Recognition and phagocytosis of apoptotic cells

Physiological elimination of unwanted cells within the organism occurs via cell death by apoptosis and phagocytosis of these cells represents a key event in the apoptotic process. Macrophages, which are the dedicated phagocytes, and other occasionally phagocytic cells ingest the apoptotic cells while they are still intact, thus preventing the leakage of potentially harmful materials from the dying cells. Although evidence has been presented that the elimination of apoptotic bodies from the tissue operates by means of specific recognition systems, the molecular mechanisms by which an apoptotic cell is recognized are poorly understood. Recent data indicate that phagocyte recognition of apoptotic cells involves at least four classes of receptors on the phagocyte surface. On the other side, dying cells may display different signals to signal their status. Exposure of phosphatidyl serine (PS) on the surface of apoptotic lymphocytes triggers their specific recognition and removal by macrophages. Apoptotic thymocytes are also identified by altered lipid packing on their surface. Different populations of macrophages use either the vitronectin receptor or the PS receptor to recognize and remove apoptotic cells. It has been suggested that the asialoglycoprotein and the galactose-specific receptors of healthy hepatocytes and sinusoidal liver cells are implicated in the engulfment of apoptotic hepatocytes, likely in cooperation with other hepatic carbohydrate-specific receptor systems. The purpose of this review is to examine current knowledge of the mechanisms by which phagocytes recognize and ingest apoptotic cells.