Arsenite is a human carcinogen causing skin, bladder, and lung tumors, but the cellular mechanisms underlying these effects remain unclear. We investigated expression of the essential base excision DNA repair enzyme apurinic endonuclease 1 (Ape1) in response to sodium arsenite. In mouse 10T 1 ⁄2 fibroblasts, Ape1 induction in response to arsenite occurred about equally at the mRNA, protein, and enzyme activity levels. Analysis of the APE1 promoter region revealed an AP-1/CREB binding site essential for arsenite-induced transcriptional activation in both mouse and human cells. Electrophoretic mobility shift assays indicated that an ATF4/c-Jun heterodimer was the responsible transcription factor. RNA interference targeting c-Jun or ATF4 eliminated arsenite-induced APE1 transcription. Suppression of Ape1 or ATF4 sensitized both mouse fibroblasts (10T 1 ⁄2) and human lymphoblastoid cells (TK6) to arsenite cytotoxicity. Expression of Ape1 from a transgene did not efficiently restore arsenite resistance in ATF4-depleted cells but did offset initial accumulation of abasic DNA damage following arsenite treatment. Mutagenesis by arsenite (at the TK and HPRT loci in TK6 cells) was observed only for ATF4-depleted cells, which was strongly offset by Ape1 expression from a transgene. Therefore, the ATF4-mediated up-regulation of Ape1 and other genes plays a key role against arsenite-mediated toxicity and mutagenesis.Epidemiological studies from Bangladesh, India (West Bengal), Taiwan, and South America indicate that arsenic ingestion, typically via contaminated drinking water, is associated with increased incidence of diverse human diseases, such as atherosclerosis, diabetes, and cancers of the skin, bladder, and lung (55). The arsenic found in drinking water is overwhelmingly one of the inorganic arsenic forms, mostly pentavalent arsenate and trivalent arsenite (55).Arsenite treatment has recently been introduced as therapy for acute promyelocytic leukemia (61). The pathological and therapeutic mechanisms of arsenic are actively debated, and DNA may be an important target for arsenic-related damage. For example, comet assays demonstrate that exposure to as little as 1 nM of sodium arsenite could rapidly (within 30 min) induce DNA base damage in human HeLa, neutrophilic NB4, and HL-60 cells (59, 69). For comparison, the reported mean blood arsenic concentration in people consuming highly contaminated water was 560 nM (49), while the mean plasma arsenite concentration for cancer treatment was 1,000 to 6,000 nM (60). However, many cell-based assays have failed to detect a significant increase in point mutations due to arsenite (55). One conclusion from these observations is that a strong cellular antimutagenesis mechanism counteracts the mutational potential of arsenite-induced DNA damage.Oxidized and other small base lesions are excised by DNA glycosylases, which channel damage into the base excision DNA repair (BER) pathway. In mammalian cells, glycosylase products are processed by the abasic (apurinic/apyrimidinic [AP]) end...