Recent evidence indicates that cell death can be induced through multiple mechanisms. Strikingly, the same death signal can often induce apoptotic as well as non-apoptotic cell death. For instance, inhibition of caspases often converts an apoptotic stimulus to one that causes necrosis. Because a dedicated molecular circuitry distinct from that controlling apoptosis is required for necrotic cell injury, terms such as "programmed necrosis" or "necroptosis" have been used to distinguish stimulus-dependent necrosis from those induced by non-specific traumas (e.g. heat shock) or secondary necrosis induced as a consequence of apoptosis. In several experimental models, programmed necrosis/necroptosis has been shown to be a crucial control point for pathogen-or injury-induced inflammation. In this review, we will discuss the molecular mechanisms that regulate programmed necrosis/necroptosis and its biological significance in pathogen infections, drug-induced cell injury and trauma-induced tissue damage.
Keywords
RIP1; RIP3; programmed necrosis; inflammation; TNF
Non-apoptotic cell death comes in different flavorsMetazoan homeostasis is achieved through balancing cell proliferation and cell death. The critical role of apoptosis is demonstrated by the many experiments where genetic ablation of components of the apoptosis pathway leads to blunted embryonic development. Work in recent years shows that cell death in multi-cellular organisms comes in many flavors. For instance, paraptosis is a form of non-apoptotic cell death marked by mitochondrial/ER swelling and vacuolation. It was first described as a form of neuronal cell death [1,2], but has recently been observed in certain tumors treated with the chemotherapeutic drug taxol [3]. Pyroptosis is characterized by potassium efflux and caspase-1 mediated activation of the inflammasome, and the rapid loss of plasma membrane integrity [4]. It is often activated during bacterial infections and thus is an important host defense against pathogens [5]. Autophagy, a cellular survival pathway in response to nutrient deprivation [6], has been shown to cause cell death in certain situations [7][8][9]. Although these non-apoptotic cell death pathways often exhibit overlapping morphological features, it is unclear if they also utilize similar molecular machineries to execute the demise of the cell. The term "necrosis" was once used to describe cell death from trauma such as that induced by heat shock or repeated cycles of freeze/thaw. In tissue culture, cells often undergo late stage "secondary necrosis" in response to apoptotic stimuli. This observation further contributed to the notion that necrosis is a by-product of apoptosis. However, it is now clear that necrosis can be triggered as a direct result of "extrinsic" stimulation by death cytokines in the TNF superfamily (e.g. TNF, Fas ligand (FasL) and TRAIL (TNF-related apoptosis inducing factor) [10]) or by "intrinsic" signals such as DNA damage [11,12]. Emerging evidence indicates that specific signaling pathways are requi...