Polyphyllin II regulates ROS levels and promotes ferroptosis in bladder cancer cells.

Bladder cancer is a challenging disease with high recurrence rates and limited treatment options. Studies have highlighted the role of ferroptosis, an iron‑dependent cell death mechanism, in cancer progression and treatment. In the present study, the regulatory mechanisms of polyphyllin II (PPII) on ferroptosis in bladder cancer cells were investigated. Cell viability and colony formation assays demonstrated that PPII effectively inhibited the proliferation of bladder cancer cells. RNA sequencing analysis revealed differentially expressed genes upon PPII treatment, with Cluster 6 exhibiting dose‑dependent expression changes. Gene Ontology and pathway enrichment analyses revealed enrichment of ferroptosis‑related pathways. PPII treatment markedly increased reactive oxygen species (ROS) levels and promoted Fe²+ accumulation in bladder cancer cells. Additionally, PPII downregulated the expression of glutathione peroxidase 4 (GPX4), a key regulator of ferroptosis. These findings indicate that PPII promotes ferroptosis in bladder cancer cells through the modulation of ROS levels and GPX4 activity. Further investigations into the molecular mechanisms and potential combination therapies are warranted.