Phagocytosis of apoptotic cells: a matter of balance

Efficient clearance of apoptotic cells is required to control homeostasis in normal and pathological circumstances, and inappropriate clearance of cell corpses may lead to autoimmune diseases and inflammation. The multiplicity of phagocytotic mechanisms points to the relevance of removing apoptotic cells. A variety of surface molecules present in either the apoptotic bodies or phagocytes help in attachment and initiation of engulfment. Nonetheless, uncontrolled phagocytosis of apoptotic cells and other particles may lead to tissue injury; therefore, negative signals are important in balancing phagocytotic activity. This review aims at a systematic examination of positive and negative signals that modulate the uptake of apoptotic bodies and the signaling mechanisms involved in the clearance of apoptotic cells.Received 13 November 2004; received after revision 5 March 2005; accepted 8 March 2005