Response Ferroptosis hsa04216
Fatty acid metabolism hsa01212
Cell Process Cell ferroptosis
Cell autophagy
In Vitro Model CHO-S/H9C2 cells Normal Cricetulus griseus CVCL_A0TS
In Vivo Model
8-week C57BL/6J male mice purchased from Comparative Medicine Center of Yangzhou University were retained with unrestricted access to sterilized diet and water at standard bio-clean laboratory settings (Experimental Animal Center of College of Veterinary Medicine of Yangzhou University). Animals were randomly divided into four groups(n = 6-8 mice per group): control group or ISO group: injected with saline or ISO (5 mg/kg) subcutaneously for 14 days and, meanwhile, received vehicle saline via gavage for 14 days respectively; ATV (Pfizer,USA) group or ISO + ATV group: injected with saline or 5 mg/kg ISO (Sigma, USA) subcutaneously for 14 days and, meanwhile, received 20 mg/kg ATV via gavage for 14 days respectively.

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Response Description Atorvastatin showed significantly protective effects through suppressing the activation of ferroptosis related signaling, as evidenced by decreasing the mRNA levels of PTGS2 (a marker of ferroptosis), contents of malonaldehyde and protein levels of NOX4 and increasing the contents of glutathione (GSH), the ratio of GSH/GSSG and protein levels of GPX4 and SLC7A11. ATV reduced cardiac hypertrophy and fibrosis and accumulation of iron in heart failure.
Puerarin [Phase 2]
In total 1 item(s) under this drug
Experiment 1 Reporting the Ferroptosis-centered Drug Response of This Regulator [14]
Responsed Disease Congestive heart failure [ICD-11: BD10]
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model CHO-S/H9C2 cells Normal Cricetulus griseus CVCL_A0TS
In Vivo Model
Male Sprague Dawley ratsweighing 80-100 g were used to make the HF model induced by descending aortic banding (AB) procedure. Rats receiving a similar procedure except for the arterial ligation were defined as the sham-operated (SO) group. After the procedure, echocardiography was immediately applied to confirm the arterial banding. Rats receiving subcutaneous injections of low- or high-dose puerarin (100 mg/kg/day and 200 mg/kg/day, respectively) after the AB procedure were respectively defined as the Pue1 and Pue2 groups. An equal volume of normal saline was injected into the rats of the SO and AB groups.

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Response Description Ferroptosis is involved in the loss of myocytes during heart failure. Puerarin exerted protective effects against heart failure through inhibition of ferroptosis. And puerarin exerted protective effects against heart failure through inhibition of ferroptosis. Regulation of Nox4 signaling might be involved in puerarin inhibiting ferroptosis.
Levosimendan [Approved]
In total 1 item(s) under this drug
Experiment 1 Reporting the Ferroptosis-centered Drug Response of This Regulator [15]
Responsed Disease Left ventricular failure [ICD-11: BD11]
Pathway Response Glutathione metabolism hsa00480
Fatty acid metabolism hsa01212
Cell Process Cell ferroptosis
In Vitro Model rHTs (Rat hippocampal tissues)
In Vivo Model
We purchased forty-eight 3-week-old male C57BL/6N mice from Beijing HFK Bioscience Co. Ltd. and gave a twelve-hour light and dark cycle starting from 06:00 (am) to 18:00 (pm). Mice were randomly assigned into three groups after 2 weeks of adaptive feeding as follows. (1) The control group (n = 16): mice were provided with normal drinking water, a normal diet and intraperitoneal administration of solvent (5% DMSO + 40% Peg300 + 5% Tween 80 + 50% ddH2O) 3 mL/kg once a week aged 13 to 17 weeks. (2) The HFpEF group (n = 16): a double-hit model was designed, in which metabolic and mechanical stress worked together and resulted in HFpEF. Briefly, C57BL/6N mice had unrestricted access to a high-fat diet (HFD, D12492, Research Diet) starting from 5 weeks old. Meanwhile, a nitric oxide synthase inhibitor, N (gamma)-nitro-L-arginine methyl ester (L-NAME) (N5751, Sigma) was supplied in drinking water (0.5 g/L) for HFpEF groups, and the pH of the drinking water was adjusted to 7.4. The above placebo solvent was administrated in the same manner. (3) The HFpEF + Levo group (n = 16): according to the previous study, HFpEF mice received 3 mg/kg levosimendan (S2446, Selleck) (Dissolve 1 mg of levosimendan in 50 uL of DMSO, subsequently dilute to 1 mg/mL with the above solvent) intraperitoneally once a week from week 13 to 17.

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Response Description Levosimendan reversed mitochondrial malfunction in heart failure with preserved ejection fraction (HFpEF) mice, as evidenced by increased mitofilin and decreased ROS, superoxide anion, NOX4, and cytochrome C levels. Interestingly, after levosimendan administration, myocardial tissue from HFpEF mice showed restricted ferroptosis, indicated by an increased GSH/GSSG ratio; upregulated GPX4, xCT, and FSP-1 expression; and reduced intracellular ferrous ion, MDA, and 4-HNE levels. Levosimendan reverses cardiac malfunction and cardiomyocyte ferroptosis during heart failure with preserved ejection fraction via connexin 43 signaling activation.
References
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Ref 2 ATF3 contributes to brucine-triggered glioma cell ferroptosis via promotion of hydrogen peroxide and iron. Acta Pharmacol Sin. 2021 Oct;42(10):1690-1702. doi: 10.1038/s41401-021-00700-w. Epub 2021 Jun 10.
Ref 3 Role of TLR4/NADPH oxidase 4 pathway in promoting cell death through autophagy and ferroptosis during heart failure. Biochem Biophys Res Commun. 2019 Aug 13;516(1):37-43. doi: 10.1016/j.bbrc.2019.06.015. Epub 2019 Jun 10.
Ref 4 Lysine-specific demethylase 1 aggravated oxidative stress and ferroptosis induced by renal ischemia and reperfusion injury through activation of TLR4/NOX4 pathway in mice. J Cell Mol Med. 2022 Aug;26(15):4254-4267. doi: 10.1111/jcmm.17444. Epub 2022 Jun 30.
Ref 5 The Hippo Pathway Effector TAZ Regulates Ferroptosis in Renal Cell Carcinoma. Cell Rep. 2019 Sep 3;28(10):2501-2508.e4. doi: 10.1016/j.celrep.2019.07.107.
Ref 6 Delivery of Mir-196c-3p with NIR-II light-triggered gel attenuates cardiomyocyte ferroptosis in cardiac ischemia-reperfusion injury. Nanomedicine. 2023 Jan;47:102618. doi: 10.1016/j.nano.2022.102618. Epub 2022 Oct 18.
Ref 7 [MicroRNA-132 promotes atherosclerosis by inducing mitochondrial oxidative stressmediated ferroptosis]. Nan Fang Yi Ke Da Xue Xue Bao. 2022 Jan 20;42(1):143-149. doi: 10.12122/j.issn.1673-4254.2022.01.18.
Ref 8 Transcriptional activation of ENPP2 by FoxO4 protects cardiomyocytes from doxorubicininduced toxicity. Mol Med Rep. 2021 Sep;24(3):668. doi: 10.3892/mmr.2021.12307. Epub 2021 Jul 23.
Ref 9 Oncogene-Selective Sensitivity to Synchronous Cell Death following Modulation of the Amino Acid Nutrient Cystine. Cell Rep. 2017 Mar 14;18(11):2547-2556. doi: 10.1016/j.celrep.2017.02.054.
Ref 10 Pseudolaric acid B triggers ferroptosis in glioma cells via activation of Nox4 and inhibition of xCT. Cancer Lett. 2018 Aug 1;428:21-33. doi: 10.1016/j.canlet.2018.04.021. Epub 2018 Apr 24.
Ref 11 Targeting ferroptosis in rhabdomyosarcoma cells. Int J Cancer. 2020 Jan 15;146(2):510-520. doi: 10.1002/ijc.32496. Epub 2019 Jul 4.
Ref 12 A novobiocin derivative, XN4, triggers ferroptosis in gastric cancer cells via the activation of NOX4. Pharm Biol. 2022 Dec;60(1):1449-1457. doi: 10.1080/13880209.2022.2099431.
Ref 13 Atorvastatin treatment ameliorates cardiac function and remodeling induced by isoproterenol attack through mitigation of ferroptosis. Biochem Biophys Res Commun. 2021 Oct 15;574:39-47. doi: 10.1016/j.bbrc.2021.08.017. Epub 2021 Aug 12.
Ref 14 Puerarin protects against heart failure induced by pressure overload through mitigation of ferroptosis. Biochem Biophys Res Commun. 2018 Feb 26;497(1):233-240. doi: 10.1016/j.bbrc.2018.02.061. Epub 2018 Feb 8.
Ref 15 Levosimendan Reverses Cardiac Malfunction and Cardiomyocyte Ferroptosis During Heart Failure with Preserved Ejection Fraction via Connexin 43 Signaling Activation. Cardiovasc Drugs Ther. 2023 Mar 7. doi: 10.1007/s10557-023-07441-4. Online ahead of print.