In most normal, viable eukaryotic cells, the negatively charged phospholipid PS is located in the cytosolic leaflet of the plasma membrane lipid bilayer.
1 PS redistribution from the inner to the outer leaflet is an early and widespread event during apoptosis.
1,2 However, in necrosis, PS becomes accessible due to the disruption of membrane integrity.
2 Apart from necrosis and apoptosis, PS also becomes accessible in activated platelets
3 , in certain cell anomalies such as sickle cell anemia
4 , in erythrocyte senescence
5 , upon degranulation of mast cells
6 , and in certain stages of B cell differentiation
7 . PS exposure by apoptotic cells serves as a trigger for the recognition and removal by macrophages.
8,9