4.6 Article

The role of regulated necrosis in endocrine diseases

Journal

NATURE REVIEWS ENDOCRINOLOGY
Volume 17, Issue 8, Pages 497-510

Publisher

NATURE PORTFOLIO
DOI: 10.1038/s41574-021-00499-w

Keywords

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Funding

  1. Heisenberg-Professorship - German Research Foundation (DFG) [324141047]
  2. Medical Clinic 3, University Hospital Carl Gustav Carus Dresden, Germany
  3. DFG [KR3363/3-1]
  4. Hochschulmedizin Zurich through the Flagship project Immuno-TarGET
  5. international research training group (IRTG) 2251
  6. [SFB-TRR 205]
  7. [SFB-TRR 127]

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Research on basic cell death has shown that most pathophysiologically significant cell death is necrotic in nature, while regulated necrosis can take different forms such as necroptosis, pyroptosis, and ferroptosis. Necrosis leads to an immune response by releasing damage-associated molecular patterns, and thus the consequences of regulated necrosis in the endocrine environment are specific.
The death of endocrine cells is involved in type 1 diabetes mellitus, autoimmunity, adrenopause and hypogonadotropism. Insights from research on basic cell death have revealed that most pathophysiologically important cell death is necrotic in nature, whereas regular metabolism is maintained by apoptosis programmes. Necrosis is defined as cell death by plasma membrane rupture, which allows the release of damage-associated molecular patterns that trigger an immune response referred to as necroinflammation. Regulated necrosis comes in different forms, such as necroptosis, pyroptosis and ferroptosis. In this Perspective, with a focus on the endocrine environment, we introduce these cell death pathways and discuss the specific consequences of regulated necrosis. Given that clinical trials of necrostatins for the treatment of autoimmune conditions have already been initiated, we highlight the therapeutic potential of such novel therapeutic approaches that, in our opinion, should be tested in endocrine disorders in the future.

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