| Current
Molecular Medicine
ISSN: 1566-5240
Current Molecular Medicine
Volume 8, Number 2, March 2008
Contents
Apoptosis, Necrosis and Autophagy: From Mechanisms
to Biomedical Applications (Part-I)
Guest Editor: Claudio Hetz

Editorial Pp. 76-77
Claudio Hetz
Autophagy
To Die or Not to Die: That is the Autophagic
Question Pp. 78-91
Lorenzo Galluzzi, José Miguel Vicencio, Oliver Kepp,
Ezgi Tasdemir, Maria Chiara Maiuri and Guido Kroemer
[Abstract]
Autophagy: For Better or for Worse, in Good Times
or in Bad Times… Pp. 92-101
Cecilia Lerena, Sebastián D. Calligaris and María
Isabel Colombo
[Abstract]
Apoptosis
Regulation of Bcl-2 Family Proteins by Posttranslational Modifications
Pp. 102-118
Ozgur Kutuk and Anthony Letai
[Abstract]
Ca2+
Signaling, Mitochondria and Cell Death Pp. 119-130
Carlotta Giorgi, Anna Romagnoli, Paolo Pinton and Rosario
Rizzuto
[Abstract]
Mitochondrial Dynamics: To be in Good Shape to Survive
Pp. 131-137
Sébastien Herzig and Jean-Claude Martinou
[Abstract]
Unique Biology of Mcl-1: Therapeutic Opportunities
in Cancer Pp. 138-147
Matthew R. Warr and Gordon C. Shore
[Abstract]
The Bax Inhibitor-1 (BI-1) Family in Apoptosis and
Tumorigenesis Pp. 148-156
Kerstin Reimers, Claudia Y.U. Choi, Vesna Bucan and
Peter M. Vogt
[Abstract]
Abstracts

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Editorial: Apoptosis, Necrosis and Autophagy:
From Mechanism to Biomedical Applications
Cell death under physiological and pathological conditions
occurs with diverse morphological patterns, suggesting highly
complex cell death mechanisms (Fig. 1). Apoptosis
is a conserved cell death form essential for normal development
and tissue homeostasis in multicellular organisms. Although
apoptosis presumably participates in the development of all
cell lineages, aberrations in the expression of pro- or anti-apoptotic
proteins have been implicated in the initiation of a variety
of human diseases, including autoimmunity, immunodeficiency,
cancer, neurodege-nerative diseases and many others. Several
signaling pathways have been implicated in the regulation
of apoptosis, including the extrinsic death receptor pathway,
and the intrinsic mitochondrial pathway, which depends on
activation of cysteine proteases of the caspase family for
the execution of apoptosis. In the apoptosis pathway, the
BCL-2 family of proteins is located upstream at organelle
membranes, controlling the activation of downstream caspases.
Although apoptosis is the prevalent form of programmed cell
death (PCD) employed to control cell viability and homeostasis
during development, increasing evidence indicates that alternative
PCD pathways exist that may be particularly relevant under
pathological conditions. Necrosis, also referred to as accidental
cell death, is characterized by rapid swelling of the dying
cell, rupture of the plasma membrane, and release of the cytoplasmic
content to the cell environment. Despite the profound effects
of necrosis-like cell death in pathological conditions such
as stroke, ischemia, and several neurodegenerative diseases,
the molecular mechanisms underlying necrotic cell death are
poorly understood. Necrosis has traditionally been defined
as an unregulated, accidental celldeath process that occurs
under conditions of cellular injury related to the loss of
ion homeostasis and drastic decreases in ATP levels. In recent
years, however, an increasing number of reports indicate that
cell death with necrotic features can occur under normal physiological
conditions during development by regulated and controlled
mechanisms.
Cell death is often associated with the presence of numerous
cytoplasmic autophagic vacuoles of lysosomal origin. Lysosomes
have been referred to as “suicide bags” because
they contain several unspecific digestive enzymes that, upon
release into the cytosol, cause autolysis and cell death.
Autophagy, also defined as type II PCD, acts as a critical
survival response under starvation conditions in which the
degradation of intracellular proteins and organelles provides
a source of amino acids during poor nutritional conditions.
Intracellular components can be delivered to lysosomes for
degradation by three different mechanisms known as macroautophagy,
microautophagy and chaperone-mediated autophagy. Lysosome-mediated
cell death has been linked to the apoptotic pathway through
alterations in mitochondrial function, but its actual role
as a cell death effecter is actively debated. The hallmark
of autophagy is the formation of double membrane bound autophagosomes.
Autophagosomes fuse with lysosomes to form autophagolysosomes,
where intracellular components are degraded. Autophagy is
a highly regulated process with complex steps controlled by
a group of autophagic related genes of the atg family which
function in diverse processes including development, cell
differentiation, tissue remodeling, immunity, host-to-pathogen
response and cell death/survival under stress conditions.Members
of the BCL-2 protein family have been recently shown to modulate
autophagy through the formation of distinct regulatory protein
complexes, suggesting a direct link between autophagy and
apoptosis.
This special edition of the Current Molecular Medicine
contains a selection of reviews focused on different aspects
of apoptosis, necrosis and autophagy to provide an overview
of the relevance of these stress pathways in many physiological
and pathological conditions. In this volume of Curr. Mol.
Med., Guido Kroemer and María Isabel Colombo give
a comprehensive summary of regulatory mechanisms governing
autophagy, highlighting its emerging function in both immune
response and the intimate connections with cell death. Anthony
Letai and Gordon Shore discuss recent data highlighting the
relevance of the BCL-2 protein family in disease conditions
such as cancer and the possible therapeutic benefits of targeting
the pathway with small molecules. To complement this view,
Kerstin Reimers describe an uncharacterized family of conserved
regulators of cell death, the BAX-inhibitor 1 family, and
its possible role in cancer. The inability of a cell to adapt
to prolonged perturbations of organelle homeostasis ends with
the activation of specific cell death pathways. Accumulation
of abnormal protein aggregates composed of misfolded proteins
is a common characteristic of many neurological diseases,
engaging organelle stress responses. Here we discuss recent
data about the involvement of apoptosis and autophagy in neurodegeneration.
To complement this view, Dale Bredesen presents a broad view
about the role of cell death in neurological disorders. JeanClaude
Martinou and Rosario Rizzuto prepared a deep summary of the
involvement of mitochondria in calcium homeostasis and apoptosis,
and the relevance of fission/fusion events in cell death and
disease conditions. Finally, Andrew Quest, Andres Stutzin
and Peter Vandenabeele uncover the molecular regulation of
necrosis-like cell death and its role in diverse pathologies.
With these set of specialized reviews we aim to provide a
comprehensive view of the current understanding of cell death
pathways and adaptive reactions to cellular stress. A special
emphasis is given on the possible therapeutic benefits of
targeting the aforementioned pathways in disease conditions.
Fig. (1). Characteristic features of cells undergoing apoptosis,
necrosis and autophagy.
ACKNOWLEDGEMENTS
FONDECYT no. 1070444, FONDAP grant no. 15010006 and High Q
Foundation.
We thank Eric Smith (Dana Farber Cancer Institute, Boston,
MA, USA) for graphics design of cover.
Claudio Hetz
Director Laboratory Cellular Stress and Biomedicine
Program of Cellular and Molecular Biology
Institute of Biomedical Sciences, Faculty of Medicine
The FONDAP Center for Molecular Studies of the Cell
University of Chile
Independencia 1027, P.O. Box 70086
Santiago, Chile
Tel: 56-2-9786506
Fax: 56-2-9786871
E-mail: chetz@med.uchile.cl
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To Die or Not to Die: That is the Autophagic Question
Lorenzo Galluzzi, José Miguel Vicencio, Oliver Kepp,
Ezgi Tasdemir, Maria Chiara Maiuri and Guido Kroemer
Macroautophagy (commonly referred to as autophagy) is
the process by which intact organelles and/or large portions
of the cytoplasm are engulfed within double-membraned autophagic
vacuoles for degradation. Whereas basal levels of autophagy
ensure the physiological turnover of old and damaged organelles,
the massive accumulation of autophagic vacuoles may represent
either an alternative pathway of cell death or an ultimate
attempt for cells to survive by adapting to stress. The activation
of the autophagic pathway beyond a certain threshold may promote
cell death directly, by causing the collapse of cellular functions
as a result of cellular atrophy (autophagic, or type II, cell
death). Alternatively, autophagy can lead to the execution
of apoptotic (type I) or necrotic (type III) cell death programs,
presumably via common regulators such as proteins
from the Bcl-2 family. On the other hand, limited self-eating
can provide cells with metabolic substrates to meet their
energetic demands under stressful conditions, such as nutrient
deprivation, or favor the selective elimination of damaged
(and potentially dangerous) organelles. In these instances,
autophagy operates as a pro-survival mechanism. The coordinate
regulation of these opposite effects of autophagy relies upon
a complex network of signal transducers, most of which also
participate in non-autophagic signaling cascades. Thus, autophagy
occupies a crucial position within the cell’s metabolism,
and its modulation may represent an alternative therapeutic
strategy in several pathological settings including cancer
and neurodegeneration. Here, we present a general outline
of autophagy followed by a detailed analysis of organelle-specific
autophagic pathways and of their intimate connections with
cell death.
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Autophagy: For Better or for Worse, in Good Times
or in Bad Times…
Cecilia Lerena, Sebastián D. Calligaris and María
Isabel Colombo
Autophagy is a bulk cytosolic degradative process which
in the last few years has become a key pathway for the advancement
of molecular medicine. Autophagy (cellular self-eating) has
several implications in human disorders involving accumulation
of cytosolic protein aggregates such as Alzheimer, Parkinson,
Huntington diseases, as well as in myopathies caused by deficient
lysosomal functions and in cancer. Moreover, autophagy affects
intracellular microorganism lifespan, acting either as a cellular
defense mechanism or, on the contrary, promoting pathogen
replication. Furthermore, autophagy also participates in antigen
presentation, as a part of the adaptive immune response. Therefore,
autophagy association with cell survival or cell death would
depend on cell nutrition conditions, presence of cell intruders,
and alterations in oncogene or suppressor gene expression.
In this review we will focus on the wide spectra of disease-related
topics where autophagy is involved, particularly, in those
processes concerning microorganism infections.
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Regulation of Bcl-2 Family Proteins by Posttranslational Modifications
Ozgur Kutuk and Anthony Letai
Like many proteins, function and abundance of Bcl-2 family
proteins are influenced by posttranslational modifications.
These modifications include phosphorylation, proteolytic cleavage,
ubiquitination, and proteosomal degradation. These modifications,
depending on cellularcontext and the proteins involved, can
result either in a promotion of inhibition of apoptosis. Many
of these modifications are governed by the activity of enzymes.
As modulation of enzymatic activity can be achieved fairly
efficiently using small molecules, understanding the effects
of posttranslational modifications may allow for the therapeutic
inhibition or promotion of apoptosis.
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Ca2+ Signaling, Mitochondria
and Cell Death
Carlotta Giorgi, Anna Romagnoli, Paolo Pinton and Rosario
Rizzuto
In the complex interplay that allows different signals
to be decoded into activation of cell death, calcium (Ca2+)
plays a significant role. In all eukaryotic cells, the cytosolic
concentration of Ca2+ ions
([Ca2+]c) is tightly controlled
by interactions among transporters, pumps, channels and binding
proteins. Finely tuned changes in [Ca2+]c
modulate a variety of intracellular functions ranging from
muscular contraction to secretion, and disruption of Ca2+
handling leads to cell death. In this context, Ca2+
signals have been shown to affect important checkpoints of
the cell death process, such as mitochondria, thus tuning
the sensitivity of cells to various challenges. In this contribution,
we will review (i) the evidence supporting the involvement
of Ca2+ in the three major
process of cell death: apoptosis, necrosis and autophagy (ii)
the complex signaling interplay that allows cell death signals
to be decoded into mitochondria as messages controlling cell
fate.
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Mitochondrial Dynamics: To be in Good Shape to Survive
Sébastien Herzig and Jean-Claude Martinou
Mitochondria are essential organelles of all eukaryotic
cells that play a key role in several physiological processes
and are involved in the pathology of many diseases. These
organelles form a highly dynamic network, which results from
continuous fusion and fission processes. Importance of these
processes is underlined by inherited human diseases caused
by mutations in two mitochondrial pro-fusion genes: Charcot-MarieTooth
disease, caused by mutations in Mitofusin 2 gene and ADOA
due to mutations in OPA1. During apoptosis, the mitochondrial
network is disintegrated and the outer mitochondrial membrane
permeabilized, which results in the release of several apoptogenic
proteins, including cytochrome c. Although modulating mitochondrial
fusion and fission machineries has been reported to influence
the apoptotic response to various stimuli, it is still unclear
whether fission is absolutely required for apoptosis. In this
review, we present the latest progress in the field of mitochondrial
dynamics with a particular emphasis on its implication in
apoptosis and in diseases.
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Unique Biology of Mcl-1: Therapeutic Opportunities
in Cancer
Matthew R. Warr and Gordon C. Shore
Accumulating evidence suggests that Mcl-1 plays a critical
pro-survival role in the development and maintenance of both
normal and malignant tissues. Regulation of Mcl-1 expression
occurs at multiple levels, allowing for either the rapid induction
or elimination of the protein in response to different cellular
events. This suggests that Mcl-1 can play an early role in
response to signals directing either cell survival or cell
death. Deregulation of pathways regulating Mcl-1 that result
in its over expression likely contribute to a cell’s
inability to properly respond to death signals possibly leading
to cell immortalization and tumorigenic conversion. Correspondingly,
Mcl-1 has been shown to be up-regulated in numerous hematological
and solid tumor malignancies. Moreover, this up-regulation
appears to be a factor in the resistance of some cancer types
to conventional cancer therapies. Mechanisms that abrogate
the pro-survival function of Mcl-1 either by diminishing its
levels or inactivating its functional BH3 groove have shown
promise for the combinational treatment with existing cancer
therapies and as single agents in certain malignancies. Here
we review the various pathways that regulate Mcl-1 expression
and describe agents that are currently under development to
modulate Mcl-1 activity for therapeutic benefit in oncology.
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The Bax Inhibitor-1 (BI-1) Family in Apoptosis
and Tumorigenesis
Kerstin Reimers, Claudia Y.U. Choi, Vesna Bucan and
Peter M. Vogt
The signaling pathways that determine the fate
of a cell regarding death or survival depend on a large number
of regulatory proteins. The Bax Inhibitor-1 (BI-1) family
is a highly preserved family of small transmembrane proteins
located mostly in the endoplasmic reticulum (ER). Although
most members of this family are still not characterized an
antiapoptotic effect has been described for BI-1, Lifeguard
(LFG), and the Golgi antiapoptotic protein (GAAP). The cytoprotective
activity has been associated to the control of ion homeostasis
and ER stress but includes other cell death stimuli as well.
Recent data describes multiple interactions between the proteins
of the BI-1 family and the Bcl-2 family either stimulating
the antiapoptotic function of Bcl-2 or inhibiting the proapoptotic
effect of Bax. The potent cell death suppression makes this
protein family an interesting target for the development of
new drugs and gene therapeutic approaches for diseases caused
by apoptotic dysregulation, such as cancer.
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