Figure 4.

Apoptosis pathways mediated by chemo- and immunotherapy. Both chemo- and immunotherapy converge on common pathways (black lines) in which pro-apoptotic Bid and Bim play a key role as connecting elements. Cell death induced by chemotherapy (blue dotted line): Cell stress caused by chemotherapy entails the activation of p53 and BH3-only-proteins. As a result, proapoptotic Bid, Bim and Bax/Bak-like proteins are activated and anti-apoptotic Bcl-2-like proteins inhibited. Cell death induced by immunotherapy (blue solid line): T lymphocytes can trigger cell death by directly activating caspase cascade and by activating caspase-independent apoptosis mediated by Bim as well. This cytotoxic effect is also enhanced by activating pro-apoptotic Bid.