Apoptosis and its clinical significance for bladder cancer therapy

the confusion over definitions of cell death and the need Introduction to view apoptosis within the broader context as a process of growth regulation. Apoptosis describes the Apoptosis is a unique form of cell death in which the cell activates a self-destruct mechanism, causing its events of cell death which occur throughout normal development and as a response to a variety of initiation death. The realization that most, if not all, anticancer agents eCect tumour killing through the activation of stimuli. Apoptosis is often incorrectly referred to as being synonymous with programmed cell death (PCD). apoptosis has emphasized the key role of the process in tumour growth and cytotoxic resistance [1]. In the last Not all apoptosis is PCD but, as implied by the term PCD, cell death is predetermined by a genetic clock decade, there has been intensive scientific research in the field and as the understanding of the genetic moduwhich is activated at an appropriate time [6,7]. An example of PCD can be seen in the perfect timing of the lation of the apoptotic process evolves, new therapeutic options arise. A critical development in the current death of individual cells in invertebrates and in embryonic development [8]. Thus PCD should be reserved for understanding of cytotoxic cell killing is that DNA damage induced by an anticancer agent does not necesdescribing death that is a normal part of life or development, but not related to a specific form of sarily result in cell death. Thus, cells cannot be seen as passive recipients of drug-induced damage. Rather, eCeccell death. Another form of cell death, necrosis, is distinct from tive killing involves the cell being able to activate the genes involved in the apoptotic process [2,3]. Therefore, apoptosis and occurs after injury or toxic damage. It is not seen in normal development and is fundamentally inappropriate expression of oncogenes and tumour suppressor genes (TSGs) is fundamental to the sequential diCerent from apoptosis both in its nature and biological significance [9,10]. In necrosis, the cell is unable events which lead to the development of cancer and resistance to cytotoxic therapy [4]. to maintain ionic homeostasis and metabolic collapse results. Consequently, the cell swells and the membranes In bladder cancer the mechanisms of chemoresistance are not fully understood and this may in part be due to a leak, resulting in an inflammatory reaction. In contrast, during apoptosis, the cell membrane maintains its integlack of knowledge of the processes involved in apoptosis. However, many investigators within the bladder cancer rity and cytosolic proteins cross-link to produce a net which envelopes the cell and prevents leakage of cellular research community are now addressing the issue of drug resistance and apoptosis. This review will discuss the curstructures. Therefore, in apoptosis, the surrounding tissue architecture is not disrupted and there is no rent understanding of the concepts of apoptosis and the clinical significance of the processes involved in resistance inflammation [11]. to cytotoxic therapy in bladder cancer.