Pyroptosis is a form of programmed cell death that is highly proinflammatory. Pyroptosis was originally observed in macrophages in response to bacterial infection or bacterial toxin stimulation. This cell death, then misclassified as a type of apoptosis specifically in macrophages, requires caspase-1 that also processes interleukin-1β mainly expressed in monocytic cells. Caspase-1 is activated by canonical inflammasomes, a major cytosolic innate immune surveillance mechanism that can detect various pathogen-associated molecular patterns (PAMPs) or damage-associated molecular patterns (DAMPs). Studies on innate immunity to cytosolic lipopolysaccharide (LPS) have established that murine caspase-11 and its human counterparts caspase-4/5 can also mediate pyroptosis upon directly binding to the lipid A moiety of LPS. Caspase-11/4/5 do not process interleukin and caspase-11/4/5-mediated pyroptosis is prevalent in non-monocytic cells. Very recent studies have identified gasdermin D (GSDMD) as the pyroptotic substrate for both caspase-1 and caspase-11/4/5. GSDMD represents a large gasdermin family that shares membrane pore-forming activity, rendering a new concept of pyroptosis as gasdermin-mediated programmed necrotic cell death. In this article, we review the concept evolvement of pyroptotic cell death from a historic perspective, covering the innate immune pathways upstream of caspase-1 and caspase-11/4/5. We also discuss the recent advances on pyroptosis, particularly mechanistic and functional understandings of GSDMD and the gasdermin family of pyroptosis executor proteins.
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