In brain and tumor cells, the hexokinase isoforms, HK-I and HK-II, bind to the voltage-dependent anion channel (VDAC) in the outer mitochondrial membrane. The VDAC domains interacting with these anti-apoptotic proteins were recently defined using site-directed mutagenesis. Now, we demonstrate that synthetic peptides corresponding to the VDAC1 N-terminal region and selected sequences bound specifically, in a concentrationand time-dependent manner, to immobilized HK-I, as revealed by real time surface plasmon resonance technology. The same VDAC1-based peptides also detached HK bound to brain or tumor-derived mitochondria. Moreover, expression of the VDAC1-based peptides in cells overexpressing HK-I or HK-II prevented HK-mediated protection against staurosporine-induced release of cytochrome c and subsequent cell death. One loop-shaped VDAC1-based peptide corresponding to a selected sequence and fused to a cell-penetrating peptide entered the cell and prevented the anti-apoptotic effects of HK-I and HK-II. This peptide detached mitochondrial-bound HK better than did the same peptide in its linear form. Both cell-expressed and exogenously added cell-penetrating peptide detached mitochondrial-bound HK-I-GFP. These results point to HK-I and HK-II as promoting tumor cell survival through binding to VDAC1, thereby inhibiting cytochrome c release and apoptotic cell death. Moreover, VDAC1-based peptides interfering with HK-mediated anti-apoptotic activity may potentiate the efficacy of conventional chemotherapeutic agents.Cancer cells are characterized by a high rate of glycolysis that serves as their primary energy-generating pathway (1). The molecular basis of this high rate of glycolysis involves a number of genetic and biochemical events, including overexpression of the mitochondria-bound hexokinase isoforms, HK-I 2 and HK-II (1-5). In mammals, HK-I and HK-II are strategically located at the outer membrane of mitochondria, where they gain preferential access to mitochondrially generated ATP (6). In this manner, HK-I and HK-II drive the high glycolytic rates typical of tumor cells, even under aerobic conditions (1, 3). Such elevated levels of mitochondria-bound HK is suggested to play a pivotal role in promoting cell growth and survival in rapidly growing, highly glycolytic tumors and in protecting against mitochondria-mediated cell death (1, 4, 7). The elevated levels of HK-I and HK-II allow tumor cells to evade apoptosis, thereby allowing proliferation to continue (4). Indeed, overexpression of mitochondria-bound HK in the tumor-derived cell line U-937, in T-REx-293, or in vascular smooth muscle cells suppressed staurosporine-induced apoptotic cell death (8, 9). A decrease in apoptotic cell death and concomitant increase in cell proliferation have also been reported to be induced upon HK-II expression in NIH-3T3 (7), rat 1a fibroblasts (10), and WEHI 7.1 cells (11). In addition, binding of HK-II to mitochondria inhibited Bax-induced cytochrome c release and apoptosis (12).Mitochondria-mediated apoptosis results in th...