Article

  • The EMBO Journal (2009) 28, 578 - 590
  • doi:10.1038/emboj.2009.1

Published online: 22 January 2009

Mechanisms of pre-apoptotic calreticulin exposure in immunogenic cell death

Theocharis Panaretakis1,2,3,a, Oliver Kepp1,2,3,a, Ulf Brockmeier4,a, Antoine Tesniere1,2,3, Ann-Charlotte Bjorklund5, Daniel C Chapman4, Michael Durchschlag6, Nicholas Joza1,2,3, Gérard Pierron7, Peter van Endert8,9, Junying Yuan10, Laurence Zitvogel2,3,11, Frank Madeo6, David B Williams4 and Guido Kroemer1,2,3

  1. INSERM, Unit 848, Villejuif, France
  2. Institut Gustave Roussy, Villejuif, France
  3. Université Paris Sud, Paris 11, Villejuif, France
  4. Department of Biochemistry, University of Toronto, Toronto, Ontario, Canada
  5. CancerCentrum Karolinska, Karolinska Institute, Stockholm, Sweden
  6. Institute of Molecular Biosciences, University of Graz, Graz, Austria
  7. CNRS, FRE 2937, Institut Andre Lwoff, Villejuif, France
  8. INSERM, U580, Paris, France
  9. Faculté de Médecine René Descartes, Université Paris-Descartes, Paris, France
  10. Department of Cell Biology, Harvard Medical School, Boston, MA, USA
  11. INSERM, U805, Institut Gustave Roussy, Villejuif, France

Correspondence to:

Guido Kroemer, INSERM, U848, Institut Gustave Roussy, PR1, 39, rue Camille Desmoulins, 94805 Villejuif, France. Tel.: +33 1 42 11 60 46; Fax: +33 1 42 11 60 47; E-mail: kroemer@igr.fr

aThese authors contributed equally to this work

Received 27 June 2008; Accepted 29 December 2008


Dying tumour cells can elicit a potent anticancer immune response by exposing the calreticulin (CRT)/ERp57 complex on the cell surface before the cells manifest any signs of apoptosis. Here, we enumerate elements of the pathway that mediates pre-apoptotic CRT/ERp57 exposure in response to several immunogenic anticancer agents. Early activation of the endoplasmic reticulum (ER)-sessile kinase PERK leads to phosphorylation of the translation initiation factor eIF2alpha, followed by partial activation of caspase-8 (but not caspase-3), caspase-8-mediated cleavage of the ER protein BAP31 and conformational activation of Bax and Bak. Finally, a pool of CRT that has transited the Golgi apparatus is secreted by SNARE-dependent exocytosis. Knock-in mutation of eIF2alpha (to make it non-phosphorylatable) or BAP31 (to render it uncleavable), depletion of PERK, caspase-8, BAP31, Bax, Bak or SNAREs abolished CRT/ERp57 exposure induced by anthracyclines, oxaliplatin and ultraviolet C light. Depletion of PERK, caspase-8 or SNAREs had no effect on cell death induced by anthracyclines, yet abolished the immunogenicity of cell death, which could be restored by absorbing recombinant CRT to the cell surface.

  • Keywords:

    • calreticulin,
    • caspase,
    • endoplasmic reticulum stress,
    • ERp57,
    • exocytosis
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