Apoptosis: the sculptor of development

Apoptosis is a programmed mechanism of cell death recognized by its characteristic morphological and biochemical changes. Over the last decade, our understanding of the biochemistry of apoptosis has flourished. However, the physiological relevance of apoptosis remains elusive. Here, I propose that the process of programmed cell death plays an essential role in structural development. From pioneering studies almost a century ago to recent findings using modern technology, similar conclusions have emerged that highlight the fundamental role of apoptosis in vascular development. This review will recount these classic and modern studies as I survey evidence that implicates apoptosis in other aspects of development and ask how cell death can possibly contribute to homeostasis and development of the immune system. I briefly consider the mechanisms that may determine the fate of cells within the vasculature and propose new roles for the contribution of apoptosis to development and differentiation. More provocatively, I explore the possibilities that arise from this growing field of study, including prevention of developmental defects and even abnormal development after birth, such as neoplastic development. To realize these end points, the biochemical bases of apoptosis must be thoroughly understood.