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The Signaling Pathway of lipid peroxidation. In hyperglycemia, hyperlipidemia, and hypoxia, NOX catalyzes the reaction of H2O2 with lipids to produce ROS, leading to ferroptosis. ACSL4 attaches coenzyme A (CoA) to AA/AdA forming AdA-CoA, then LPCAT3 facilitates AdA-CoA esterification in the cell membrane to form AA/AdA-PE which could be directly oxidized to AA/AdA-PE-OOH by LOX, eventually causing ferroptosis.
