Apoptosis induced by most stimuli proceeds through the mitochondrial pathway. One such stimulus is nutrient deprivation. In this study we studied death induced by glucose deprivation in cells deficient in Bax and Bak. These cells cannot undergo mitochondrial outer membrane permeabilization (MOMP) during apoptosis, but they undergo necrosis when treated with MOMPdependent apoptotic stimuli. We find in these cells that glucose deprivation, rather than inducing necrosis, triggered apoptosis. Cell death required caspase activation as inhibition of caspases with peptidic inhibitors prevented death. Glucose deprivationinduced death displayed many hallmarks of apoptosis, such as caspase cleavage and activity, phosphatidyl-serine exposure and cleavage of caspase substrates. Neither overexpression of Bcl-xL nor knockdown of caspase-9 prevented death. However, transient or stable knockdown of caspase-8 or overexpression of CrmA inhibited apoptosis. Cell death was not inhibited by preventing death receptor-ligand interactions, by overexpression of c-FLIP or by knockdown of RIPK1. Glucose deprivation induced apoptosis in the human tumor cell line HeLa, which was prevented by knockdown of caspase-8. Thus, we have found that glucose deprivation can induce a death receptor-independent, caspase-8-driven apoptosis, which is engaged to kill cells that cannot undergo MOMP. Apoptosis is a form of cell death required for homeostasis of human tissues. Apoptotic cells display several morphological and biochemical changes, which are a consequence of the activity of caspase proteases.1 Caspases are normally inactive in the cytosol, but they become activated by dimerization and/or proteolysis by other caspases. 'Executioner' caspases such as caspase-3 are activated through cleavage by 'initiator' or 'apical' caspases, of which the best characterized are caspases-8 and -9. Caspase-8 is activated by its recruitment to the multimeric DISC (death-inducing signaling complex) in response to extracellular ligands such as Fas/CD95-ligand, TRAIL or TNF; 2 this is the death receptor, or extrinsic pathway of apoptosis. Caspase-9 is activated by dimerization after recruitment to the apoptosome, a complex of APAF1 proteins formed in response to the release of the mitochondrial protein cytochrome c into the cytosol. 3 This caspase activation cascade is called the mitochondrial or intrinsic pathway of apoptosis.The mitochondrial pathway of apoptosis is regulated by proteins of the Bcl-2 family, which regulate the integrity of the mitochondrial outer membrane, thereby controlling cytochrome c and subsequent caspase activation.4 Impairment of the mitochondrial pathway is common in human tumors. Cancer cells frequently overexpress the antiapoptotic proteins Bcl-2, Bcl-xL and Mcl-1, or they lack functional proapoptotic Bcl-2 family members, including Bax, Bak or both. 5 The overexpression of antiapoptotic Bcl-2 proteins not only blocks the morphological features of apoptosis, but also enables clonogenic cell survival. 6 For these reasons, cells from Bax, B...