What happens if DNA damage is irreparable?
When a cell experiences DNA damage, it usually activates DNA repair mechanisms to fix the damage and continue the normal cell cycle. However, if the DNA damage is too severe or irreparable, meaning it cannot be fixed by any known cellular repair systems, then the cell initiates irreversible fail-safe responses. These responses are extremely important to protect the organism from mutations that could lead to cancer or developmental defects. There are two major irreversible outcomes in such situations:
1. Apoptosis (Programmed Cell Death)
This is the most common and well-studied response when DNA damage is beyond repair. The cell activates a self-destruction program called apoptosis, which is highly regulated and highly efficient. This process is mainly controlled by the p53 tumour suppressor protein, which acts like a cellular guardian.
When p53 remains stabilised due to irreparable damage, it induces the transcription of pro-apoptotic genes like BAX, PUMA and NOXA. These proteins target the mitochondrial membrane, leading to the release of cytochrome c into the cytoplasm. Cytochrome c then binds with Apaf-1 and forms the apoptosome, which activates caspase-9 and subsequently caspase-3, initiating a cascade of proteolytic reactions that lead to DNA fragmentation, cell shrinkage, membrane blebbing and finally complete destruction of the cell.
This entire process ensures that the damaged and dangerous cell is safely removed without causing inflammation or damage to surrounding tissues.
2. Cellular Senescence (Permanent Arrest of the Cell Cycle)
If apoptosis is not triggered or in some cases like ageing tissues, the cell may instead enter a state called senescence. This is a condition where the cell remains alive and metabolically active but permanently exits the cell cycle. It can no longer divide or replicate and stays arrested in a G₀ phase-like state.
Senescence is also mainly controlled by p53, and RB (retinoblastoma protein) pathways. These proteins inhibit CDK activity and stop the progression of the cell cycle at the G1 phase. Senescent cells are often seen to accumulate in ageing tissues and may also secrete inflammatory signals {called SASP (Senescence-Associated Secretory Phenotype)}.
Although the cell does not die, it is permanently prevented from passing the damaged DNA to daughter cells. This is another protective mechanism against tumour formation.
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