Metal ions play an important role in living organisms and are involved in essential physiological activities. However, the overload state of ions can cause excess free radicals, cell damage, and even cell death. Ferroptosis and cuproptosis are specific forms of cell death that are distinct from apoptosis, necroptosis, and other regulated cell death. These unique modalities of cell death, dependent on iron and copper, are regulated by multiple cellular metabolic pathways, including steady-state metal redox treatment mitochondrial activity of lipid, amino acid and glucose metabolism, and various signaling pathways associated with disease. Although the mechanisms of ferroptosis and cuproptosis are not yet fully understood, there is no doubt that ion overload plays a crucial act in these metal-dependent cell deaths. In this review, we discussed the core roles of ion overload in ferroptosis and cuproptosis, the association between metabolism imbalance and ferroptosis and cuproptosis, the extract the diseases caused by ion overload and current treatment modalities.

Renal ischemia-reperfusion injury (RIRI), a major contributor to acute kidney injury (AKI) and delayed graft function (DGF), is closely associated with dysregulation of metal ion homeostasis. Although copper and iron metabolism exhibit interconnected regulatory pathways, the temporal dynamics and functional interplay of these metal ions in RIRI pathogenesis remain poorly understood. Our study demonstrates that cuproptosis and ferroptosis, two distinct forms of cell death induced by metal ion overload, occur simultaneously within 6 h after reperfusion. Notably, ischemia-reperfusion injury induced iron overload significantly sensitizes renal tubular cells to copper-mediated cytotoxicity. Mechanistic investigations demonstrate that hypoxia-reoxygenation triggers Fe (II) accumulation, which subsequently downregulates [4Fe–4S] cluster assembly proteins. This impairment directly compromises the structural integrity of the cuproptosis-regulating protein LIAS by inducing [4Fe–4S] cluster loss, ultimately leading to defective protein lipoylation that drives cuproptosis progression. Crucially, these pathological effects can be attenuated through either overexpression of [4Fe–4S] cluster assembly machinery or therapeutic application of iron-chelating agents. Our findings establish a novel iron-copper crosstalk mechanism in RIRI pathophysiology and propose targeted strategies focusing on [4Fe–4S] cluster homeostasis and iron chelation for clinical intervention.