3.1.4 Possible ferroptosis biomarkers for AS
Prostaglandin peroxidase synthase 2 (PTGS2) gene encodes cyclic oxygenase-2 (COX-2)74. PTGS2 has been proposed as a potential ferroptosis-related biomarker for ischemic stroke75. The pathological analysis of human coronary arteries showed that the late ferroptosis-related proteins PTGS2 and ACSL4 were up-regulated, while GPX4 was down-regulated. The severity of atherosclerosis was positively correlated with the expression of PTGS2 and ACSL4, and negatively correlated with the expression of GPX4. This study further confirmed that cellular ferroptosis can regulate the development and progression of atherosclerosis. The study also suggests that PTGS2 may be a central gene in atherosclerosis68. Then, by constructing a protein-protein interaction (PPI) network and histological verification of related genes, five AS-related ferroptosis hub genes (TP53 ,MAPK1 , STAT3 , HMOX1 , and PTGS2 ) were finally identified. This study further demonstrated that PTGS2 may be a key hub gene for AS and its expressed protein may serve as a biomarker of atherosclerosis severity76. These findings may provide new ideas and potential targets for the prevention and treatment of atherosclerosis. Atherosclerosis eventually leads to clot deposits and narrowing of blood vessels, which reduces blood flow to the brain and restricts oxygen supply, eventually leading to hypoxia-ischemia and AIS. Therefore, it is necessary to understand the specific mechanism of ferroptosis in AS, so AS to provide thinking for the treatment of AS and prevention of AIS by targeting ferroptosis. However, research on ferroptosis and AS is still in its infancy. More studies will reveal the specific molecular mechanism of ferroptosis and thus provide more evidence for ferroptosis prevention and treatment of AS. (Figure 2)