We have previously demonstrated that nitrosylcobalamin (NO-Cbl), an analogue of vitamin B 12 that delivers nitric oxide (NO), had potent antiproliferative activity against several human cancer cell lines. NO-Cbl induced apoptosis via a death receptor/caspase-8 pathway. In this study, we demonstrate that a functional Apo2L/ TRAIL receptor was necessary for the induction of cell death by NO-Cbl. Furthermore, the Apo2L/TRAIL death receptor DR4 (TRAIL R1) was S nitrosylated following NO-Cbl treatment. Human melanoma (A375), renal carcinoma (ACHN), and ovarian carcinoma (NIH-OVCAR-3) cells were treated with NO-Cbl and subjected to the biotin switch assay; S-nitrosylated DR4 was detected in all three cell lines. NO-Cbl treatment did not cause S nitrosylation of DR5. The seven cysteine residues located in the cytoplasmic domain of DR4 were individually point mutated to alanines. NIH-OVCAR-3 cells expressing the DR4 C336A mutation lacked S nitrosylation following NO-Cbl treatment. Overexpression of wild-type DR4 sensitized cells to growth inhibition by NO-Cbl. Cells expressing the DR4 C336A mutant were more resistant to NO-Cbl and Apo2L/ TRAIL than were the other six C-A mutations or wild-type cells. The C336A mutant also displayed blunted caspase-8 enzymatic activity following NO-Cbl treatment compared to the other mutants. Thus, DR4 residue C336 becomes S nitrosylated and promotes apoptosis following NO-Cbl treatment.Mammalian cells have two major apoptotic pathways, the extrinsic and intrinsic pathways. The extrinsic pathway is triggered by members of the death receptor superfamily (Fas/ CD95, TNFR1, and TRAIL receptors DR4 and DR5). Binding of ligands to their cognate death receptors induces receptor clustering and the formation of a death-inducing signaling complex. The intrinsic apoptotic pathway is controlled by mitochondrial events.We have previously demonstrated the antitumor activity of nitrosylcobalamin (NO-Cbl), a prodrug based upon vitamin B 12 that delivers nitric oxide (NO). NO-Cbl induces the expression of tumor necrosis factor-related apoptosis-inducing ligand (Apo2L/TRAIL) and its receptors (DR4 and DR5) in ovarian carcinoma cells (4). NO-Cbl induces tumor cell apoptosis through the extrinsic apoptotic pathway rather than the mitochondrion-dependent intrinsic pathway.Nitric oxide is a pleiotropic short-lived free radical that regulates blood vessel and airway tone, inflammation, and apoptosis. NO covalently modifies heme groups (as in guanylyl cyclase) and also nitrosylates protein sulfhydryl groups (S nitrosylation), an important posttranslational modification that affects signal transduction (27). Nitrosylation of cellular proteins regulates the normal physiologic ventilatory response to hypoxia (21), ion channel activity and neurotransmission (6), smooth muscle relaxation (19), and blood pressure regulation (8).In neurons, the plasma membrane N-methyl-D-aspartate receptor becomes S nitrosylated by neuronal nitric oxide synthase (NOS1), which modulates receptor activity (15). Recently, S nitrosylatio...