Paraquat (PQ), a herbicide used worldwide, causes fatal injury to organs upon high dose ingestion. Treatments for PQ poisoning are unreliable, and numerous deaths have been attributed inappropriate usage of the agent. It is generally speculated that a microsomal drug-metabolizing enzyme system is responsible for PQ toxicity. However Paraquat (PQ 2 ; methyl viologen, 1,1Ј-dimethyl-4,4Ј-bipyridinium dichloride) is an effective herbicide used in more than 120 countries (1). Although it is classified as a low hazard compound, PQ is hazardous when used improperly and has been found responsible for thousands of deaths worldwide because of intentional overdose and high levels of occupational and accidental exposure especially in developing countries (1). Direct exposure to PQ causes severe irritation to the eyes and skin, and ingestion of concentrated products may result in fatal injury to lungs because of edema, hemorrhage, and subsequent fibrosis as well as damage to other organs (2). Additionally, PQ has emerged as a risk factor for Parkinson disease (3). The acute toxicity of PQ in mammals is mediated by reactive oxygen species (ROS) produced by a cyclic oxidation-reduction reaction (4). It is generally speculated that NADPH-cytochrome P450 reductase in microsomal drug-metabolizing enzyme systems is responsible for the production of ROS (5). However, we previously observed that the initial ultrastructural alterations associated with PQ exposure occurred only in mitochondria and not in the endoplasmic reticulum in pulmonary cells in vivo (6) and in vitro (7). In addition, several reports have suggested the cytotoxicity of PQ via mitochondrial dysfunction (8 -10). Despite the development of a number of treatments for PQ poisoning, the efficacy and reliability of currently available treatments have remained limited because of an insufficient understanding of PQ cytotoxicity (2).We recently discovered that active NADH-dependent oxidoreductase located on the mitochondrial outer membrane reduced PQ to a radical form that spontaneously formed superoxide anion (O 2 . ) and destroyed mitochondria (11-13). Furthermore, we demonstrated that 1) PQ was initially metabolized to monopyridone in the cytosol and subsequently hydroxylated by the microsomes and 2) the induction of drugmetabolizing enzymes and the administration of a ROS scavenger reduced PQ toxicity in mice (11,14). These results indicate that the mitochondrial system, not the microsomal system, is responsible for PQ toxicity. We verified that enzymes in the electron transport chain and NADH-cytochrome b 5 reductase, an NADH-dependent oxidoreductase in the outer membrane, were not involved in this reaction (11,12). A voltage-dependent anion channel (VDAC), an abundant pore-forming protein in the outer membrane, exerts numerous physiological functions as a channel; it regulates both the metabolite flux of mitochondria and transmembrane potential, and plays a role in apoptosis. Recently, it was reported that NADH regulates VDAC func-*