why do some cells in the body prefer necrosis to apoptosis as a means of cell death?

Question

There are many programmed cell death pathways, but some cells show a greater preference for some over the other. I'm wondering as to why if necrosis is an inflammatory response that causes damage to neighboring cells, why some cells would prefer this as opposed to a more controlled mechanism such as apoptosis or even autophagy.

Answer 1

Your right when you say necrosis is bad. In fact, cells typically prefer apoptosis or autophagy over simple necrosis because programmed cell death is far safer. But unfortunately, ischemia, toxins and certain infections will force the cell to undergo necrosis.

Interestingly, programmed cell death (apoptosis) requires energy (ATP). When ATP is low the cell cannot go through the apoptosis process and therefore resorts to necrosis. This is also why cells that don't have a lot of mitochondria (RBCs) or don't produce a lot of ATP will also undergo necrosis.

Normal cells that have lots of ATP generation capacity can also undergo ATP depletion. Consider the example of an ischemic stroke - which is when a blood vessel to the brain is blocked. When this happens, individual neurons in the area of the stroke get less oxygen. This reduced oxygen exchange will invariently lead to less ATP (oxidative phosphorylation pathway is less active). These ATP depleted neurons can't go through the stages of apoptosis and instead undergo necrosis. Sadly this causes inflammatory effects to nearby neurons and also explains why strokes cause permanent and rapid brain damage.

Answer 2

The answer is due to genetics. This is simply how our DNA has hardwired the cells to respond. As to a more thorough answer, researchers are currently working to answer this exact question.