Realgar Transforming Solution Triggers Ferroptosis-Associated Death in NB4 Leukemia Cells through Disruption of Iron Homeostasis and Suppression of the SLC7A11/GPX4 Axis
Abstract
Realgar (As4S4) has long been used in traditional medicine, yet its clinical application remains limited due to poor bioavailability and toxicity. Realgar transforming solution (RTS), a bioleached product generated through microbial transformation of realgar, exhibits enhanced anti-tumor activity; however, its underlying mechanism remains unclear. This study investigated whether ferroptosis contributes to the anti-leukemic effects of RTS in NB4 cells, focusing on iron homeostasis and the solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) antioxidant axis. NB4 cells were treated with RTS, arsenic trioxide (ATO), or realgar, and cell viability was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Transcriptomic profiling, biochemical assays, fluorescence probes, flow cytometry, and Western blotting were employed to evaluate ferroptosis-related changes. RTS inhibited NB4 cell viability more effectively than ATO or realgar at comparable arsenic concentrations. Transcriptomic analysis indicated significant enrichment of ferroptosis-related pathways. RTS decreased glutathione and superoxide dismutase levels, increased malondialdehyde accumulation and lipid peroxidation, disrupted mitochondrial membrane potential, and elevated intracellular total iron and mitochondrial Fe2+ levels. Additionally, RTS downregulated SLC7A11 and GPX4 and altered the expression of iron metabolism-related proteins, including transferrin receptor protein 1, nuclear receptor coactivator 4, ferritin heavy chain 1, ferroportin 1, iron-responsive element-binding protein 2, and heme oxygenase 1. Moreover, ferrostatin-1 and deferoxamine mesylate partially rescued RTS-induced cytotoxicity and alleviated oxidative damage and iron overload. These results indicate that RTS induces ferroptosis-associated cell death in NB4 cells by disrupting iron homeostasis and inhibiting the SLC7A11/GPX4 axis, supporting further investigation of RTS as a modernized arsenic-based anti-leukemic formulation.
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BibTeX
@article{yue2026realgar,
title = {{Realgar Transforming Solution Triggers Ferroptosis-Associated Death in NB4 Leukemia Cells through Disruption of Iron Homeostasis and Suppression of the SLC7A11/GPX4 Axis}},
author = {Zhaorong Yue and Qinghong Liu and Yanni Wang and Ruyue Wang and Zhongqing Li and Manjie Xu and Piao Luo and Jiaxuan Li and Jiawen Xu and Wenjun Xu and Weizhong Zhang and Jianing He and Jiayi Chen and Shahab Uddin and Yang Li and Xin Wang and Hongyu Li},
journal = {Biological and Pharmaceutical Bulletin},
year = {2026},
month = sep,
doi = {10.1248/bpb.b26-00225},
url = {https://www.jstage.jst.go.jp/article/bpb/49/9/49_b26-00225/_article},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Realgar Transforming Solution Triggers Ferroptosis-Associated Death in NB4 Leukemia Cells through Disruption of Iron Homeostasis and Suppression of the SLC7A11/GPX4 Axis
AU - Zhaorong Yue
AU - Qinghong Liu
AU - Yanni Wang
AU - Ruyue Wang
AU - Zhongqing Li
AU - Manjie Xu
AU - Piao Luo
AU - Jiaxuan Li
AU - Jiawen Xu
AU - Wenjun Xu
AU - Weizhong Zhang
AU - Jianing He
AU - Jiayi Chen
AU - Shahab Uddin
AU - Yang Li
AU - Xin Wang
AU - Hongyu Li
PY - 2026
DA - 2026/09/10
JO - Biological and Pharmaceutical Bulletin
DO - 10.1248/bpb.b26-00225
UR - https://www.jstage.jst.go.jp/article/bpb/49/9/49_b26-00225/_article
AB - Realgar (As4S4) has long been used in traditional medicine, yet its clinical application remains limited due to poor bioavailability and toxicity. Realgar transforming solution (RTS), a bioleached product generated through microbial transformation of realgar, exhibits enhanced anti-tumor activity; however, its underlying mechanism remains unclear. This study investigated whether ferroptosis contributes to the anti-leukemic effects of RTS in NB4 cells, focusing on iron homeostasis and the solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) antioxidant axis. NB4 cells were treated with RTS, arsenic trioxide (ATO), or realgar, and cell viability was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Transcriptomic profiling, biochemical assays, fluorescence probes, flow cytometry, and Western blotting were employed to evaluate ferroptosis-related changes. RTS inhibited NB4 cell viability more effectively than ATO or realgar at comparable arsenic concentrations. Transcriptomic analysis indicated significant enrichment of ferroptosis-related pathways. RTS decreased glutathione and superoxide dismutase levels, increased malondialdehyde accumulation and lipid peroxidation, disrupted mitochondrial membrane potential, and elevated intracellular total iron and mitochondrial Fe2+ levels. Additionally, RTS downregulated SLC7A11 and GPX4 and altered the expression of iron metabolism-related proteins, including transferrin receptor protein 1, nuclear receptor coactivator 4, ferritin heavy chain 1, ferroportin 1, iron-responsive element-binding protein 2, and heme oxygenase 1. Moreover, ferrostatin-1 and deferoxamine mesylate partially rescued RTS-induced cytotoxicity and alleviated oxidative damage and iron overload. These results indicate that RTS induces ferroptosis-associated cell death in NB4 cells by disrupting iron homeostasis and inhibiting the SLC7A11/GPX4 axis, supporting further investigation of RTS as a modernized arsenic-based anti-leukemic formulation.
SN - 1347-5215
SN - 0918-6158
ER -