Protease activation and glucocorticoid-induced apoptosis in chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) is at present an incurable disease, All of the drugs used in the treatment of CLL induce apoptosis in the cells, an d in vitro responses to glucocorticoid or analogs correlate with in vivo se nsitivity to these agents. Since CLL lymphocytes accumulate rather than pro liferate, the idea that CLL is a disease involving defective apoptosis is p articularly attractive. Recent studies have identified many of the central components of the apoptotic pathway that appear to be conserved from one ce ll type to another. Thus, investigation into the functionality of these mol ecules should reveal where the defect(s) in apoptosis may lie in CLL cells, Protease activation is a central event during apoptosis, and leads to many of the familiar characteristics of apoptosis. Here we will examine the rol e of apoptotic proteases in CLL and speculate on their contribution to dise ase emergence and drug resistance.