Frontiers in Hematology,
Journal Year:
2023,
Volume and Issue:
2
Published: Dec. 4, 2023
Apoptosis
is
a
tightly
regulated
process
of
cell
death
occurring
through
extrinsic
and
intrinsic
pathways.
The
Bcl-2
family
proteins
implicated
in
the
pathway
encompasses
both
pro-apoptotic
anti-apoptotic
proteins.
Anti-apoptotic
are
frequently
overexpressed
hematologic
malignancies
so
inhibitors
have
been
developed
to
combat
these
malignancies.
first
so-far
only
FDA-approved
inhibitor
has
venetoclax,
initially
for
treatment
chronic
lymphocytic
leukemia
(CLL)
with
17-p
deletion
as
second-line
agent,
followed
by
later
expansion
all
CLL
selected
acute
myeloid
(AML)
indications.
Venetoclax
other
members
demonstrated
significant
potential.
However,
their
use
requires
careful
consideration
disease
indication,
along
biomarkers
associated
optimal
drug
combinations.
Side-effect
profiles
specific
patterns
resistance
must
be
considered
well.
In
this
review,
we
examine
detail
characteristics
role
apoptosis.
We
discuss
development
that
led
first-in-class
approval
relevant
considerations.
Finally,
future
directions
domain
pharmaceutical
development.
Immunological Reviews,
Journal Year:
2023,
Volume and Issue:
319(1), P. 4 - 6
Published: Oct. 1, 2023
It
is
estimated
that
an
average
adult
human
turns
over
roughly
330
±
20
billion
cells
every
day
as
part
of
healthy
living.1,
2
This
translates
to
0.4%
our
body
mass.
Such
a
large
number
for
cell
turnover
then
begs
the
question—what
are
these
and
why?
The
reasons
this
multi-factorial.
First,
there
in
have
finite
life
span,
such
neutrophils
(~1
day)
erythrocytes
(~120
days),
also
other
types
many
hematopoietic
span
few
days
weeks;
need
be
removed
after
their
useful
replaced
by
new
cells.
Second,
aspects
development
where
we
generate
excess
cells,
which
only
deemed
fit
progress
full
maturation,
rest
undergo
death
removed;
examples
include
T
thymus,
B
bone
marrow,
neurogenesis
brain.1
Third,
“damaged”
emerge
daily
body,
due
light/UV
damage,
example
skin
photoreceptors
eye.3
Thus,
all
events
result
undergoing
essentially
organs
tissues,
albeit
at
different
magnitude.2
Although
forms
processes,
destined
die
via
homeostatic
do
so
primarily
process
caspase-dependent
apoptosis.4
What
happens
dying
cells?
Despite
billions
per
day,
when
one
looks
it
hard
recognize
even
those
with
high
cellular
turnover.
because
recognition
clearance
remarkably
efficient.5,
6
Just
like
dedicated
set
molecules
mechanisms
induce
programmed
death,
possess
machinery
remove
cells.7
under
homeostasis
conditions
occurs
quickly,
efficiently,
from
immunological
perspective,
quietly.8
worth
noting
just
apoptotic
machinery,
processes
highly
conserved
evolutionarily,
studies
nematode,
flies,
zebrafish,
mice,
humans
established
components
process.9,
10
volume
Immunological
Reviews
focuses
on
its
implications
disease.
While
phagocytosis,
phagocytes
has
been
termed
“efferocytosis,”
term
originally
coined
Dr.
Peter
Henson.
(where
“effero”
means
“carry
grave”).11
should
distinguished
Fc
receptor
mediated
phagocytosis
or
complement
receptor-mediated
involves
opsonization
target
specific
ligands
uptake
respective
receptors.
A
key
distinction
does
not
immune
response;
further
efferocytosis
actively
anti-inflammatory.8
makes
sense
considers
fact
if
were
inflammatory
response
clear
may
end
up
walking
bags
inflammation.
However,
failure
promptly
can
secondary
necrosis
lead
sequelae,
detailed
some
chapters
volume.
Works
laboratories
now
steps
removal
cells.1,
12
first
step
When
macrophages,
dendritic
neighbors
close
proximity
cell,
recognized
receptors
engulfing
leading
subsequent
intracellular
signaling,
cytoskeletal
reorganization,
corpse
internalization.13
exposed
apoptosis,
best
exposure
phospholipid
phosphatidylserine
(PtdSer).14,
15
PtdSer
normally
kept
active
energy
dependent
inner
leaflet
but
gets
outer
process.15,
16
turn,
multiple
receptors—either
directly,
indirectly,
intermediary
bridging
molecules.16,
17
As
chapter,
Tal
Brustyn-Cohen
details
described
families
linked
namely
TAM
receptors.18
These
indirectly
Gas6
Protein
S
bind
PtdSer,
chapter
role
contexts
highlights
physiology.
One
challenges
studying
mammals
homologues
engulfment
signaling
molecules,
complexities
arise
individual
knockouts
often
phenotype.
defining
function
well
visualizing
vivo
challenge
past
couple
decades.
Will
Wood,
Andrew
Davidson,
colleagues
detail
beautiful
model
systems
fruit
fly
Drosophila
provided
insights.19
They
approaches
developed
visualize
apoptosis
vivo,
plus
molecular
employed
macrophages
After
phagocyte
engulfs
second
ensues—that
is,
digesting
corpse.
no
small
feat,
another
nearly
same
size
itself.
Further,
engulf
cells.20
Mylvaganam
Freeman
take
comprehensive
approach
how
resolves
phagolysosome
membrane
traffic,
solute
carriers
managing
contents
put
disease
lysosomal
storage
disorders.21
Another
inherent
faces
handle
biomass.
To
way,
basically
doubles
lipids,
carbohydrates,
proteins,
name
contents.
ingest
corpses
succession,
greater
dealing
metabolic
overload.20,
22
Shilperoort,
Tabas,
beautifully
macrophage
immunometabolism.23
amino
acids
arginine
methionine
conversion
within
impact
continued
additional
corpses,
responses,
processes.
authors
lactate
regulation
relevance
atherosclerosis,
limitations
current
studies.
get
lot
attention
“professional
phagocytes”
capable
nonprofessional
phagocytes.
slower
kinetics
than
they
play
important
routine
body.
retinal
pigmented
epithelial
(RPE)
retina
provide
example,
basis
“used”
damaged
light
during
allow
place.24,
25
aspect
RPE
postmitotic,
born
RPE.
throughout
lifetime,
addition
nurse
functions
maintain
retina.
Silvia
Finnemann
background
receptors,
RPE-mediated
clearance,
diseases
disturbed
inflammation.26
fully
appreciate
importance
garbage
workers
until
go
strike,
“cellular
crew”
gotten
much
better
appreciation
two
decades
failures
associated
contribute
links
cancer.8
four
final
Christopher
Gregory
complexity
cancer
context.27
He
products
(including
extracellular
vesicles
factors
released
cells)
regulate
tumor
microenvironment;
includes
responses
solid
tumors,
either
direct
contact
products,
reshaping
microenvironment
growth.
followed
description
Wagoner,
Michael
Elliott,
antibody-mediated
cells—which
antibody-bound
macrophages.28
present
modifications
FcR-mediated
overcome
them.
become
increasingly
auto-inflammatory
arthritis,
certain
colitis
component
defective
minimally
release
late
stage
promote
pro-inflammatory
milieu,
chronic
inflammation.1
self-antigens
presented
environment,
evolve
autoimmunity.
Schneider
Arandjelovic
arthritis.
Interestingly,
roles,
neutrophil
migration
arthritic
joints
turn
arthritis.29
Lastly,
Gabrielle
Fredman
Sayeed
Khan
discuss
specialized
pro-resolving
mediators
(SPMs)
dead
cells.30
highlight
SPMs
facilitating
necroptotic
link
non-resolving
atherosclerosis.
In
sum,
investigations
die,
removed,
consequences
regulated
efficient
exploded.
led
remarkable
increase
knowledge
mechanisms,
defects
states
tissue
contexts.
collection
reviews,
contributions
own
laboratories,
discoveries
larger
context
what
known,
challenges,
about
addressing
next
questions
field.
research
turnover,
single
tissue,
bound
continue,
modulating
providing
opportunities
treating
diseases.31
work
was
supported
grants
K.S.R.
NIAID
(R01AI159551),
NHLBI
(P01HL120840),
BJC
Investigator
funds
Washington
University
School
Medicine
(St.
Louis,
MO).
author
declares
competing
interests.
Data
sharing
applicable
article
data
created
analyzed
study.
Frontiers in Hematology,
Journal Year:
2023,
Volume and Issue:
2
Published: Dec. 4, 2023
Apoptosis
is
a
tightly
regulated
process
of
cell
death
occurring
through
extrinsic
and
intrinsic
pathways.
The
Bcl-2
family
proteins
implicated
in
the
pathway
encompasses
both
pro-apoptotic
anti-apoptotic
proteins.
Anti-apoptotic
are
frequently
overexpressed
hematologic
malignancies
so
inhibitors
have
been
developed
to
combat
these
malignancies.
first
so-far
only
FDA-approved
inhibitor
has
venetoclax,
initially
for
treatment
chronic
lymphocytic
leukemia
(CLL)
with
17-p
deletion
as
second-line
agent,
followed
by
later
expansion
all
CLL
selected
acute
myeloid
(AML)
indications.
Venetoclax
other
members
demonstrated
significant
potential.
However,
their
use
requires
careful
consideration
disease
indication,
along
biomarkers
associated
optimal
drug
combinations.
Side-effect
profiles
specific
patterns
resistance
must
be
considered
well.
In
this
review,
we
examine
detail
characteristics
role
apoptosis.
We
discuss
development
that
led
first-in-class
approval
relevant
considerations.
Finally,
future
directions
domain
pharmaceutical
development.