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Furthermore, under OA-related inflammatory and metabolic stress environments, cells may promote GPX4 ubiquitination and subsequent proteasomal degradation by inducing specific E3 ubiquitin ligase activity, thereby increasing cellular susceptibility to ferroptosis ( 3.3 Downstream effects of GPX4 3.3.1 Inhibition of lipid peroxidation and maintenance of membrane and mitochondrial integrity The most direct and core downstream biological effect of GPX4 lies in its ability to specifically catalyze the reduction of lipid peroxides on cellular and organellar membranes to harmless lipid alcohols