Molecular switches that govern the balance between proliferation and apoptosis

Tissue modelling during embryogenesis and tissue homeostasis during adult life is governed by a dynamic equilibrium between growth and programmed cell death (apoptosis). Growth control and apoptosis are intimately associated, and a disturbance of the balance between these two processes often leads to pathological situations, such as for example cell accumulations in cancer. To date many of the molecular mechanisms controlling growth control on the one hand, and apoptosis on the other hand are known, whereas the switch that controls the decision between both pathways remains elusive. A cell is continuously exposed to multiple opposing "death" and "survival" triggers. A challenging question is how a cell senses these signals and decides to live or die. A decision in favour of survival should automatically result in a shut down of the death pathways. Alternatively, a decision for death should result in inhibition of futile attempts to survive. The molecular events controlling this balance of signals will be discussed with special emphasis on the role of cyclin-dependent kinases and the ubiquitin-dependent and proteasome-mediated protein degradation pathway.