Will knowledge of the mechanisms of apoptosis lead to new therapeutic procedures

Apoptosis (programmed cell death) ensures under physiological conditions cell homeostasis. Under pathological conditions excessive apoptosis, premature apoptosis or delayed or infinite apoptosis of cell is a sign of various serious diseases. Due to intensive research in this field it proved possible to assess nowadays at a molecular level a number of pro- and anti-apoptotic factors and their function in the process of apoptosis. Apoptosis proceeds by external as well as internal pathway. Factors involved in apoptosis are studied from the aspect of their possible therapeutic application in tissue cultures, experimental animals, and there are already some initial reports from human pathology. Delayed or infinite apoptosis is a typical property of tumor cells. So far most attention was paid to two ways of apoptosis induction of tumor cells: suppressed translation of the antiapoptic factor Bcl 2 by means of an antisense nucleotide and induction of apoptosis by TRAIL (TNF related apoptosis inducing ligand). Conversely a delay of premature apoptosis gives hope for hitherto untreatable neurodegenerative diseases, myelodysplastic syndromes, ischaemic events and some severe infections. This is achieved by means of peptides inhibiting caspases. Provided that modulation of cell apoptosis will not be associated with unacceptable side-effects, it will become a new therapeutic approach in hitherto inadequately curable diseases.