Mechanisms of cell injury and death.

Control of the rate of cell death relative to the rate of cell division maintains organ integrity and physiological homeostasis. Cell death is valuable for the organism because it removes terminally injured or unwanted cells that utilize valuable substrates and nutrients. Likewise, cell death also has value for the species, as it provides a mechanism for eliminating terminally injured individuals who consume necessary societal resources or harbour toxic pathogens. Recent advances in cellular biology have contributed substantially to our understanding of the processes of cell injury and death, and have provided the molecular tools necessary to control it. This paper reviews cell injury and adaptation; mechanisms of cell death; the roles of cell injury and death in the pathophysiology of organ dysfunction; and implications for prevention and therapy of multiple organ dysfunction syndrome (MODS).