J Biol Chem. 2026 Jul 28. pii: S0021-9258(26)02242-8. [Epub ahead of print]
113370
Cell death is a key effector mechanism of the innate immune system for host defense. While it is beneficial for pathogen clearance, excess lytic cell death is linked to inflammation, pathology, and disease. Therefore, tight regulation of cell death execution is critical. PANoptosis is an innate immune, lytic, and inflammatory cell death pathway initiated by innate immune sensors and driven by caspases and RIPKs, with roles in infection, inflammatory disease, and cancer. During PANoptosis, caspases and RIPKs within PANoptosome complexes activate multiple executioner proteins, including gasdermin (GSDM) family proteins and mixed lineage kinase domain-like pseudokinase (MLKL). These executioners form membrane pores that lead to membrane lysis and the release of DAMPs and cytokines. Although multiple executioners are activated during PANoptosis, the requirement for individual executioners in driving the lytic cell death remains unclear. To address this, we performed a comprehensive genetic analysis of GSDMD, GSDME, and MLKL using single, double, and triple knockout primary macrophages across triggers known to activate distinct PANoptosomes. Deletion of individual executioners did not reduce the activation of caspases or other executioners and did not fully block PANoptosis, suggesting these executioner molecules often act in a compensatory manner to execute PANoptosis. Furthermore, combined deletion of all three executioners provided greater protection than any single or double deletion. However, residual cell death still occurred even after genetic deletion of all three executioner proteins, suggesting the involvement of additional executioners that remain to be identified. Overall, our study suggests that targeting individual executioners will not be sufficient in disease contexts where PANoptosis drives pathology, and targeting the full executioner network or upstream molecules, such as sensors or essential PANoptosome complex components, will be needed for therapeutic efficacy in infection, inflammatory disease, and cancer.
Keywords: AIM2; GSDMD; GSDME; MLKL; NLR; NLRC5; NLRP12; NLRP3; PANoptosis; PANoptosome; RIPK1; RIPK3; ZBP1; caspase; caspase-1; caspase-8; cell death; executioner; gasdermin; inflammasome; innate immunity