OTUD5 promotes AML progression by stabilizing SLC7A11 to suppress ferroptosis

Acute myeloid leukemia (AML) is a highly aggressive malignancy with frequent therapeutic resistance, necessitating the identification of novel molecular targets. This study aims to elucidate the role of the deubiquitinase OTUD5 in AML progression by regulating SLC7A11 to suppress ferroptosis. We analyzed OTUD5 expression in AML patient samples and cell lines using RNA sequencing and quantitative PCR. Functional roles were assessed through OTUD5 silencing and overexpression in AML cell lines (THP-1, HL-60), followed by proliferation, colony formation, and ferroptosis assays (ROS, labile Fe^{2 +}, GSH, MDA). Co-immunoprecipitation and ubiquitination assays confirmed OTUD5-SLC7A11 interactions, while in vivo xenograft models validated findings. Molecular docking and transmission electron microscopy further elucidated mechanisms. OTUD5 was significantly upregulated in AML, correlating with ferroptosis suppression. OTUD5 directly interacted with and deubiquitinated SLC7A11, enhancing its stability and promoting AML cell survival. OTUD5 silencing induced ferroptosis, marked by increased labile iron, ROS, and mitochondrial damage, which was reversed by SLC7A11 overexpression or GSH supplementation. In vivo, OTUD5 knockdown reduced tumor growth, an effect mitigated by SLC7A11 overexpression or GSH. The OTUD5-SLC7A11 axis drives AML progression by suppressing ferroptosis, offering a novel therapeutic target to exploit ferroptosis sensitivity and overcome treatment resistance in AML.