Ginsenoside Re attenuates homocysteine‑induced endothelial cell ferroptosis through upregulation of GPX4/xCT signaling

Endothelial dysfunction is a key pathophysiological basis of atherosclerosis (AS). Potential mechanisms by which Hcy causes vascular injury include inhibiting endothelial cell growth, inducing endothelial dysfunction, and promoting vascular remodeling. Suppression of GPX4 synthesis can lead to exacerbated lipid peroxidation, triggering ferroptosis. The objective of the present study was to investigate whether ginsenoside Re attenuates homocysteine (Hcy)-induced endothelial cell ferroptosis by upregulating glutathione peroxidase 4 (GPX4). After treating EA.hy926 cells with different concentrations of Hcy for 24 h, cell viability was assessed using an MTT assay to determine the appropriate concentrations of Hcy for establishing a cell damage model. EA.hy926 cells were then divided into the following four groups: Control group, Hcy group, low-dose ginsenoside Re + Hcy group and high-dose ginsenoside Re + Hcy group. Cell viability was assessed using an MTT assay, whereas the BODIPY^™ 581/591 C11 probe was used to measure cellular lipid peroxidation levels. Additionally, a 2',7'-dichlorodihydrofluorescein diacetate probe was used to measure the intracellular reactive oxygen species (ROS) content, while a microplate reader was used in combination with corresponding assay kits to measure the intracellular glutathione (GSH), malondialdehyde (MDA) and total iron ion levels. Furthermore, western blotting was conducted to determine the expression levels of GPX4, solute carrier family 7 member 11 (SLC7A11) and acyl-CoA synthetase long-chain family member 4 in the cells. Results demonstrated that high-dose and low-dose ginsenoside Re significantly alleviated the reduction in cell viability induced by Hcy and reduced the increase in ROS and lipid peroxide levels caused by Hcy. High concentrations of ginsenoside Re effectively mitigated the increase in MDA and total iron ion levels and the decrease in GSH levels induced by Hcy. Furthermore, western blotting results revealed that compared with the control group, the Hcy group exhibited lower expression levels of GPX4 and SLC7A11, while ACSL4 expression was elevated. By contrast, both low- and high-concentration ginsenoside Re significantly increased GPX4 and SLC7A11 expression levels and decreased ACSL4 expression levels compared with the Hcy group. In conclusion, ginsenoside Re significantly increased the expression levels of GPX4 in EA.hy926 cells and alleviated Hcy-induced endothelial cell ferroptosis. Ginsenoside Re may prevent microvascular endothelial dysfunction and subsequent tissue damage by reducing ferroptosis and protecting endothelial cells.