Suppressing ferroptosis via modulating FTH1 by silybin for treatment of renal fibrosis

Background: Renal fibrosis, a hallmark pathological manifestation of chronic kidney disease, arises from diverse etiological factors. While Ferroptosis has emerged as a pivotal contributor to renal fibrogenesis, the regulatory mechanisms governing this process-particularly those involving iron metabolism-remain poorly characterized.

Objective: This study aimed to elucidate the molecular mechanism through which silybin modulates FTH1 to regulate iron homeostasis, thereby suppressing Ferroptosis and attenuating fibrotic progression in renal pathology.

Study design: The therapeutic efficacy of ferrostatin-1 (Fer-1) and silybin was systematically evaluated in complementary in vivo and in vitro renal fibrosis models. Mechanistic investigations employed FTH1 knockout and overexpression systems to validate its role as a therapeutic target.

Methods: Fibrotic inhibition was assessed histologically and via quantification of fibrotic markers. Iron ion concentrations and Reactive Oxygen Species (ROS) levels were measured using standardized commercial assay kits. The silybin-FTH1 interaction was investigated through surface plasmon resonance (SPR) analysis.

Results: Silybin administration demonstrated potent Ferroptosis inhibition, significantly ameliorating pathological alterations and fibrotic marker expression across experimental models. FTH1 ablation exacerbated ferroptotic cell death and fibrotic progression, whereas FTH1 overexpression conferred robust protection against renal fibrosis. Mechanistically, silybin directly bound FTH1 protein, stabilizing its expression to counteract iron overload-induced Ferroptosis.

Conclusions: Our study unveils FTH1 stabilization as a mechanistically novel strategy to disrupt the vicious cycle of iron overload and Ferroptosis in renal fibrosis, offering a superior alternative to conventional Ferroptosis inhibitors targeting downstream effectors.

FTH1; Ferroptosis; Renal fibrosis; Silybin.