Role of ferroptosis in fibrosis:From mechanism to potential therapy

Fibrosis,which is a manifestation of the physiological response to injury characterized by excessive accumulation of extracellular matrix components,is a ubiquitous outcome of the repair process.However,in cases of repetitive or severe injury,fibrosis may become dysregulated,leading to a pathological state and organ failure.In recent years,a novel form of regulated cell death,referred to as ferroptosis,has been identified as a possible contributor to fibrosis;it is characterized by iron-mediated lipid peroxidation.It has garnered attention due to the growing body of evidence linking ferroptosis and fibrogenesis,which is believed to be driven by underlying inflammation and immune responses.Despite the increasing interest in the relationship between ferroptosis and fibrosis,a comprehensive understanding of the precise role that ferroptosis plays in the formation of fibrotic tissue remains limited.This review seeks to synthesize previous research related to the topic.We categorized the different direct and indirect mechanisms by which ferroptosis may contribute to fibrosis into three categories:(1)iron overload toxicity;(2)ferroptosis-evoked necroinflammation,with a focus on ferroptosis and macrophage interplay;and(3)ferroptosis-associated pro-fibrotic factors and pathways.Furthermore,the review considers the potential implications of these findings and highlights the utilization of ferroptosis-targeted therapies as a promising strategy for mitigating the progression of fibrosis.In conclusion,novel anti-fibrotic treatments targeting ferroptosis could be an effective treatment for fibrosis.

Current attitudes toward organ donation after cardiac death in northwest China

Background People＇s attitude toward organ donation after cardiac death （DCD） has not come to an agreement in different countries and regions.Influenced by the local culture in China for thousands of years,the general public has different ideas about this issue.The purpose of this study was to investigate the current attitudes trend and characteristics of transplantation with organs donated after cardiac death in northwest China.Methods This largest single-center cohort study was performed by an interview or by telephone using a questionnaire.The family members of potential DCD donors were recruited from the First Affiliated Hospital,medical college of Xi＇an Jiaotong University located in a metropolitan area of northwest China.The 12-item attitude questionnaire was specifically developed from the literature review with coordinator,physician,and donor＇s family feedback.The participants were asked to rate the queries on a 5-point Likert intensity scale.Results The 174 participants included 56 （32.2％） women and 118 （67.8％） men.Most people were aged between 41 and 50 years （n=63,36.2％）,31 and 40 years （n=59,33.9％）,and less than 30 years （n=36,20.7％）.The top five attitudes of participants were the best person to suggest organ donation to a family was ranked as the DCD coordinator of Red Cross Organization （RCO,n=160,92％）,donor is a hero （n=143,82.2％）,honor to be a donor＇s family member （n=136,78.2％）,improved relationship with colleagues （n=124,71.3％）,and with recipient after donation （n=123,70.7％）.The best person to suggest organ donation to a family was ranked as the coordinator of RCO （n=160,92％）,doctor unrelated to transplantation （n=104,59.8％）,social worker （n=36,20.7％）,and doctor related to transplantation （n=25,14.4％）.The top two reasons for non-consent to donation were that the family insisted on intact body after patient death and did not want to have surgery again （n=51,41.5％）,and feared that they would be misunderstood by neighbors,relatives,and friends about donation （n=28,22.8％）.Conclusions This study revealed initial attitudes toward DCD in China.Some data afford insight into the decision-making procedure.The concerns of potential DCD donors and their families may help professionals provide better interventions in the future.