Hyperoside Inhibits Doxorubicin-Induced Ferroptosis in Cardiomyocytes via the Nrf2/GPX4 Pathway

Hyperoside (Hyp) exhibits notable protective effects by targeting oxidative stress, ferroptosis, and apoptosis. In vivo experiments used a murine model of DOX-induced cardiotoxicity with Hyp co-treatment. Hyp co-administration mitigated doxorubicin-induced cardiac impairment in mice, demonstrated by enhanced ejection fraction (EF) and fractional shortening (FS), diminished inflammatory cell infiltration and fibrotic changes, reduced circulating levels of cardiac biomarkers including cTnT, CK, CK-MB, LDH, and LDH-1. Hyp reduced oxidative stress (lower MDA, higher SOD and GSH-Px activity), inhibited ferroptosis (decreased intracellular Fe2 + , MDA, 4-HNE, PTGS2, and ASCL4; increased GSH and Ferritin), and suppressed apoptosis (fewer TUNEL-positive cells, balanced Bax/Bcl-2). Mechanistically, Hyp activated the Nrf2/GPX4 axis: it promoted Nrf2 nuclear translocation, upregulated GPX4 expression as shown by molecular docking. These effects were abrogated by ML385, confirming Nrf2 dependence. Hyp alleviates DOX-induced cardiotoxicity via Nrf2/GPX4 activation, suppressing oxidative stress, ferroptosis, with potential as a therapeutic agent.