Diagnostic and prognostic value of ferroptosis-related genes in patients with Myelodysplastic neoplasms

This study delves into the emerging role of ferroptosis in Myelodysplastic Neoplasms (MDS) and aims to identify a prognostic ferroptosis-related gene signature for MDS. Utilizing RNA-seq data and clinical information from the Gene Expression Omnibus database, the researchers extracted ferroptosis-related genes from the FerrDb website and conducted differential expression analysis using the 'limma' package in R. Hub ferroptosis-related genes in MDS were screened using the “RandomForest” and “carat” R packages. Kaplan -Meier and Cox regression analyses were employed to assess the prognostic role of three identified hub genes (<i>BNIP3, MDM2, and RRM2</i>). Receiver operator characteristic curve analysis confirmed the diagnostic efficacy of these genes. The study delved further into immune infiltration correlations, ncRNA-transcription factor coregulatory network analysis, and the identification of potential therapeutic drugs targeting hub ferroptosis-related genes in MDS. The researchers constructed a 3-gene signature-based risk score using datasets GSE58831 and GSE19429, demonstrating high accuracy (AUC &gt; 0.75) in both datasets for survival prediction in MDS. A nomogram analysis reinforced the prognostic value of the risk-scoring model. Immunological analysis revealed an association between the risk score and immune infiltration. Quantitative reverse transcription polymerase chain reaction (qPCR) data indicated significant expression differences in <i>MDM2, RRM2</i>, and <i>BNIP3</i> between MDS and healthy bone marrow samples. Notably, MDM2 and RRM2 showed decreased expression, while <i>BNIP3</i> exhibited increased expression in MDS samples. This comprehensive study concludes that <i>BNIP3, MDM2</i>, and <i>RRM2</i> hold diagnostic and prognostic significance in MDS and provide valuable insights into immune cell landscapes and potential therapeutic avenues for this condition.