Ordering the Multiple Pathways of Apoptosis

Apoptosis plays an important role in development, homeostasis, and disease. Current work has suggested that apoptosis can be evoked by multiple stimuli that, in turn, initiate distinct death pathways. Recently, exciting advances have been made in the understanding of biochemical pathways that regulate apoptotic processes. These pathways contain both evolutionarily conserved elements and components that are dependent on the death stimulus and cell context. Accordingly, this review focuses on the compositions and relative ordering of the apoptotic pathways in four different death paradigms: activation of receptors of the Fas ligand, destruction by cytotoxic T lymphocytes, exposure to DNA damaging agents, and loss of support by neurotrophic factors. These examples illustrate the conservation and divergence in the ways that death pathways are composed and ordered. (Trends Cardiovasc Med 1997;7:294-301).