Neuronal regulated cell death in aging-related neurodegenerative diseases: key pathways and therapeutic potentials

Regulated cell death (such as apoptosis, necroptosis, pyroptosis, autophagy, cuproptosis, ferroptosis, disulfidptosis) involves complex signaling pathways and molecular effectors, and has been proven to be an important regulatory mechanism for regulating neuronal aging and death. However, excessive activation of regulated cell death may lead to the progression of aging-related diseases. This review summarizes recent advances in the understanding of seven forms of regulated cell death (RCD) in age-related diseases. Notably, the newly identified ferroptosis and cuproptosis have been implicated in the risk of cognitive impairment and neurodegenerative diseases. These forms of cell death exacerbate disease progression by promoting inflammation, oxidative stress, and pathological protein aggregation. The review also provides an overview of key signaling pathways and crosstalk mechanisms among these RCD forms, with a focus on ferroptosis, cuproptosis, and disulfidptosis. For instance, FDX1 directly induces cuproptosis by regulating copper ion valency and dihydrolipoamide S-acetyltransferase (DLAT) aggregation, while copper mediates glutathione peroxidase 4 (GPX4) degradation, enhancing ferroptosis sensitivity. Additionally, inhibiting the Xc- transport system to prevent ferroptosis can increase disulfide formation and shift the NADP+/NADPH ratio, transitioning ferroptosis to disulfidptosis. These insights help to uncover the potential connections among these novel RCD forms and differentiate them from traditional RCD mechanisms. In conclusion, identifying key targets and their crosstalk points among various RCD pathways may aid in developing specific biomarkers to reverse the aging clock and treat age-related neurodegenerative conditions.