The optimal regulation mode of Bcl-2 apoptotic switch revealed by bistability analysis.

In most cell types, apoptosis occurs by the mitochondrial outer membrane permeability (MOMP)-mediated pathway, which is controlled by Bcl-2 family proteins (often referred to as Bcl-2 apoptotic switch). These proteins, which display a range of bioactivities, can be divided into four types: effectors, inhibitors, activators and sensitizers. Although the complex interactions among Bcl-2 family members have been studied intensively, a unifying hypothesis for the mechanism they use to regulate MOMP remains elusive. The bistable behaviors are often used to explain the all-or-none decisions of apoptosis. Here, we attempt to reveal the optimal interaction mode by comparing the bistable performances of three different modes (direct activation, indirect activation, and unified mode) proposed by biologists. Using the method that combines mathematical analysis and numerical simulation, we discover that bistability can only emerge from the unified mode when proteins synthesis and degradation are considered, which is in favor of it as an optimal regulation mode of Bcl-2 apoptotic switch. The parameter sensitivity analysis for the unified mode further consolidates this view. Moreover, two-parameter bifurcation analysis suggests that the sensitizers lower the threshold of activation of Bax, but have a negative influence on the width of the bistability region. Our study may provide mechanistic insights into the heterogeneity of tumor cells and the efficiency of BH3 mimetic-mediated killing of cancer cells, and suggest that a combination treatment might be required to overcome apoptosis resistance in the Bcl-2 family targeted therapies.