Learning objectives: Reading this article will introduce the reader to the basic concept of physiologic cell death referred to as apoptosis. In addition, the role of apoptosis in immune function as well as its contribution to various clinical disorders will be developed.
Data source: The author's experience with recently described patients who have a unique autoimmune syndrome associated with a defect in apoptosis. In addition, recent reviews on the subject of apoptosis in health and disease served as informational outlines.
Study selection: Data source included pertinent reviews and articles meeting the educational objectives and these were critically reviewed.
Results: Apoptosis is a critical process in cellular homeostasis that only recently has been appreciated. Its role in both immune development and the control of immune responses as well as in T cell cytotoxic effector function has been established. Information is accumulating that diseases such as cancer can be linked to underlying defects in the apoptosis pathway allowing cells that normally would have been eliminated to live. The role of alterations in apoptosis in other chronic diseases, including autoimmune and neurodegenerative disorders, is beginning to emerge.
Conclusions: Apoptosis plays a central part in normal tissue homeostasis as well as having a role in a variety of clinical diseases that are characterized by either increased or decreased cell survival.