Cuproptosis: Biomarkers, Mechanisms and Treatments in Diseases

The homeostasis balance of copper, as an essential trace element for life activities, is crucial for maintaining the normal function of cells. Cuproptosis, discovered in recent years, is a novel type of programmed cell death triggered by the accumulation of excessive copper ions in mitochondria. The core mechanism lies in that copper ions, after being reduced by ferridoxin (FDX1), directly target and induce the oligomerization of the acylated tricarboxylic acid (TCA) cycle enzyme, thereby triggering fatal protein toxic stress. This distinctive mechanism operates independently of other recognized pathways of cell death, offering a novel perspective for elucidating the pathological processes underlying various diseases. A review of pertinent research conducted over the past four years reveals that cuproptosis is not only significantly implicated in the onset, progression, and treatment resistance of tumors but is also intricately associated with diverse pathological processes, including neurodegenerative diseases, cardiovascular diseases, metabolic disorders, and immune abnormalities. This article conducts a multi-level summary from molecular mechanisms to physiological and pathological significance; deeply explores the interaction between cuproptosis and various subcellular structures, as well as their complex signal regulatory network; and systematically expounds the cutting-edge strategies for treating cuproptosis, including traditional copper chelating agents, ion carriers, and copper-based nanomedicines, with a particular focus on the latest progress in the field of natural product research. This review has systematically summarized the therapeutic potential demonstrated by numerous natural active ingredients when precisely regulating the cuproptosis pathway to provide a theoretical reference for future research in this field.