Dexamethasone Promotes Autophagy Dependent Ferroptosis of Placental Trophoblast Cells Through <scp>GRα</scp>

Dexamethasone (DEX) has been extensively employed for the treatment of pregnancy disorders related to preterm birth. However, the precise mechanism by which prenatal DEX exposure affects foetal development remains unclear. This study delves into investigating the influence of DEX and ferroptosis inhibitors on the activity and ferroptosis level of placental trophoblast cells through various in vitro tests. The results demonstrated that prenatal administration of DEX led to a substantially increased ferroptosis level in placental tissues. DEX decreased cell viability, increased iron accumulation and increased lipid peroxidation. Treatment with ferroptosis inhibitors reversed these effects. Mechanistically, DEX regulated autophagy and modulated the protein levels of AMPKα/BECN1 and ATG5/ATG7/NCOA4 signalling pathways by inhibiting its receptor GRα. Additionally, autophagy activation mediated through the AMPKα/BECN1 axis and ferritin degradation via ATG5/ATG7/NCOA4 signalling was associated with DEX-induced ferroptosis. Overall, this study provides experimental evidence supporting the detrimental side effects of DEX on preterm pregnancy-related disorders. It identified that AMPKα/BECN1 and ATG5/ATG7/NCOA4 were key pathways by which DEX induced autophagy-dependent ferroptosis in placental trophoblast cells.