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doi: 10.1161/01.CIR.0000129501.88485.1f 55

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ACSL4 catalyzes the reaction of PUFAs to polyunsaturated fatty acid-coenzyme A (PUFA-CoA), and then the PUFA-CoA undergoes esterification by lysophosphatidylcholine acyltransferase 3 (LPCAT3) to become polyunsaturated fatty acid-phospholipids (PUFA-PLs), which are then oxidized by reactive oxygen species (ROS) to cytotoxic phospholipid hydroperoxides (PL-OOH), leading to cell death through membrane modification (Liu et al., 2025