Cystathionine ␥-lyase (CSE) is a key enzyme in the transsulfuration pathway, which uses L-cysteine to produce hydrogen sulfide (H 2 S). Functional changes of pancreatic beta cells induced by endogenous H 2 S have been reported, but the effect of the CSE/H 2 S system on pancreatic beta cell survival has not been known. In this study, we demonstrate that H 2 S at physiologically relevant concentrations induced apoptosis of INS-1E cells, an insulin-secreting beta cell line. Transfection of INS-1E cells with a recombinant defective adenovirus containing the CSE gene (Ad-CSE) resulted in a significant increase in CSE expression and H 2 S production. Ad-CSE transfection also stimulated apoptosis. The other two end products of CSE-catalyzed enzymatic reaction, ammonium and pyruvate, had no effects on INS-1E cell apoptosis, indicating that overexpression of CSE may stimulate INS-1E cell apoptosis via increased endogenous production of H 2 S. Both exogenous H 2 S (100 M) and Ad-CSE transfection inhibited ERK1/2 but activated p38 MAPK. Interestingly, BiP and CHOP, two indicators of endoplasmic reticulum (ER) stress, were up-regulated in H 2 S-and CSE-mediated apoptosis in INS-1E cells. After suppressing CHOP mRNA expression, H 2 S-induced apoptosis of INS-1E cells was significantly decreased. Inhibition of p38 MAPK, but not of ERK1/2, inhibited the expression of BiP and CHOP and decreased H 2 S-stimulated apoptosis, suggesting that p38 MAPK activation functions upstream of ER stress to initiate H 2 S-induced apoptosis. It is concluded that H 2 S induces apoptosis of insulin-secreting beta cells by enhancing ER stress via p38 MAPK activation. Our findings may help unmask a novel role of CSE/H 2 S system in regulating pancreatic functions under physiological condition and in diabetes.Cystathionine ␥-lyase (CSE, 5 EC 4.4.1.1) is a key pyridoxal 5Ј-phosphate-dependent enzyme in the trans-sulfuration pathway, which uses L-cysteine to produce hydrogen sulfide (H 2 S), a novel and important gasotransmitter (1-3). Endogenous productions of H 2 S in different organs and tissues as well as the circulatory concentration of H 2 S have been elucidated, and the physiological importance of H 2 S has gained increasing recognition (2-5).Diabetes is a spectrum of clinical conditions arising from relative or absolute insulin deficiency with decreased functional beta cell mass (6). Any change in beta cell mass must reflect an imbalance between proliferation (neogenesis or replication) and cell death (necrosis or apoptosis) (7). Excessive loss of beta cells constitutes one of the causes of diabetes, and apoptosis is considered to be the main mode of beta cell death in type I and type II diabetes (8). In recent years, pathophysiological implications of the CSE/H 2 S system in diabetes have been reported (9, 10). Endogenous production of H 2 S together with the expression of CSE and cystathionine -synthase (CBS), another H 2 S-producing enzyme, was identified in rat pancreatic tissues (9, 10). CSE mRNA expression and H 2 S formation in the rat...