Multiple oestradiol functions inhibit ferroptosis and acute kidney injury

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

Abstract

Acute tubular necrosis mediates acute kidney injury (AKI) and nephron loss1, the hallmark of end-stage renal disease2-4. For decades, it has been known that female kidneys are less sensitive to AKI5,6. Acute tubular necrosis involves dynamic cell death propagation by ferroptosis along the tubular compartment7,8. Here we demonstrate abrogated ferroptotic cell death propagation in female kidney tubules. 17β-oestradiol establishes an anti-ferroptotic state through non-genomic and genomic mechanisms. These include the potent direct inhibition of ferroptosis by hydroxyoestradiol derivatives, which function as radical trapping antioxidants, are present at high concentrations in kidney tubules and, when exogenously applied, protect male mice from AKI. In cells, the oxidized hydroxyoestradiols are recycled by FSP19,10, but FSP1-deficient female mice were not sensitive to AKI. At the genomic level, female ESR1-deficient kidney tubules partially lose their anti-ferroptotic capacity, similar to ovariectomized mice. While ESR1 promotes the anti-ferroptotic hydropersulfide system, male tubules express pro-ferroptotic proteins of the ether lipid pathway which are suppressed by ESR1 in female tissues until menopause. In summary, we identified non-genomic and genomic mechanisms that collectively explain ferroptosis resistance in female tubules and may function as therapeutic targets for male and postmenopausal female individuals.

Details

Original languageEnglish
Pages (from-to)1011-1019
Number of pages9
JournalNature
Volume645
Issue number8082
Publication statusPublished - Sept 2025
Peer-reviewedYes

External IDs

PubMedCentral PMC12460175
Scopus 105013283984
ORCID /0000-0001-8423-6173/work/200627186
ORCID /0000-0001-8893-5326/work/200630947
ORCID /0000-0002-4692-3885/work/200630953
ORCID /0000-0003-2739-345X/work/200631310
ORCID /0000-0001-6287-9725/work/200631352
ORCID /0000-0002-9728-1413/work/200631405

Keywords

Keywords

  • Ferroptosis/drug effects, Animals, Acute Kidney Injury/pathology, Female, Male, Mice, Estradiol/pharmacology, Estrogen Receptor alpha/metabolism, Kidney Tubules/metabolism, Humans, Mice, Inbred C57BL, Ovariectomy