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Potential role and therapeutic implications of
glutathione peroxidase 4 in the treatment of
Alzheimer’s disease
Yanxin Shen, Guimei Zhang, Chunxiao Wei, Panpan Zhao, Yongchun Wang, Mingxi Li, Li Sun
2025, 20 (3):
613-631.
doi: 10.4103/NRR.NRR-D-23-01343
Alzheimer’s disease is an age-related neurodegenerative disorder with a complex and
incompletely understood pathogenesis. Despite extensive research, a cure for Alzheimer’s
disease has not yet been found. Oxidative stress mediates excessive oxidative responses,
and its involvement in Alzheimer’s disease pathogenesis as a primary or secondary
pathological event is widely accepted. As a member of the selenium-containing antioxidant
enzyme family, glutathione peroxidase 4 reduces esterified phospholipid hydroperoxides
to maintain cellular redox homeostasis. With the discovery of ferroptosis, the central
role of glutathione peroxidase 4 in anti-lipid peroxidation in several diseases, including
Alzheimer’s disease, has received widespread attention. Increasing evidence suggests that
glutathione peroxidase 4 expression is inhibited in the Alzheimer’s disease brain, resulting
in oxidative stress, inflammation, ferroptosis, and apoptosis, which are closely associated
with pathological damage in Alzheimer’s disease. Several therapeutic approaches, such
as small molecule drugs, natural plant products, and non-pharmacological treatments,
ameliorate pathological damage and cognitive function in Alzheimer’s disease by
promoting glutathione peroxidase 4 expression and enhancing glutathione peroxidase 4
activity. Therefore, glutathione peroxidase 4 upregulation may be a promising strategy
for the treatment of Alzheimer’s disease. This review provides an overview of the gene
structure, biological functions, and regulatory mechanisms of glutathione peroxidase
4, a discussion on the important role of glutathione peroxidase 4 in pathological events
closely related to Alzheimer’s disease, and a summary of the advances in small-molecule
drugs, natural plant products, and non-pharmacological therapies targeting glutathione
peroxidase 4 for the treatment of Alzheimer’s disease. Most prior studies on this subject
used animal models, and relevant clinical studies are lacking. Future clinical trials are
required to validate the therapeutic effects of strategies targeting glutathione peroxidase
4 in the treatment of Alzheimer’s disease.
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