The ability of the Unfolded Protein Response (UPR) to modulate cell death, following an unsuccessful attempt to restore homeostatic protein folding in the ER lumen, remains an incomplete story. Recently some of the key molecular players have been identified and at the transcriptional level and it has become clear that multiple proteins interacting in the nucleus to coordinately shut off survival genes and activate pro-death genes is a common theme. The ATF4-mediated induction of CHOP, following PERK activation and eIF2α phosphorylation, is a key event in the switch, under stress, from adaptation toward death and has received the most attention in the literature. Initial clues implicating CHOP as a participant in the UPR-mediated cell death program came to light when it was reported that overexpression of CHOP could induce cell cycle arrest and apoptosis (
Barone, Crozat et al. 1994;
Matsumoto, Minami et al. 1996); and that
Chop null mice were partially resistant to ER stress-mediated apoptosis (
Zinszner, Kuroda et al. 1998;
Oyadomari, Koizumi et al. 2002). Though it is clear that CHOP has an important role in ER stress-induced apoptosis a comprehensive analysis of its target (downstream of
CHOP or DOC) genes has not revealed a smoking gun (
Wang, Kuroda et al. 1998) (and our un-published observation), suggesting that this effect might be indirect.
Though CHOP target genes capable of directly inducing apoptosis have not been identified it can induce the expression of death receptor 5 (DR5) and
tribbles-related protein 3 (TRB3) in a stress-dependent fashion to modulate the UPR death response. DR5 is a member of the TNFR family and can mediate cell death via the FADD signaling complex (
Chaudhary, Eby et al. 1997). Thapsigargin enhanced DR5 expression was found to be mediated by CHOP in human cancer cell lines and sensitized them to TRAIL-induced cell death (
Hetschko, Voss et al. 2008). Increased expression of DR5 enhanced ligand binding and led to the recruitment of adaptor proteins at the intracellular DR5 death domain and initiated a signaling cascasde that culminated in the cleavage and activation of caspase 8 similar to TNFR1, Fas and DR3 and DR4. The discovery that CHOP could modulate DR5 expression linked the UPR to the “extrinsic” death receptor-mediated apoptosis pathway which, following caspase 8 cleavage, culminates in the activation of executioner caspases 3 and 7 to target substrates in the nucleus such as a lamins and PARP immediately prior to DNA fragmentation. It should be noted that additional
in vitro experiments revealed that siRNA knockdown of DR5 could interfere with the conformational change of Bax and caspase 3 activation required for apoptotic cell death following stress (
Yamaguchi and Wang 2004).
Tribbles-related protein 3 (
TRB3) has also been identified as an ER stress-inducible target of CHOP/ATF4 signaling that can modulate UPR-dependent cell death induced by various ER stressors (
Ohoka, Yoshii et al. 2005;
Ord and Ord 2005;
Ord, Meerits et al. 2007). Though there is a report that siRNA knockdown of TRB3 could reduce ER stress-dependent cell death in 293 cells (
Ohoka, Yoshii et al. 2005) most studies have reported that TRB3 antagonizes the anti-proliferative and cytotoxic effects of the UPR by down-regulating ATF4 transcriptional activity thereby lowering the level of intracellular reactive oxygen species (ROS) (
Ord, Meerits et al. 2007).
The UPR utilizes the BCL2 family during the cell death process via distinct and complementary mechanisms. CHOP induction can dramatically reduce cellular levels of BCL2 to directly potentiate the release of cytochrome c and initiate the mitochondrial or “intrinsic” cell death pathway (
McCullough, Martindale et al. 2001). The subset of BCL2 family members that possess only the BCL2 homology domain 3 (BH3 domain), in stark contrast to BCL2, are all known to be pro-apoptotic. In general this small group of proteins have a similar
modus operandi in the apoptotic push toward death which is characterized by their ability to interact with BCL2 impeding its ability to keep Bax and Bak in an inactive conformation. Activation of Bax or Bak precipitates the release of cytochrome c from mitochondria and Ca
+2 from the ER, thus setting in motion the process of apoptosis. Though currently 9 members of the BH3-only protein family have been identified only NBK/BIK, BIM, NOXA and PUMA have been closely associated with the UPR-mediated cell death (
Morishima, Nakanishi et al. 2004;
Fribley, Evenchik et al. 2006;
Kieran, Woods et al. 2007;
Shimazu, Degenhardt et al. 2007;
Zou, Cao et al. 2009).
A number of molecules in addition to CHOP, ATF4, Bax/Bak, and caspase 12 are known to be involved with UPR-mediated cell death. It has been known for over a decade that thapsigargin could activate the c-Jun NH(2)-terminal kinase cascade and apoptosis in an oxidative stress-dependent fashion (
Srivastava, Sollott et al. 1999). Several years later it was reported that the activation of IRE1α led to the formation of a tripartite complex at the cell membrane with TRAF2 and ASK1 prior to the activation of the JNK cell death program (
Urano, Wang et al. 2000;
Matsuzawa, Nishitoh et al. 2002;
Nishitoh, Matsuzawa et al. 2002). It is clear that JNK plays an important role in UPR-mediated cell death. Since we will not describe any large scale methods focused to identify the activation of JNK signaling, further discussion has been omitted. For thorough and recent reviews of stress mediated activation of JNK signaling:[(
Nagai, Noguchi et al. 2007;
Rincon and Davis 2009)