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Interplay of Ferroptosis, Cuproptosis, Autophagy and Pyroptosis in Male Infertility: Molecular Crossroads and Therapeutic Opportunities

International Journal of Molecular Sciences 2025 8 citations ? Citation count from OpenAlex, updated daily. May differ slightly from the publisher's own count. Score: 63 ? 0–100 AI score estimating relevance to the microplastics field. Papers below 30 are filtered from public browse.
Dong-Zhen Cai, Junda Li, Peng Zhang, Rongguo Fu, Chuyang Chen, Feihong Liu, Y. Li, Yanjing Su, Chunyun Li, Wei Chen

Summary

This review examines how different types of cell death, including ferroptosis, cuproptosis, pyroptosis, and autophagy, contribute to male infertility by damaging sperm-producing cells. Environmental toxins, including microplastics, can trigger these destructive pathways through oxidative stress and mitochondrial damage. Understanding these mechanisms is important because it helps explain how environmental pollutant exposure could be contributing to declining male fertility worldwide.

Male infertility is intricately linked to dysregulated cell death pathways, including ferroptosis, cuproptosis, pyroptosis, and autophagy. Ferroptosis, driven by iron-dependent lipid peroxidation through the Fenton reaction and inactivation of the GPX4/Nrf2/SLC7A11 axis, disrupts spermatogenesis under conditions of oxidative stress, environmental toxin exposure, or metabolic disorders. Similarly, cuproptosis-characterized by mitochondrial dysfunction and disulfide stress due to copper overload-exacerbates germ cell apoptosis via FDX1 activation and NADPH depletion. Pyroptosis, mediated by the NLRP3 inflammasome and gasdermin D, amplifies testicular inflammation and germ cell loss via IL-1β/IL-18 release, particularly in response to environmental insults. Autophagy maintains testicular homeostasis by clearing damaged organelles and proteins; however, its dysregulation impairs sperm maturation and compromises blood-testis barrier integrity. These pathways intersect through shared regulators; reactive oxygen species and mTOR modulate the autophagy-pyroptosis balance, while Nrf2 and FDX1 bridge ferroptosis-cuproptosis crosstalk. Therapeutic interventions targeting these mechanisms have shown promise in preclinical models. However, challenges persist, including the tissue-specific roles of gasdermin isoforms, off-target effects of pharmacological inhibitors, and transgenerational epigenetic impacts of environmental toxins. This review synthesizes current molecular insights into the cell death pathways implicated in male infertility, emphasizing their interplay and translational potential for restoring spermatogenic function.

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