Research progress on ferroptosis in periodontitis

Periodontitis is a chronic inflammatory disease caused by plaque microorganisms, which is the main cause of tooth loss in adults in China. Due to the complexity of periodontitis, their pathogenesis is still unclear. Ferroptosis is a form of iron-dependent regulation of cell death, which affects the function of glutathione peroxidase (GPX4) in the cell through different signaling pathways, thus decreasing antioxidant capacity, accumulation of reactive oxygen species and lipid peroxidation, eventually causing cell and tissue damage. Recent studies have found that iron overload, oxidative stress and lipid peroxidation are closely related to the occurrence and development of periodontitis. This article reviews the characteristics of ferroptosis and the relationship between ferroptosis and inflammatory diseases, especially periodontitis, to provide new ideas for the diagnosis, treatment, and prognosis evaluation of periodontitis. ferroptosis is mainly manifested as the disruption of the body's redox homeostasis, decreased antioxidant capacity, activation of damage related molecular patterns, release of pro-inflammatory mediators, and induction or exacerbation of inflammation. Iron dependent oxidative stress and lipid peroxidation are simultaneously involved in the regulation of ferroptosis and inflammatory diseases. Pathogenic bacteria of periodontitis can induce ferroptosis of periodontal ligament stem cells, thereby activating the release of inflammatory factors such as interleukin-17, tumor necrosis factor alpha, and hypoxia inducible factor-1 alpha, exacerbating periodontitis; In addition, inflammatory factors activated by ferroptosis play an important role in alveolar bone homeostasis, and ferroptosis is involved in the process of lipopolysaccharide induced inflammation of gingival fibroblasts. Future research can focus on exploring the molecular mechanisms and therapeutic targets of ferroptosis in periodontitis, providing new strategies for the prevention and treatment of periodontal disease.