Cuproptosis and Aging: Molecular Mechanisms and Therapeutic Implications

With the accelerated pace of global population aging, the number of people suffering from age-related diseases is increasing, posing a serious threat to human health and well-being. Age-related diseases, including Alzheimer's disease (AD), Parkinson's disease (PD), hypertension, atherosclerosis, type 2 diabetes (T2DM), and osteoporosis (OP), are often characterized by physiological function decline and metabolic disorders caused by aging, among which dysregulation of metal ion homeostasis, especially copper homeostasis imbalance, has emerged as a major factor. Copper is an essential enzymatic cofactor whose homeostasis is tightly regulated at systemic, cellular, and subcellular levels. However, during the aging process, the balance between copper uptake and efflux becomes compromised, alongside a reduction in cellular copper-buffering capacity. These alterations may lead to the loss of copper homeostasis and induce cuproptosis, which is a recently elucidated form of regulated cell death (RCD) triggered by copper overload and disrupts mitochondrial metabolism by promoting the aggregation of lipoylated proteins in the tricarboxylic acid cycle (TCA) and destabilizing respiratory chain complexes. Copper homeostasis imbalance and the resulting cuproptosis accelerate the aging process by promoting molecular mechanisms, including telomere attrition, mitochondrial dysfunction, oxidative stress, proteostasis imbalance, epigenetic changes, and chronic inflammation. This review focuses on the reciprocal interactions between aging and copper homeostasis: it elucidates how aging impairs copper homeostatic regulation, and how dysregulated copper metabolism and subsequent cuproptosis accelerate aging and exacerbate age-related diseases. Furthermore, it explores potential therapeutic strategies targeting copper homeostasis and cuproptosis to treat age-related diseases.