Figure 1
The extrinsic and intrinsic apoptotic pathways. The extrinsic pathway is initiated by engagement of DRs via their respective ligands TNF, FASL/CD95L, or TRAIL. Together with the adaptor FAS-associated death-domain (FADD) protein and the initiator procaspase-8 (or -10) they form the death-inducing signaling complex (DISC). This assembly enables the dimerization and autoactivation of the initiator caspases, which in turn cleave and activate the executioner caspase-3 and -7, ultimately leading to apoptosis unless they are inhibited by XIAP. The intrinsic pathway can be engaged by diverse intracellular stresses that modulate BCL-2 family protein interactions that control the activation of the BCL-2 effector proteins BAX and BAK. Once activated, BAX and BAK cause MOMP, leading to the release of proapoptotic IMS proteins. Cytochrome c (Cyt c) engages APAF1 and induces its oligomerization, leading to apoptosome formation that recruits and activates the initiator procaspase-9. Active caspase-9 cleaves and activates the executioner caspase-3 and -7. Simultaneously with Cyt c, Smac is released from the IMS and inhibits XIAP. The extrinsic and intrinsic pathways are linked; caspase-8 can cleave the BH3-only protein BH3-interacting domain death agonist (Bid), leading to its active, truncated form tBid, which in turn activates BAX/BAK. Numbers in circles indicate the respective pro- and active caspase; interrupted circles represent active caspases
