The P2X 7 receptor is known for the cytotoxic activity because of its ability to cause opening of non-selective pores in the plasma membrane and activate apoptotic caspases. A key factor of P2X 7 -dependent cytotoxicity is the massive intracellular Ca 2؉ increase triggered by its activation. Here we show that P2X 7 transfection increased the ability of the endoplasmic reticulum to accumulate, store, and release Ca 2؉ . This caused a larger agonist-stimulated increase in cytosol and mitochondrial Ca 2؉ in P2X 7 transfectants than in mock transfected cells. P2X 7 transfectants survived and even proliferated in serum-free conditions and were resistant to apoptosis triggered by ceramide, staurosporin, or intracellular Zn 2؉ chelation. Finally, the nuclear factor of activated T cells complex 1 (NFATc1) was strongly activated in the P2X 7 transfectants. These observations support our previous finding that the P2X 7 receptor under tonic conditions of stimulation, i.e. those observed in response to basal ATP release, has an anti-apoptotic or even growth promoting rather than cytotoxic activity.Cell responses to extracellular ATP are mediated by P2 receptors: ionotropic P2X and metabotropic P2Y (1). The P2X 7 receptor (P2X 7 R) 4 subtype stands out in the P2X subfamily for its ability to trigger a host of physiologic or pathologic responses: plasma membrane blebbing (2, 3), rapid release of interleukin-1 via microvesicle shedding (2, 4), cell fusion (5), lymphoid cell proliferation (6), cell death (7,8), and bone formation/ resorption (9). This receptor is characterized by low affinity for ATP and by two states of permeability (10, 11). At high micromolar ATP concentrations, P2X 7 behaves as a cation-selective channel, whereas a prolonged exposure to nearly millimolar concentrations triggers the transition to a nonselective pore that admits hydrophilic solutes of molecular mass up to 900 Da (12-14). A common feature of both conductance states is a strong elevation of free cytoplasmic calcium levels ([Ca 2ϩ ] i ), a response critical for the biological role of this receptor.Recent evidence from our group shows that basal levels of ATP, naturally present in the extracellular milieu, cause a tonic activation of the P2X 7 R, which in turn triggers [Ca 2ϩ ] i increase and Ca 2ϩ entry into the mitochondria. The increased intramitochondrial Ca 2ϩ concentration ([Ca 2ϩ ] mt ) then enhances mitochondrial potential, increases ATP synthesis, and promotes survival and proliferation in the absence of serum (15). Increased mitochondrial potential and ability to grow under serum-free conditions are hallmark of tumor transformation (16). Furthermore, overexpression of the P2X 7 R is associated with several cancers or growth disturbances such as chronic lymphocytic leukemia (17), prostate (18)