Reperfusion after acute ischemic stroke (AIS) triggers a series of ferroptosis-related molecular events, including iron dyshomeostasis, oxidative/nitrative stress, antioxidant depletion, and membrane lipid peroxidation. Conventional ferroptosis assays mainly rely on ex vivo or endpoint measurements, limiting their ability to dynamically monitor the spatiotemporal
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Reperfusion after acute ischemic stroke (AIS) triggers a series of ferroptosis-related molecular events, including iron dyshomeostasis, oxidative/nitrative stress, antioxidant depletion, and membrane lipid peroxidation. Conventional ferroptosis assays mainly rely on ex vivo or endpoint measurements, limiting their ability to dynamically monitor the spatiotemporal evolution of these events during ischemia–reperfusion. Recent advances in chemical sensing and optical imaging have enabled in situ detection of key ferroptosis-related nodes, such as Fe
2+/labile iron pool, ROS/ONOO
−, GSH/Cys/GPX4, H
2S/Cys–Met metabolism, and lipid peroxidation. In this review, we summarize sensing targets, reaction-based probe design, near-infrared and two-photon imaging, photoacoustic imaging, and multimodal validation strategies for AIS-related ferroptosis. Representative probes for H
2O
2, ONOO
−, H
2S, Fe
2+, and lipid peroxidation are discussed in the context of cellular models, oxygen-glucose deprivation/reoxygenation, middle cerebral artery occlusion/reperfusion, and in vivo brain imaging. We emphasize that a single probe signal cannot independently confirm ferroptosis and should be interpreted together with GPX4/ACSL4 alterations, MDA/4-HNE levels, tissue injury, neurological outcomes, and Fer-1/Lip-1 rescue experiments. Finally, we discuss current challenges, including limited tissue penetration, blood–brain barrier delivery, quantitative stability, probe safety, and clinical translation, and highlight future directions involving ratiometric, NIR/NIR-II, two-photon, multitarget, and imaging-guided validation strategies.
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