The gastrointestinal tract is characterized by a rapid proliferation of ste
m cells that differentiate to become terminal mature cells and ultimately d
ie through a genetically programmed form of cell death: termed apoptosis, w
hich is responsible for maintaining of tissue size. Apoptosis has also been
shown to play an important role in the pathophysiology of several gastroin
testinal diseases. The development of man infectious and immune-mediated di
seases, such as gastritis, coeliac disease, inflammatory bowel diseases, ma
y be triggered by the prevalence of pro-apoptotic signals, whereas prolonge
d cell survival, due to apoptosis inhibition, may give rise to neoplastic c
lones. Elucidation of the biochemical pathways and of specific proteins reg
ulating apoptosis may provide a remarkable opportunity to manipulate the li
fe and death decisions of the gastrointestinal cells and to develop new the
rapeutic strategies. This review will deal with the mechanisms potentially
involved in apoptosis and with the clinical relevance of this phenomenon in
gastrointestinal diseases.