. Chemical inhibitor of nonapoptotic cell death with therapeutic potential for ischemic brain injury. Nat Chem Biol. 2005 Jul;1(2):112-9. PubMed.

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  1. The paper by Degterev et al. is a tour de force characterization of necroptosis, a non-apoptotic form of programmed cell death that involves necrosis and autophagy. Existence of this caspase-independent pathway was hypothesized from observations that several different cultured cell types undergo a common necrotic death upon stimulation of death domain receptor proteins in the presence of caspase inhibitors. To investigate a necroptosis pathway, the authors performed a chemical screen of 15,000 small molecules for necroptosis inhibition. Of these, a heterocyclic compound, Necrostatin-1 (Nec-1), was shown to be a very potent and specific inhibitor of necroptosis.

    Application of Nec-1 did not block apoptosis, autophagy, or oxidative stress-induced necrosis, and also did not disrupt normal cellular physiology. Significantly, necroptosis was shown to be a delayed component of ischemia-associated neuronal cell death induced by cerebral artery occlusion in mice. Administration of Nec-1 attenuated the extent of ischemia-induced neuronal death and did not disrupt general brain physiology. Furthermore, Nec-1 exhibited an extended time window of protection and was able to exert its effects 6 hours after the onset of injury. The simultaneous addition of Nec-1 and the zVAD.fmk caspase inhibitor yielded an additive protective effect, suggesting a potentially effective therapeutic combination.

    Overall, necroptosis has a delayed latency compared to apoptosis, and the authors hypothesize that it may act as a redundant mechanism to provide cells with an ability to die when they find themselves in an environment non-permissive to apoptosis. Future studies to determine the site of Nec-1 action and characterize the components of necroptosis pathway promise to provide important insight not only into a conserved and important mechanism for cell death, but also to develop effective treatments for a variety of human pathologies.

    View all comments by John Nambu

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