ABSTRACT
This chapter summarizes current understanding of apoptosis and cell death from a clinical perspective, focusing on the head and neck. Different in vitro and in vivo models implicate apoptosis, necrosis or necroptosis as well as cell death subsequent to extrusion from the epithelium. There is now believed to be cross-talk between the processes of apoptosis, autophagy and 'regulated/programmed necrosis'. The understanding of apoptosis regulation provides cancer diagnostic and prognostic markers and is leading to development of cancer therapies specifically targeting cell survival pathways or mimicking pro-apoptotic signalling molecules. Mitochondrial apoptosis induced by reactive oxygen species is believed to underlie ageing-related deafness and ototoxicity of some pharmaceuticals including aminoglycoside antibiotics such as gentamycin. Cells can be induced to undergo apoptosis via engagement of cell surface death receptors (DR) with ligand molecules. Compromised p53 function leads to resistance to p53-mediated cell cycle arrest and deoxyribonucleic acid (DNA) repair as well as apoptosis, leading to accumulation of genetic damage.
