Apoptotic volume decrease and the incredible shrinking cell

In summary, apoptosis is a unique and well-orchestrated series of events leading to cellular suicide of which AVD plays an important role. Clearly an ionic component exists in the apoptotic program that has emerged and participates not only in the facilitation of the death program, but also in the repression of the cell death machinery. It is this repressive aspect of intracellular ions that appears to act as a checkpoint during apoptosis in which the cell not only decides whether to live or die, but how to accomplish this goal. Once the decision to die has been made, a specific movement of ions must occur, whether it be inhibiting or overriding the inherent volume regulatory responses used to protect the cell, or activating multiple pathways to permit the efflux of potassium from the cell. What is also apparent is that once the decision has been made to die, success is only measured with the unobstructed completion of the programmed cell death process. As with any worthwhile scientific endeavor, the study of AVD has increased our understanding of the role this process plays during apoptosis, however it has naturally led to more questions then answers. Questions that will continue to define apoptosis.