APO-1-mediated apoptosis can be inhibited by a variety of factors, including the viral caspase inhibitors
CrmA and
p35, as well as viral FLICE-inhibitory proteins known as v-FLIPs. When in the presence of APO-1, v-FLIPs preferentially bind and prevent procaspase-8 from being recruited; as such, apoptosis is stalled. Humans have a homolog for v-FLIP known as c-FLIP, which occurs in two endogenous forms (c-FLIPL (long) and c-FLIPS (short)). These are similar in structure to procaspase-8, but lack the amino acids necessary for caspase-8 catalytic activity. It is thought that c-FLIP may be involved in modulating the immune system, as c-FLIPS is upregulated upon stimulation of the T cell receptor. Furthermore, as high expression of FLIP is known to promote tumor growth, these inhibitor molecules play a role in cancer proliferation. The DISC has been implicated as a possible drug development target for various cancers, including leukemia, glioma, and colon cancer. In glioma cells, the effects of
TRAIL (tumor necrosis factor-related apoptosis-inducing ligand) have been shown to induce DISC-mediated apoptosis. Specifically, TRAIL works by activating two death receptors,
DR4 and
DR5; these bind to FADD, which then interacts with caspase-8 to assemble the DISC. Tumor cells show varying sensitivity to TRAIL modulated apoptosis, depending on the presence of the antiapoptotic FLIP proteins. Additionally, studies in leukemia have indicated that the histone deacetylase inhibitor LAQ824 increases apoptosis by decreasing the expression levels of the c-FLIPs. As such, these inhibitors are promising targets for anti-cancer therapy. ==References==