Morphine tolerance is a classic, challenging clinical
issue. However,
the mechanism underlying this phenomenon remains poorly understood.
Recently, studies have shown that ferroptosis correlates with drug
resistance. Therefore, this study investigated whether spinal cord
ferroptosis contributes to morphine tolerance. C57BL/6 mice were continuously
subcutaneously injected with morphine, with or without the ferroptosis
inhibitor liproxstatin-1. We found that chronic morphine exposure
led to morphine antinociception tolerance, accompanied by loss of
spinal cord neurons, increase in the levels of iron, malondialdehyde,
and reactive oxygen species, and decreases in the levels of superoxide
dismutase. Additionally, inflammatory response and mitochondrial shrinkage,
processes that are involved in ferroptosis, were observed. Simultaneously,
we found that 10 mg/kg of liproxstatin-1 could alleviate iron overload
by balancing transferrin receptor protein 1/ferroportin expression
and attenuate morphine tolerance by increasing glutathione peroxidase
4 levels, while reducing the levels of malondialdehyde and reactive
oxygen species. It also downregulated the expression of extracellularly
regulated protein kinases that had been induced by chronic morphine
exposure. Our results indicate that spinal cord ferroptosis contributes
to morphine tolerance, while liproxstatin-1 attenuates the development
of morphine tolerance. These findings suggest that ferroptosis may
be a potential therapeutic target for morphine tolerance.