Inhibition of SLC11A1-Mediated Lysosomal Iron Accumulation in Microglia Promotes Repair Following White Matter Stroke

White matter stroke (WMS) results in demyelinating changes and neurological deficits. However, the underlying molecular mechanisms of demyelination after stroke and the specific role of microglia in white matter rehabilitation remain incompletely elucidated. This study identifies a time-dependent accumulation of iron in microglial lysosomes mediated by solute carrier family 11 member 1 (SLC11A1), which persists from 12 h to 14 days following WMS. This iron accumulation results in damaged lysosomal myelin debris uptake and degradation in microglia. Notably, iron chelation with deferoxamine (DFO), microglia-specific knockdown of SLC11A1, and administration of LM22B-10, a SLC11A1 antagonist identified in this study, effectively reduce lysosomal iron accumulation in microglia, enhance microglial uptake and clearance of myelin debris, and ultimately promote functional recovery after WMS. Furthermore, SLC11A1 functions as a H + /Fe 2+ antiporter that transports Fe 2+ from the cytoplasm into lysosomes both in vitro and in vivo. Collectively, these results highlight that targeting SLC11A1 represents a previously unrecognized therapeutic strategy for WMS repair with significant clinical implications.