Despite the central role of mitochondria in oxidative

Despite the central role of mitochondria in oxidative metabolism, it remains unclear whether mitochondria play a central role in ferroptosis. Supporting this possibility, ferroptosis is associated with dramatic morphological changes of mitochondria, including mitochondrial fragmentation and cristae enlargement (Dixon et al., 2012, Doll et al., 2017), and some potent ferroptosis inhibitors appear to be exquisitely targeted to mitochondria (Krainz et al., 2016). Furthermore, glutamine metabolism, known as glutaminolysis, is required for cysteine-deprivation-induced (CDI) ferroptosis (Gao et al., 2015a, Gao et al., 2015b), and one of the major functions of glutaminolysis is to fuel the mitochondrial tricarboxylic capmatinib (TCA) cycle. Intriguingly, mitochondrial glutaminase (GLS), GLS2, instead of cytosolic GLS1, has been shown to be required for ferroptosis, although both enzymes catalyze glutaminolysis (Cassago et al., 2012, Gao et al., 2015a, Jennis et al., 2016). All these observations are consistent with the potential involvement of mitochondria in ferroptosis. However, there is also strong evidence arguing against a major role of mitochondria in ferroptosis. For example, a comparison between a mitochondrial DNA-depleted (ρ0) cancer cell line and its parental line did not show a significant difference in ferroptosis sensitivity (Dixon et al., 2012), and a mechanistic investigation into a cohort of ferrostatin analogs (inhibitors of ferroptosis) failed to establish a correlation between mitochondrial localization of ferrostatins with their anti-death potency (Gaschler et al., 2018). Taken together, the functional relevance of mitochondria in ferroptosis is still highly debatable. In this study, through a series of cellular, molecular, pharmacological, and metabolomic analyses, we demonstrated that the mitochondrion is a crucial player in ferroptosis induced by cysteine deprivation (inhibition of system Xc− by erastin or using culture medium free of cystine). Mechanistically, the canonical metabolic activity of mitochondria, including both the TCA cycle and mitochondrial electron transport chain (ETC) activity, are required for the generation of sufficient lipid ROS to initiate ferroptosis. Furthermore, cancer cells deficient of the mitochondrial tumor suppressor fumarate hydratase (FH) are resistant to CDI ferroptosis—this result supports the notion that ferroptosis might be a physiologically relevant tumor suppressive mechanism and provides insights into potential ferroptosis-inducing cancer therapeutic approaches. Importantly, the role of mitochondria in ferroptosis is context dependent; if the activity of the glutathione-dependent peroxidase (GPX4) is inhibited, cells undergo ferroptosis independent of mitochondrial function.
Results
Discussion Cellular metabolism and ferroptosis closely interact with one another, and lipid ROS, mainly a product of oxygen/iron-driven metabolism, is essential for the execution of ferroptosis. For these reasons, it appears logical that mitochondria should play a central role in ferroptosis. Nonetheless, whether the mitochondria are an important component in ferroptosis remains highly controversial. In this study, we present evidence to demonstrate that the mitochondrion is indeed a crucial player in ferroptotic cell death induced by cysteine deprivation. When mitochondria are depleted via Parkin-dependent mitophagy, cells become more resistant to ferroptosis upon CC starvation or pharmacological inhibition of CC import (Figure 1). Mechanistically, we showed that the role of the mitochondrion in ferroptosis is due to its metabolic function, and both mitochondrial TCA cycle and the action of ETC are required for a potent ferroptosis (Figures 2, 3, S2, and S3). Ferroptotic function of TCA cycle is the reason why glutaminolysis, a major source of anaplerosis, is required for ferroptosis (Figures 2 and S2). Why, then, is the role of mitochondria in ferroptosis so controversial? The following three reasons can reconcile this discrepancy. First, our study indicates that the role of mitochondria in ferroptosis is context dependent: blockage of mitochondrial function potently inhibits CDI ferroptosis; however, upon elimination or pharmacological inhibition of GPX4, the very downstream component of the ferroptosis pathway responsible for lipid ROS clearance, cells can commit ferroptosis independently of mitochondria (Figures 5 and S5). When cysteine is scarce, mitochondrial metabolism contributes significantly to rapid glutathione depletion and subsequent lipid ROS generation and ferroptosis. On the other hand, upon GPX4 inhibition, although one would predict that inhibition of mitochondria should also attenuate lipid ROS generation and thus may at least delay ferroptosis, we did not observe a measurable effect of mitochondrial ETC inhibitors on slowing down ferroptosis in GPX4-KO HT1080 cells (Figure S5D). It is likely that once GPX4 is eliminated, the low amount of lipid ROS produced by other mechanisms will be rapidly amplified through the Fenton chain reaction, leading to full-blown ferroptotic cell death even when mitochondrial activity is diminished. It is also possible that GPX4 inactivation may transduce a signal to, and thus hyperactivate, certain enzymes responsible for lipid ROS generation. Future investigation is needed to clarify this issue. Second, since ferroptosis is dictated by cellular metabolism, long-term alteration of cellular metabolism may rewire the molecular processes underlying ferroptosis. For example, in a type of experimental model cells known as ρ0 cells, mitochondrial DNA is depleted permanently (King and Attardi, 1989, King and Attardi, 1996). To compensate the long-term lack of mitochondria, these cells need to be cultured with nutrients different from mitochondria-containing cells (King and Attardi, 1989, King and Attardi, 1996). Therefore, metabolism in ρ0 cells, including lipid ROS generation (mainly a consequence of metabolism), is fundamentally rewired. For this reason, the mechanism governing the mitochondria-independent ferroptosis in ρ0 cells may differ significantly from that in normal, mitochondria-containing cells. Third, the methods for cell death measurement need to be carefully considered. For example, although cell viability assays are often used to infer cell death, they are not suitable for the study of the role of mitochondria in ferroptosis. This is because that manipulation of mitochondrial function may impact the outcome of these assays (many of them are ATP content based or metabolic activity based), regardless of cell death status. Assays directly measuring cell death are preferable for this purpose.