The role of the presumptive phosphatidylserine receptor (PSR) in the recognition and engulfment of apoptotic cells, and the antiinflammatory response they exert, has been of great interest. Genetic deficiency of PSR in the mouse is lethal perinatally, and results to date have been ambiguous with regard to the phagocytic and inflammatory phenotypes associated with that deficiency. Recently, we found that the specific functional recognition of apoptotic cells is a ubiquitous property of virtually all cell types, including mouse embryo fibroblasts, and reflects an innate immunity that discriminates live from effete cells. Physiological cell death is a process whose purpose is the elimination of functionally inappropriate cells in a manner that does not elicit inflammation. The ability of apoptotic corpses to be cleared in a noninflammatory manner by phagocytes is a consequence of their specific expression of determinants for recognition and modulation of pro-inflammatory responses. The acquisition of these apoptotic determinants is a gain-of-function common to all physiological cell deaths, without regard to suicidal stimulus, and conserved widely across species (1, 2).Numerous cellular alterations associated with apoptotic cell death have been described, including plasma membrane reorganization associated with blebbing (3), shrinkage, and the loss of membrane phospholipid asymmetry (4, 5). In particular, phosphatidylserine (PS), 4 an anionic phospholipid normally cloistered in the inner leaflet of the plasma membrane, is externalized during physiological cell death (5). It still remains to be determined what specific molecular events are responsible for the recognition of the effete cell.The view that externalized PS serves as a ligand for macrophage recognition of apoptotic cells followed from studies demonstrating that similar changes target aged erythrocytes for clearance (6, 7) and gained support from observations that phospho-L-serine and PS vesicles could inhibit partially the interaction of dying nucleated cells with macrophages (5,8,9).A presumptive cell surface PS-specific receptor (PSR) was identified molecularly following a screen for monoclonal antibodies whose binding to human macrophages was inhibited by PS-containing liposomes (10). The product of that screen, mAb 217, bound to cell surface determinants on macrophages and other cell types, notably excluding lymphoid cells. Significantly, mAb 217 triggered macrophages to release the anti-inflammatory cytokine TGF, further suggesting that mAb 217 engaged an apoptotic-like recognition mechanism (10).Controversy regarding this presumptive receptor arose, however, when PSR was observed to localize to the nucleus in mammalian cells (11) as well as in Hydra (12). The role of PSR has been further clouded by the disparate results of three groups of investigators who independently generated mice with targeted disruptions of the PSR locus (13-15). While homozygous PSR disruptions result in perinatal lethality in each case, different effects on the phagocytosi...