MARCHF6 regulates ferroptosis in myocardial ischemia-reperfusion injury via the ADAMTS4/SDC-1 pathway

Reports indicate that MARCHF6 can regulate ferroptosis. • The high expression of MARCHF6 alleviates myocardial ischemia-reperfusion injury. • Elevated MARCHF6 expression inhibits ferroptosis in CMECs. • MARCHF6 regulates ferroptosis through the ADAMTS4/SDC-1 pathway. • MARCHF6 is a promising therapeutic target for MIRI. Myocardial ischemia-reperfusion injury is a key factor affecting prognosis after acute myocardial infarction. MARCHF6, as an E3 ubiquitin ligase, is closely implicated in the ferroptosis process. The role of MARCHF6 in MIRI and its mechanism for regulating myocardial cell ferroptosis remained unclear. A mouse model of MIRI overexpressing MARCHF6 was established by tail vein injection of MARCHF6-overexpressing AAV9 virus, followed by left anterior descending coronary artery ligation surgery in mice. High expression of MARCHF6 significantly improved cardiac function and reduced myocardial injury in MIRI mice. Compared with the MIRI mice, the MARCHF6 overexpression mice exhibited a reduction of approximately 14% in myocardial infarction area. Histological damage in the cardiac ischemic penumbra region was markedly alleviated, and the number of cell deaths was significantly decreased. Concurrently, MARCHF6 overexpression substantially reduced serum levels of myocardial injury markers CK-MB, cTnI, and LDH. Mitochondrial morphological alterations and expression of ferroptosis-related indicators in the ischemic penumbra of the heart indicated that MARCHF6 overexpression alleviated ferroptosis in MIRI hearts. In an OGD/R-induced cardiomyocyte microvascular endothelial cell (CMEC) model, MARCHF6 overexpression alleviated lipid peroxidation and inhibited ferroptosis. MARCHF6 overexpression suppressed the upregulation of ACSL4 and 4-HNE while blocking the downregulation of SLC7A11 and GPX4 in vivo and vitro . Mechanistically, MARCHF6 promoted the ubiquitin-mediated degradation of ADAMTS4, thereby upregulating its downstream target SDC-1. This sequence of events inhibits lipid peroxidation, mitigates mitochondrial damage, and ultimately blocks the ferroptosis process in endothelial cells. These findings unveil a novel regulatory pathway involving MARCHF6/ADAMTS4/SDC-1 against MIRI by inhibiting ferroptosis. Download: Download high-res image (104KB) Download: Download full-size image