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Figure 1 2.3 Lipid antioxidant system in RA When lipid peroxides accumulate, cells can resist oxidation and prevent ferroptosis through various regulatory mechanisms, the most important of which is the antioxidant regulatory system composed of the cystine/glutamate antitransporter (System Xc-) and phospholipid hydroperoxidase glutathione peroxidase 4 (GPX4) ( With the progress of research, in addition to the GPX4 antioxidant pathway, three other new pathways unrelated to GPX4 in ferroptosis have been identified: ferroptosis inhibition protein 1 (FSP1)/CoQ10, GTP cyclic hydrolase 1 (GCH1)/tetrahydrobiopterin (BH4), and dihydroorotate dehydrogenase (DHODH)