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. We have previously shown that HK-I decreases murine VDAC1 (mVDAC1) channel conductance, inhibits cytochrome c release, and protects against apoptotic cell death. Now, we define mVDAC1 residues, found in two cytoplasmic domains, involved in the interaction with HK-I. Protection against cell death by HK-I, as induced by overexpression of native or mutated mVDAC1, served to identify the mVDAC1 amino acids required for interaction with HK-I. HK-I binding to mVDAC1 either in isolated mitochondria or reconstituted in a bilayer was inhibited upon mutation of specific VDAC1 residues. HK-I anti-apoptotic activity was also diminished upon mutation of these amino acids. HK-I-mediated inhibition of cytochrome c release induced by staurosporine was also diminished in cells expressing VDAC1 mutants. Our results thus offer new insights into the mechanism by which HK-I promotes tumor cell survival via inhibition of cytochrome c release through HK-I binding to VDAC1. These results, moreover, point to VDAC1 as a key player in mitochondrially mediated apoptosis and implicate an HK-I-VDAC1 interaction in the regulation of apoptosis. Finally, these findings suggest that interference with the binding of HK-I to mitochondria by VDAC1-derived peptides may offer a novel strategy by which to potentiate the efficacy of conventional chemotherapeutic agents.Accumulating evidence indicates that the mitochondrially bound isoforms of hexokinase, HK-I and HK-II, play pivotal roles in promoting cell growth and survival in rapidly growing, highly glycolytic tumors (1). As such, HK-I and HK-II were found to be overexpressed in many types of cancer, including colon, prostate, lymphoma, glioma, gastric adenomas, carcinomas, and breast cancers (2-5). The elevated levels of HK-I and HK-II allow tumor cells to evade apoptosis, thereby allowing proliferation to continue (6, 7). HK-I and HK-II dock onto the cytosolic surface of the outer mitochondrial membrane mainly through binding to the voltage-dependent anion channel (VDAC) 4 (8). It has been proposed that binding of HK to mitochondria allows a continuous ATP flux, providing energy for the phosphorylation of glucose, and thus an increased glycolytic rate (7). VDAC, also known as mitochondrial porin, functions as the major channel allowing passage of nucleotides, ions, Ca 2ϩ , and other metabolites between the intermembrane space and cytoplasm (9 -11).In vitro and in vivo studies have shown that HK-I and HK-II play a clear role in protecting against mitochondrially regulated apoptosis through direct interaction with mitochondria (3) and, more specifically, with VDAC (6). Several recent studies demonstrated that in tumor cells, HK-I (12-14) and HK-II (15, 16) not only augment cellular energy supply and levels of glucose 6-phosphate, an intermediate metabolic in many biosynthetic pathways, but also protect against cell death. The molecular mechanisms by...