{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:49:43Z","timestamp":1782276583720,"version":"3.54.5"},"reference-count":113,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Despite significant progress in lipid-lowering and anti-thrombotic therapies, atherosclerosis remains a leading cause of myocardial infarctions and ischemic strokes. Residual risk persists, often linked to sustained vascular inflammation, oxidative stress, and plaque instability\u2014processes that converge on lipid peroxidation pathways within the arterial wall. Ferroptosis, an iron-dependent form of regulated cell death, occurs when antioxidant defenses fail, leading to toxic accumulation of phospholipid peroxides. Atherosclerotic plaques provide a permissive microenvironment rich in oxidized lipids, redox-active iron, inflammatory mediators, and hypoxia, suggesting ferroptosis may contribute to endothelial barrier dysfunction, macrophage foam cell death, vascular smooth muscle cell loss, and necrotic core expansion. However, current understanding is constrained by operational definition inconsistencies, reliance on non-specific oxidative stress markers, and insufficient validation in human plaques. This review systematically synthesizes knowledge on ferroptosis in arterial atherosclerosis, incorporating core pathway dynamics\u2014iron homeostasis, polyunsaturated phospholipid metabolism, and lipid peroxide detoxification via systems like Xc\u2013GPX4\u2014alongside parallel protective axes. It evaluates cell-type-specific vulnerabilities across disease stages, highlighting how disturbed flow, dyslipidemia, metabolic disorders, and innate immune signaling modulate ferroptosis susceptibility and plaque phenotype. The analysis extends to candidate biomarkers, tissue-level signatures, and therapeutic strategies targeting iron availability, lipid peroxidation, or key regulatory proteins, while addressing safety concerns and experimental gaps. Ultimately, delineating ferroptosis-specific signatures in human tissues and establishing causality through cell-targeted interventions are vital for translating this pathway into clinically actionable risk assessment and management strategies.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1868492","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:44:07Z","timestamp":1782276247000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ferroptosis in arterial atherosclerosis: mechanistic hypotheses, cell type specific vulnerabilities, translational biomarkers, and therapeutic opportunities"],"prefix":"10.3389","volume":"17","author":[{"given":"Cai","family":"Li","sequence":"first","affiliation":[{"name":"College of Basic Medical Science, Qilu Medical University","place":["Zibo, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinxia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Binzhou Medical University Hospital","place":["Binzhou, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Sun","sequence":"additional","affiliation":[{"name":"College of Basic Medical Science, Qilu Medical University","place":["Zibo, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.3390\/biomedicines10081938","article-title":"Pathophysiology of cardiovascular diseases: New insights into molecular mechanisms of atherosclerosis, arterial hypertension, and coronary artery disease","volume":"10","author":"Fr\u0105k","year":"2022","journal-title":"Biomedicines"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24097910","article-title":"Atherosclerosis and inflammation: Insights from the theory of general pathological processes","volume":"24","author":"Gusev","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B3","doi-asserted-by":"publisher","first-page":"7295","DOI":"10.3390\/ijms25137295","article-title":"From atherosclerotic plaque to myocardial infarction-the leading cause of coronary artery occlusion","volume":"25","author":"M\u0142ynarska","year":"2024","journal-title":"Int J Mol Sci"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2023.106873","article-title":"Apolipoprotein B compared with low-density lipoprotein cholesterol in the atherosclerotic cardiovascular diseases risk assessment","volume":"195","author":"Galimberti","year":"2023","journal-title":"Pharmacol Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/s43556-024-00218-7","article-title":"The functions of apolipoproteins and lipoproteins in health and disease","volume":"5","author":"Ma","year":"2024","journal-title":"Mol BioMed"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-021-00613-5","article-title":"Apolipoproteins in vascular biology and atherosclerotic disease","volume":"19","author":"Mehta","year":"2022","journal-title":"Nat Rev Cardiol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1096\/fj.202403281r","article-title":"Refining the impact of early intermittent hyperlipidemia on atherosclerosis: Unveiling the role of neutrophil reprogramming, sex differences, gut microbiota, and maternal hypercholesterolemia","volume":"39","author":"Cabrera-Fuentes","year":"2025","journal-title":"FASEB J"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2021.05.011","article-title":"SIRT1-autophagy axis inhibits excess iron-induced ferroptosis of foam cells and subsequently increases IL-1B and IL-18","volume":"561","author":"Su","year":"2021","journal-title":"Biochem Biophys Res Commun"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1186\/s11658-026-00941-9","article-title":"Implications of ferritinophagy in cardiovascular diseases and its pharmacological modulation: underlying mechanisms and clinical translation strategies","author":"Wu","year":"2026","journal-title":"Cell Mol Biol Lett"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-023-00957-0","article-title":"Programmed death of macrophages in atherosclerosis: Mechanisms and therapeutic targets","volume":"21","author":"De Meyer","year":"2024","journal-title":"Nat Rev Cardiol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1161\/atvbaha.124.319396","article-title":"Differences in stable and unstable atherosclerotic plaque","volume":"44","author":"Kawai","year":"2024","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-024-01037-7","article-title":"Efferocytosis in atherosclerosis","volume":"21","author":"Adkar","year":"2024","journal-title":"Nat Rev Cardiol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/sji.13251","article-title":"Macrophage efferocytosis in atherosclerosis","volume":"97","author":"Baraniecki","year":"2023","journal-title":"Scand J Immunol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.585285","article-title":"Potential mechanisms and effects of efferocytosis in atherosclerosis","volume":"11","author":"Wang","year":"2021","journal-title":"Front Endocrinol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/jcp.30366","article-title":"Role of pyroptosis in atherosclerosis and its therapeutic implications","volume":"236","author":"He","year":"2021","journal-title":"J Cell Physiol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1161\/atvbaha.122.318177","article-title":"Regulated necrosis in atherosclerosis","volume":"42","author":"Puylaert","year":"2022","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2022.07.004","article-title":"Necroptosis in atherosclerosis","volume":"534","author":"Zhang","year":"2022","journal-title":"Clin Chim Acta"},{"key":"B18","doi-asserted-by":"publisher","first-page":"104546","DOI":"10.1016\/j.drudis.2025.104546","article-title":"Regulators of system xc\u2014glutathione-glutathione peroxidase 4 antioxidant pathway: Recent advances and challenges in targeting ferroptosis for cancer treatment","volume":"30","author":"Gupta","year":"2025","journal-title":"Drug Discov Today"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.910292","article-title":"System X(c) (-)\/GSH\/GPX4 axis: An important antioxidant system for the ferroptosis in drug-resistant solid tumor therapy","volume":"13","author":"Li","year":"2022","journal-title":"Front Pharmacol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s10637-021-01070-0","article-title":"System Xc-: A key regulatory target of ferroptosis in cancer","volume":"39","author":"Liu","year":"2021","journal-title":"Invest New Drugs"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s10565-022-09778-2","article-title":"Ferroptosis: From regulation of lipid peroxidation to the treatment of diseases","volume":"39","author":"Lv","year":"2023","journal-title":"Cell Biol Toxicol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1038\/s41419-021-04054-3","article-title":"Ferroptosis: the potential value target in atherosclerosis","volume":"12","author":"Ouyang","year":"2021","journal-title":"Cell Death Dis"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1096\/fj.202201486r","article-title":"The role of metabolic reprogramming of oxygen\u2010induced macrophages in the dynamic changes of atherosclerotic plaques","volume":"37","author":"Shen","year":"2023","journal-title":"FASEB J"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1080\/15548627.2020.1810918","article-title":"Ferroptosis: machinery and regulation","volume":"17","author":"Chen","year":"2021","journal-title":"Autophagy"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1007\/s12035-023-03640-0","article-title":"Mechanisms of ferritinophagy and ferroptosis in diseases","volume":"61","author":"Li","year":"2024","journal-title":"Mol Neurobiol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1002\/anie.202300379","article-title":"Ferroptosis detection: from approaches to applications","volume":"135","author":"Zeng","year":"2023","journal-title":"Angew Chem"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2025.11.010","article-title":"Chronic intermittent cold stress-induced lipophagy promotes foamy macrophage susceptibility to ferroptosis and exacerbates atherosclerosis","volume":"242","author":"Zhao","year":"2026","journal-title":"Free Radical Biol Med"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/9304383","article-title":"High level of uric acid promotes atherosclerosis by targeting NRF2-mediated autophagy dysfunction and ferroptosis","volume":"2022","author":"Yu","year":"2022","journal-title":"Oxid Med Cell Longevity"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3390\/cells12050804","article-title":"Polyunsaturated fatty acids drive lipid peroxidation during ferroptosis","volume":"12","author":"Mortensen","year":"2023","journal-title":"Cells"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcb.2023.05.003","article-title":"Regulation of ferroptosis by lipid metabolism","volume":"33","author":"Pope","year":"2023","journal-title":"Trends Cell Biol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1002\/pmic.202100308","article-title":"A tale of two lipids: lipid unsaturation commands ferroptosis sensitivity","volume":"23","author":"Rodencal","year":"2023","journal-title":"PROTEOMICS"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2023.05.013","article-title":"FSP1: A key regulator of ferroptosis","volume":"29","author":"Li","year":"2023","journal-title":"Trends Mol Med"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1111\/cpr.13525","article-title":"Comprehensive view of macrophage autophagy and its application in cardiovascular diseases","volume":"57","author":"Pan","year":"2024","journal-title":"Cell Prolif"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3390\/biology10030184","article-title":"Lipid metabolism and ferroptosis","volume":"10","author":"Lee","year":"2021","journal-title":"Biology"},{"key":"B35","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1089\/ars.2023.0278","article-title":"Dynamic regulation of ferroptosis by lipid metabolism","volume":"39","author":"Naowarojna","year":"2023","journal-title":"Antioxid Redox Signal"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1016\/j.cell.2024.01.030","article-title":"Phospholipids with two polyunsaturated fatty acyl tails promote ferroptosis","volume":"187","author":"Qiu","year":"2024","journal-title":"Cell"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/1225578","article-title":"ROS: Basic concepts, sources, cellular signaling, and its implications in aging pathways","volume":"2022","author":"de Almeida","year":"2022","journal-title":"Oxid Med Cell Longev"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1021\/acs.chemrev.3c00608","article-title":"The chemical reactivity of membrane lipids","volume":"124","author":"Duch\u00e9","year":"2024","journal-title":"Chem Rev"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.5772\/intechopen.95802","article-title":"Lipid peroxidation","author":"Onur Yaman","year":"2021"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1111\/cpr.70154","article-title":"Insights into macrophage ferroptosis: Implications for atherosclerosis","volume":"59","author":"Chen","year":"2025","journal-title":"Cell Prolif"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1096\/fj.202201486r","article-title":"The role of metabolic reprogramming of oxygen-induced macrophages in the dynamic changes of atherosclerotic plaques","volume":"37","author":"Shen","year":"2023","journal-title":"FASEB J"},{"key":"B42","doi-asserted-by":"publisher","first-page":"368","DOI":"10.21037\/atm-21-6942","article-title":"The critical role and molecular mechanisms of ferroptosis in antioxidant systems: A narrative review","volume":"10","author":"Liu","year":"2022","journal-title":"Ann Transl Med"},{"key":"B43","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1152\/physrev.00031.2024","article-title":"Ferroptosis: when metabolism meets cell death","volume":"105","author":"Zheng","year":"2025","journal-title":"Physiol Rev"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2022.810327","article-title":"Blockade of GCH1\/BH4 axis activates ferritinophagy to mitigate the resistance of colorectal cancer to erastin-induced ferroptosis","volume":"10","author":"Hu","year":"2022","journal-title":"Front Cell Dev Biol"},{"key":"B45","article-title":"Role of GTP cyclohydrolase I in mitigating oxidative stress in glioblastoma","volume-title":"The University of Alabama at Birmingham","author":"Tuy","year":"2023"},{"key":"B46","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1093\/cvr\/cvae270","article-title":"Iron, lipid peroxidation, and ferroptosis play pathogenic roles in atherosclerosis","volume":"121","author":"Jinson","year":"2025","journal-title":"Cardiovasc Res"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2021.809955","article-title":"Autophagy, pyroptosis, and ferroptosis: New regulatory mechanisms for atherosclerosis","volume":"9","author":"Lin","year":"2021","journal-title":"Front Cell Dev Biol"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-024-01251-1","article-title":"The role of iron in atherosclerosis and its association with related diseases","volume":"27","author":"Gao","year":"2025","journal-title":"Curr Atheroscler Rep"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2021.781839","article-title":"Heme in cardiovascular diseases: A ubiquitous dangerous molecule worthy of vigilance","volume":"9","author":"Guo","year":"2021","journal-title":"Front Cell Dev Biol"},{"key":"B50","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.12307\/2025.299","article-title":"ACSL4 mediates ferroptosis and its potential role in atherosclerotic cardiovascular disease","volume":"29","author":"Gao","year":"2025","journal-title":"Chin J Tissue Eng Res"},{"key":"B51","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1089\/ars.2023.0237","article-title":"LPCAT3 is transcriptionally regulated by YAP\/ZEB\/EP300 and collaborates with ACSL4 and YAP to determine ferroptosis sensitivity","volume":"39","author":"Cui","year":"2023","journal-title":"Antioxid Redox Signal"},{"key":"B52","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1038\/s41419-023-05645-y","article-title":"Glutathione system enhancement for cardiac protection: pharmacological options against oxidative stress and ferroptosis","volume":"14","author":"Tan","year":"2023","journal-title":"Cell Death Dis"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e22443","article-title":"Qi-Shen-Tang alleviates retinitis pigmentosa by inhibiting ferroptotic features via the NRF2\/GPX4 signaling pathway","volume":"9","author":"Xiong","year":"2023","journal-title":"Heliyon"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1007\/s00011-023-01785-1","article-title":"GCH1 reduces LPS-induced alveolar macrophage polarization and inflammation by inhibition of ferroptosis","volume":"72","author":"Xiao","year":"2023","journal-title":"Inflammation Res"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1097\/fjc.0000000000001030","article-title":"PDSS2 inhibits the ferroptosis of vascular endothelial cells in atherosclerosis by activating Nrf2","volume":"77","author":"Yang","year":"2021","journal-title":"J Cardiovasc Pharmacol"},{"key":"B56","doi-asserted-by":"publisher","first-page":"3346","DOI":"10.3390\/ijms23063346","article-title":"Pathophysiology of atherosclerosis","volume":"23","author":"Jebari-Benslaiman","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1254114","article-title":"Mechanisms of fibrous cap formation in atherosclerosis","volume":"10","author":"Alonso-Herranz","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1002\/jcp.31045","article-title":"The suppression of hyperlipid diet-induced ferroptosis of vascular smooth muscle cells protests against atherosclerosis independent of p53\/SCL7A11\/GPX4 axis","volume":"238","author":"You","year":"2023","journal-title":"J Cell Physiol"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2026.168240","article-title":"Ferroptosis-driven coronary plaque vulnerability: a tandem mechanism involving endothelial cells, macrophages, and smooth muscle cells","volume":"1872","author":"Zhu","year":"2026","journal-title":"Biochim Biophys Acta Mol Basis Dis"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1016\/j.redox.2024.103160","article-title":"Differentiation of intestinal stem cells toward goblet cells under systemic iron overload stress are associated with inhibition of Notch signaling pathway and ferroptosis","volume":"72","author":"Zhao","year":"2024","journal-title":"Redox Biol"},{"key":"B61","article-title":"Exercise-induced endothelial progenitor cell mobilisation: Acute and chronic effects on cardiovascular health in diverse populations","volume-title":"Leeds Beckett University","author":"Ferentinos","year":"2025"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.3390\/cells12010106","article-title":"Senescence-associated secretory phenotype of cardiovascular system cells and inflammaging: Perspectives of peptide regulation","volume":"12","author":"Khavinson","year":"2022","journal-title":"Cells"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1042\/CS20220797","article-title":"Vascular remodelling in cardiovascular diseases: hypertension, oxidation, and inflammation","volume":"138","author":"Toto\u0144-\u017bura\u0144ska","year":"2024","journal-title":"Clin Sci"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.841545","article-title":"Modified lipoproteins induce arterial wall inflammation during atherogenesis","volume":"9","author":"Lorey","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines9091221","article-title":"Macrophages and foam cells: brief overview of their role, linkage, and targeting potential in atherosclerosis","volume":"9","author":"Poznyak","year":"2021","journal-title":"Biomedicines"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1172\/jci157011","article-title":"Through the layers: how macrophages drive atherosclerosis across the vessel wall","volume":"132","author":"Susser","year":"2022","journal-title":"J Clin Invest"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1002\/adma.202110660","article-title":"Targeting the microenvironment of vulnerable atherosclerotic plaques: an emerging diagnosis and therapy strategy for atherosclerosis","volume":"34","author":"Zhang","year":"2022","journal-title":"Adv Mater"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.843712","article-title":"Macrophage subsets and death are responsible for atherosclerotic plaque formation","volume":"13","author":"Li","year":"2022","journal-title":"Front Immunol"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1215612","article-title":"Macrophage death in atherosclerosis: potential role in calcification","volume":"14","author":"Neels","year":"2023","journal-title":"Front Immunol"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0316474","article-title":"Inflammatory stimuli and hypoxia on atherosclerotic plaque thrombogenicity: linking macrophage tissue factor and glycolysis","volume":"20","author":"Maekawa","year":"2025","journal-title":"PloS One"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1093\/ehjacc\/zuab020.058","article-title":"Blood iron level and vulnerable coronary atherosclerotic plaques","volume":"10","author":"Oleksiak","year":"2021","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1161\/atvbaha.121.316154","article-title":"Accumulation of plasma-derived lipids in the lipid core and necrotic core of human atheroma: imaging mass spectrometry and histopathological analyses","volume":"41","author":"Nakagawa","year":"2021","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B73","doi-asserted-by":"publisher","DOI":"10.1016\/j.jscai.2022.100400","article-title":"Fibrous cap thickness predicts stable coronary plaque progression: Early clinical validation of a semiautomated OCT technology","volume":"1","author":"Kassis","year":"2022","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"key":"B74","doi-asserted-by":"publisher","DOI":"10.1161\/atvbaha.121.316233","article-title":"Crosstalk between macrophages and vascular smooth muscle cells in atherosclerotic plaque stability","volume":"42","author":"Yurdagul","year":"2022","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B75","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2023.104509","article-title":"Sensitive magnetic particle imaging of haemoglobin degradation for the detection and monitoring of intraplaque haemorrhage in atherosclerosis","volume":"90","author":"Tong","year":"2023","journal-title":"EBioMedicine"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.33963\/v.phj.104050","article-title":"Vulnerable atherosclerotic plaque and iron homeostasis: the role of intraplaque erythrophagocytosis, ferroptosis, and heme oxygenase-1 overexpression","volume":"83","author":"Rostoff","year":"2025","journal-title":"Pol Heart J Kardiol Pol"},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.3390\/ijms241713298","article-title":"Significance of intraplaque hemorrhage for the development of high-risk vulnerable plaque: current understanding from basic to clinical points of view","volume":"24","author":"Sakamoto","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1248934","article-title":"Ferroptosis and metabolic syndrome and complications: association, mechanism, and translational applications","volume":"14","author":"Zhou","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B79","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1097\/CRD.0000000000000327","article-title":"Gut microbiota and cardiovascular diseases: A critical review","volume":"29","author":"Anselmi","year":"2021","journal-title":"Cardiol Rev"},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2024.107334","article-title":"Microbiota alterations associated with vascular diseases: Postbiotics as a next-generation magic bullet for gut-vascular axis","volume":"207","author":"Flori","year":"2024","journal-title":"Pharmacol Res"},{"key":"B81","doi-asserted-by":"publisher","DOI":"10.3390\/biom14111463","article-title":"Gut microbe-generated metabolite trimethylamine-N-oxide and ischemic stroke","volume":"14","author":"Li","year":"2024","journal-title":"Biomolecules"},{"key":"B82","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1038\/s41419-023-05778-0","article-title":"Butyrate dictates ferroptosis sensitivity through FFAR2-mTOR signaling","volume":"14","author":"Wang","year":"2023","journal-title":"Cell Death Dis"},{"key":"B83","doi-asserted-by":"publisher","DOI":"10.1016\/j.micres.2024.128037","article-title":"Gut microbial metabolites: the bridge connecting diet and atherosclerosis, and next-generation targets for dietary interventions","volume":"292","author":"Zhang","year":"2025","journal-title":"Microbiol Res"},{"key":"B84","doi-asserted-by":"publisher","first-page":"4506","DOI":"10.3390\/nu14214506","article-title":"Ferroptosis of endothelial cells in vascular diseases","volume":"14","author":"Zhang","year":"2022","journal-title":"Nutrients"},{"key":"B85","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2025.114553","article-title":"Inhibition of ferroptosis alleviates atherosclerosis and foam cell formation by regulating lipid metabolism via AMPK activation","volume":"153","author":"Yang","year":"2025","journal-title":"Int Immunopharmacol"},{"key":"B86","doi-asserted-by":"publisher","DOI":"10.1038\/s41418-022-01099-5","article-title":"Ferroptotic stress facilitates smooth muscle cell dedifferentiation in arterial remodelling by disrupting mitochondrial homeostasis","volume":"30","author":"Ji","year":"2023","journal-title":"Cell Death Differ"},{"key":"B87","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25010047","article-title":"To gain insights into the pathophysiological mechanisms of the thrombo-inflammatory process in the atherosclerotic plaque","volume":"25","author":"Nappi","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B88","doi-asserted-by":"publisher","DOI":"10.1177\/0003319720987752","article-title":"Endothelial dysfunction and its clinical implications","volume":"72","author":"Poredos","year":"2021","journal-title":"Angiology"},{"key":"B89","doi-asserted-by":"publisher","first-page":"6467","DOI":"10.3390\/ijms26136467","article-title":"Dysfunction of microcirculation in atherosclerosis: Implications of nitric oxide, oxidative stress, and inflammation","volume":"26","author":"Aleksandrowicz","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B90","doi-asserted-by":"publisher","first-page":"781","DOI":"10.3390\/biomedicines9070781","article-title":"Inflammatory mechanisms contributing to endothelial dysfunction","volume":"9","author":"Theofilis","year":"2021","journal-title":"Biomedicines"},{"key":"B91","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1039241","article-title":"ROS-triggered endothelial cell death mechanisms: focus on pyroptosis, parthanatos, and ferroptosis","volume":"13","author":"Zheng","year":"2022","journal-title":"Front Immunol"},{"key":"B92","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.3390\/biology11101392","article-title":"IDH1 promotes foam cell formation by aggravating macrophage ferroptosis","volume":"11","author":"Li","year":"2022","journal-title":"Biol (Basel)"},{"key":"B93","doi-asserted-by":"publisher","DOI":"10.3390\/antiox10121864","article-title":"Iron overload, oxidative stress, and ferroptosis in the failing heart and liver","volume":"10","author":"Mancardi","year":"2021","journal-title":"Antioxidants"},{"key":"B94","doi-asserted-by":"publisher","first-page":"1702","DOI":"10.3390\/biom12111702","article-title":"The role of macrophage iron overload and ferroptosis in atherosclerosis","volume":"12","author":"Ma","year":"2022","journal-title":"Biomolecules"},{"key":"B95","doi-asserted-by":"publisher","first-page":"8457","DOI":"10.3390\/ijms22168457","article-title":"The macrophage iron signature in health and disease","volume":"22","author":"Mertens","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B96","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22094591","article-title":"On iron metabolism and its regulation","volume":"22","author":"Vogt","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B97","doi-asserted-by":"publisher","DOI":"10.3390\/antiox11122345","article-title":"Nrf2 and oxidative stress: a general overview of mechanisms and implications in human disease","volume":"11","author":"Ngo","year":"2022","journal-title":"Antioxidants"},{"key":"B98","doi-asserted-by":"publisher","DOI":"10.1161\/circresaha.120.315930","article-title":"Sex as a biological variable in atherosclerosis","volume":"126","author":"Man","year":"2020","journal-title":"Circ Res"},{"key":"B99","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2025.1680625","article-title":"Sex hormone-specific regulation of ferroptosis in vascular cells in atherosclerosis: molecular mechanisms and targeted strategies","volume":"16","author":"Yu","year":"2025","journal-title":"Front Physiol"},{"key":"B100","doi-asserted-by":"publisher","first-page":"11","DOI":"10.2147\/vhrm.2008.04.01.11","article-title":"Androgen therapy and atherosclerotic cardiovascular disease","volume":"4","author":"McGrath","year":"2008","journal-title":"Vasc Health Risk Manage"},{"key":"B101","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2024.03.026","article-title":"The complementary roles of iron and estrogen in menopausal differences in cardiometabolic outcomes","volume":"43","author":"Ahanchi","year":"2024","journal-title":"Clin Nutr"},{"key":"B102","doi-asserted-by":"publisher","DOI":"10.1002\/biof.1890","article-title":"Oxidized phospholipids and lipoprotein\u2010associated phospholipase A2 (LP\u2010PLA2) in atherosclerotic cardiovascular disease: an update","volume":"48","author":"Pantazi","year":"2022","journal-title":"BioFactors"},{"key":"B103","doi-asserted-by":"publisher","first-page":"101723","DOI":"10.1016\/j.xcrp.2024.101932","article-title":"How do different lipid peroxidation mechanisms contribute to ferroptosis","volume":"4","author":"Do","year":"2023","journal-title":"Cell Rep Phys Sci"},{"key":"B104","doi-asserted-by":"publisher","first-page":"258","DOI":"10.3390\/biomedicines9030258","article-title":"From mitochondria to atherosclerosis: the inflammation path","volume":"9","author":"Su\u00e1rez-Rivero","year":"2021","journal-title":"Biomedicines"},{"key":"B105","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1410832","article-title":"Mitochondrial dysfunction and metabolic reprogramming induce macrophage pro-inflammatory phenotype switch and atherosclerosis progression in aging","volume":"15","author":"Vendrov","year":"2024","journal-title":"Front Immunol"},{"key":"B106","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1038\/s41419-023-05716-0","article-title":"The interaction between ferroptosis and inflammatory signaling pathways","volume":"14","author":"Chen","year":"2023","journal-title":"Cell Death Dis"},{"key":"B107","doi-asserted-by":"publisher","DOI":"10.2147\/ijgm.s346482","article-title":"Identification of potential ferroptosis-related biomarkers and immune infiltration in human coronary artery atherosclerosis","volume":"15","author":"Liu","year":"2022","journal-title":"Int J Gen Med"},{"key":"B108","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2023.04.003","article-title":"Iron metabolism and atherosclerosis","volume":"34","author":"Guo","year":"2023","journal-title":"Trends Endocrinol Metab"},{"key":"B109","doi-asserted-by":"publisher","DOI":"10.33963\/v.phj.103196","article-title":"Iron levels and vulnerable coronary atherosclerotic plaques","volume":"82","author":"Oleksiak","year":"2024","journal-title":"Polish Heart J Kardiol Polska"},{"key":"B110","doi-asserted-by":"publisher","DOI":"10.1530\/vb-23-0020","article-title":"GPX4 overexpression does not alter atherosclerotic plaque development in ApoE knock-out mice","volume":"6","author":"Coornaert","year":"2024","journal-title":"Vasc Biol"},{"key":"B111","doi-asserted-by":"publisher","DOI":"10.7150\/thno.108817","article-title":"GPX4 knockdown suppresses M2 macrophage polarization in gastric cancer by modulating kynurenine metabolism","volume":"15","author":"Xu","year":"2025","journal-title":"Theranostics"},{"key":"B112","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvy143","article-title":"Nuclear factor E2-related factor 2 deficiency impairs atherosclerotic lesion development but promotes features of plaque instability in hypercholesterolaemic mice","volume":"115","author":"Ruotsalainen","year":"2019","journal-title":"Cardiovasc Res"},{"key":"B113","doi-asserted-by":"publisher","DOI":"10.1007\/s10787-024-01519-7","article-title":"Nrf2-mediated ferroptosis inhibition: A novel approach for managing inflammatory diseases","volume":"32","author":"Han","year":"2024","journal-title":"Inflammopharmacology"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1868492\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:44:30Z","timestamp":1782276270000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1868492\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":113,"alternative-id":["10.3389\/fimmu.2026.1868492"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1868492","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]},"article-number":"1868492"}}