CONCLUSIONS
Although it is understood that HIV PR is cytotoxic in systems in which it is expressed independently, it is less certain whether HIV PR can and does induce cell death in the context of viral infection.
Moreover, the molecular mechanisms governing the initiation of PR-induced cell death remain controversial; however, PR-mediated cleavage of procaspase-8, Bcl-2, eIF4G, and cytoskeletal proteins is likely involved. We propose that low-level expression of PR favors the selective cleavage of these regulatory proteins favoring an apoptotic phenotype, whereas higher levels of expression may favor more extensive proteolysis, favoring an autophagocytic or necrotic phenotype. Whether PR-mediated cell death plays a clinically significant role in patients also remains controversial; however, indirect evidence suggests that in patients with immunologic discordance, mutations within PR may be contributory. Additional research directed at each of these controversies will undoubtedly resolve such controversies.REFERENCES
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