Which statement BEST distinguishes necroptosis from classical apoptosis?
- A Necroptosis requires caspase activation whereas apoptosis does not
- B Apoptosis produces cellular swelling and membrane rupture while necroptosis produces cell shrinkage
- C Necroptosis is a regulated, caspase-independent cell death mediated by RIPK3 and MLKL, eliciting inflammation; apoptosis is caspase-dependent and immunologically silent ✓
- D Necroptosis is activated exclusively by intrinsic mitochondrial pathway signals
Correct answer: C. Necroptosis is a regulated, caspase-independent cell death mediated by RIPK3 and MLKL, eliciting inflammation; apoptosis is caspase-dependent and immunologically silent
Explanation
Necroptosis is a programmed form of necrosis triggered by death receptors under conditions where caspase-8 is inhibited. It proceeds via RIPK1-RIPK3 necrosome formation, MLKL phosphorylation, and plasma membrane disruption — releasing DAMPs and triggering inflammation. Classical apoptosis is caspase-dependent, producing apoptotic bodies phagocytosed without inflammation. Necroptosis produces swelling and rupture (necrosis-like morphology), not shrinkage.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
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