During DNA damage or cellular stress PARPs are activated, leading to an increase in the amount of poly(ADP-ribose) and a decrease in the amount of NAD. For over a decade it was thought that PARP1 was the only poly(ADP-ribose)polymerase in mammalian cells, therefore this enzyme has been the most studied. Caspases are a family of cysteine proteases that are known to play an essential role in programmed cell death. This protease cleaves PARP-1 into two fragments, leaving it completely inactive, to limit poly(ADP-ribose) production. One of its fragments migrates from the nucleus to the cytoplasm and is thought to become a target of autoimmunity.
During caspase-independent apoptosis, also called parthanatos, poly(ADP-ribose) accumulation can occur due to activation of PARPs or inactivation of poly(ADP-ribose)glycohydrolase, an enzyme that hydrolyses poly(ADP-ribose) to produce free ADP-ribose. Studies have shown poly(ADP-ribose) drives the translocation of the apoptosis inducing factor protein to the nucleus where it will mediate DNA fragmentation. It has been suggested that if a failure of caspase activation under stress conditions were to occur, necroptosis would take place. Overactivation of PARPs has led to a necrotic cell death regulated by the tumor necrosis factor protein. Though the mechanism is not yet understood, PARP inhibitors have been shown to affect necroptosis.