CTL cytotoxic mechanisms. The killer cell has
formed a conjugate “synapse” with the target cell and is in the
process of secreting granules (light purple) in the synaptic space.
Granule material including perforin is derived from the Golgi complex;
granzymes are processed by DPPI and stored in the granule. After
secretion into the synaptic space and pore formation, granzymes enter
into the target cell through repair endocytosis. Granzyme B activates
downstream apoptotic pathways, whereas granzyme A may activate
caspase-independent apoptosis. TNF, tumor necrosis factor;
TWEAK?, ligand in the TNF family that weakly induces apoptosis; TRAIL,
TNF-related apoptosis-inducing ligand; DRn, death
receptor n; gra, granzyme; PHAPn,
putative HLA-associated protein n; FADD, FAS-associated
death domain factor; FLASH?, FLICE-associated huge protein; ICAD/CAD,
inhibitor caspase-activated DNase/caspase-activated DNase; cFLIP,
cellular FLICE inhibitory protein; vFLIP, viral FLICE inhibitory
protein; crmA, cytokine response modifier A.