Fig. 2: Process of immunogenic cell death.
Once immunogenic cell death is activated, damage-associated molecular patterns (DAMPs) are released. Calreticulin exposure and externalisation of phosphatidylserine on the surface of the stressed cell act as to signal local immature dendritic cells. High motility group box 1 (HMGB1) protein release binds to pattern recognition receptors (PRRs) to increase inflammation. Extracellular ATP simultaneously acts as a ‘find-me’ signal itself and also activates purinergic P2X7 receptors on dendritic cells. Heat shock proteins generated secondary to cellular stress also contribute to the activation of dendritic cells. Once the immature dendritic cells are activated and phagocytose cellular fragments, tumour associated antigens (TAAs) become present on the major histocompatibility complexes leading to antigen presentation, maturation and tumour antigen response.
