Drugs modulating apoptosis: current status

Abstract

Apoptosis (programmed cell death) is a natural process that helps in removing potentially harmful cells from the body and replacing it with normal ones. Like any other process, it is also subjected to lots of deregulations and can lead to diseases like cancer, neurodegenerative conditions, multiple sclerosis, Parkinson’s disease, autoimmune disorders and inappropriate death of cells after liver failure, stroke and myocardial infarction. The knowledge of the molecular mechanisms involved in apoptosis has been progressed tremendously. Thus, therapeutics targeting apoptosis have been emerged as a novel approach for treating various disease conditions. Current approaches induce or inhibit apoptosis by targeting the key regulators of apoptosis such as Bcl2 family of proteins, TRAIL, caspases, MDM2, IAPs and p53. While many apoptotic drugs proved its efficacy in preclinical studies, some are already approved and entered the clinical setting. Numerous novel approaches such as antisense therapy, gene therapy, recombinant biologics and combinatorial chemistry are being employed to target these regulators. This review focused on the pathways of apoptosis, various therapeutic targets in apoptosis and the drugs modulating these targets.