Peroxiredoxins as novel indicators in multiple myeloma associated with ferroptosis and immune infiltration

We investigate the clinical significance of the peroxiredoxin (PRDX) family in multiple myeloma (MM) patients, focusing on its diagnostic and prognostic value, biological role and impact on the immune system. Using bioinformatics tools, such as CCLE, GEO, TCGA-MMRF, Kaplan-Meier plotter, enrichment and CIBERSORT analyses, we systematically characterized the expression levels, impact on survival and biological significance of PRDXs in MM. Bone marrow aspiration and clinical data were subsequently collected from MM patients to validate the findings related to PRDX2 from the databases. Finally, PRDX2 silencing in vitro modulated cell proliferation, immune infiltration and ferroptosis susceptibility. Compared with those in normal plasma cells, the expression levels of PRDX2/4/5/6 were significantly increased in myeloma cells. Furthermore, in relapsed MM cells, PRDX1/2/3/6 expression was significantly upregulated compared with that at baseline. Notably, PRDX2 was found to be highly expressed and associated with poor tumor characteristics, potentially contributing to disease progression and correlating with unfavourable prognosis. PRDX-related genes participate in various biological functions, influence metabolic pathways and may regulate ferroptosis and immune-related pathways in myeloma cells. This study is the first comprehensive analysis of the potential diagnostic and prognostic impact of the PRDXs family in MM, highlighting their significant associations with ferroptosis and the immune microenvironment. These findings provide a strong experimental and theoretical foundation for developing novel therapeutic strategies targeting ferroptosis and immunotherapy in MM.