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. Author manuscript; available in PMC: 2012 Jul 23.
Published in final edited form as: Thorax. 2010 Apr;65(4):362–369. doi: 10.1136/thx.2009.128025

Figure 4.

Figure 4

Synergy of chemotherapy and radiotherapy with mesenchymal stem cell (MSC)-delivered anticancer agents. Chemotherapy and radiotherapy cause DNA damage and cancer cell apoptosis by the intrinsic apoptosis pathway, whereas TRAIL leads to cancer cell apoptosis by the extrinsic apoptosis pathway. Chemotherapy and radiotherapy can enhance the TRAIL sensitivity of cancer cells by (1) activating caspase cleavage; (2) inhibiting apoptotic inhibitors (eg, c-Flice-like inhibitory protein (c-FLIP)); and (3) increasing TRAIL receptor number and their location within the lipid raft. Radiotherapy can increase the homing of systemically-delivered MSCs to tumours by increasing (4) MSC chemokine receptor expression and (5) chemokine release by the tumours.