Instead, MLKL requires the interaction of its N-terminal domain with highly phosphorylated IPs (e.g., IP6). complex mechanisms tipping the balance between different cell fates. Here, we summarize the latest discoveries in the three most well understood modalities of cell CACNB4 death, namely, apoptosis, necroptosis, and pyroptosis, highlighting common and unique pathways and their effect on the surrounding cells and the organism as a whole. or display no alterations in TNF-induced necroptosis, challenging this theory.16,18 Further disproving the potential involvement of mitochondria in necroptosis induction, the use of the ROS scavenger butylated hydroxyanisole did not affect TNF-induced necroptosis.19 Instead, two nonexclusive models explain how MLKL compromises cellular integrity: (1) MLKL constitutes a platform at the plasma membrane for the opening of calcium or sodium ion channels, thus enabling ion influx, cell swelling, and rupture,20,21 Xanthopterin and (2) MLKL itself forms pores in the plasma membrane through interaction between a positively charged patch in the 4HBD and negatively charged phosphatidylinositol phosphates (PIPs) present at the membrane.22C24 In addition, MLKL oligomerization and membrane translocation seem to depend on a specific inositol phosphate (IP) code.25 Indeed, Dovey and colleagues demonstrated that phosphorylation of MLKL by RIPK3 alone is not sufficient for MLKL translocation to the membrane. Instead, MLKL requires the interaction of its N-terminal domain with highly phosphorylated IPs (e.g., IP6). This interaction, in turn, displaces the sixth -helix of MLKL, which acts as a molecular brace believed to inhibit interactions with the MLKL N-terminal domain and control MLKL oligomerization. 24 In line with these results, expression of the MLKLD139V mutant, which alters the two-helix brace structure, endows MLKL with RIPK3-independent constitutive killing activity, causing lethal postnatal inflammation in homozygous mutant mice.26 Moreover, MLKL oligomerization was recently shown to dictate the kinetics and threshold of necroptotic cell death. Indeed, phosphorylated MLKL first assembles into cytosolic polymeric necrosomes and then traffics with tight junction proteins to the plasma membrane, where both accumulate to form micron-sized structures.27 Although mitochondrial damage and ROS production are not considered to be directly involved in the establishment of necroptotic cell death, a recent study by Yang and colleagues showed that RIPK3 instead has downstream effects on mitochondria: RIPK3 directly phosphorylates and activates the E3 subunit of the pyruvate dehydrogenase complex and promotes aerobic respiration and mitochondrial ROS production.28 This Xanthopterin finding could explain the link between necroptosis and mitochondrial destabilization. Open in a separate window Fig. 1 Necroptosis is triggered downstream of death domain receptors (e.g., TNFR and Fas) and Toll-like receptor (TLR)-4 or TLR3. Upon activation, these receptors recruit the adapter proteins FADD, TRADD, and TRIF, which interact Xanthopterin with RIPK1 and caspase-8 or -10. First, RIPK1 is ubiquitylated by IAPs, keeping it nonfunctional and enabling proinflammatory downstream activity via NFB. After detection of a death signal, RIPK1 is deubiquitylated by CYLD and can thus recruit RIPK3. The RIPK1/RIP3 complex recruits and phosphorylates MLKL. In the presence of highly phosphorylated inositol phosphate (IP6), phosphorylated MLKL oligomerizes, thus forming the necrosome. MLKL oligomers translocate to phosphatidylinositol phosphate (PIP)-rich patches in the plasma membrane and form large pores. Ultimately, MLKL pores lead to necroptotic cell death by allowing ion influx, cell swelling, and membrane lysis followed by the uncontrollable release of intracellular material. The cytosolic nucleic acid sensors RIG-I and cGAS/STING also contribute to necroptotic cell death, as they induce IFN-I and TNF and thus promote necroptosis via an Xanthopterin autocrine feedback loop. Downstream of TNFR or TLR engagement, active caspase-8 cleaves the cytokine blocker Xanthopterin N4BP1, thus promoting an increase in cytokine release. Once activated, RIPK3 phosphorylates the pyruvate dehydrogenase complex (PDC) in mitochondria and promotes aerobic respiration and mitochondrial ROS production. In the presence of cytosolic DNA released from infecting microbes, DNA-dependent activator of IFN regulatory factor (DAI) recruits RIPK3 and thus bypasses RIPK1 for activation of MLKL and formation of the necrosome complex Given its powerful and nonreversible nature, the necroptotic pathways early steps must be heavily regulated. Indeed, upon TNFR1 engagement, RIPK1 is rapidly recruited to signaling complex I, where it interacts with TRADD and TRAF2. At this location, TRAF2 and TRAF5 control the polyubiquitylation of RIPK1 via cIAP1/2, limiting the cell death function of RIPK1.29C34 Similarly, after TLR activation (e.g., by LPS or poly-(I:C)), the function of RIPK1/3 is regulated by cIAP1/2 and XIAP through ubiquitylation.30,31 Importantly, ubiquitylation of RIPK1 and RIPK3 not only prevents cell death but also is essential for NFB-dependent induction of proinflammatory genes.35 Furthermore, low extracellular pH was recently shown to act on a highly conserved histidine (His151) in the amino acid sequence of RIPK1, thus inhibiting its kinase activity and preventing cell death.36 In addition to these in vitro data, generating knockin mice expressing would undoubtedly help determine the physiological function of this pH sensitivity of RIPK1. Contributing to the death signal, CYLD deubiquitylates TRAF2 and RIPK1, allowing the formation of the.